Simple to treat, easy to get wrong — and it spreads to the nails if left.
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Prescriptions, sick notes and referral letters included
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Athlete's foot is a fungal infection of the skin of the feet. It is extremely common, it is not confined to athletes, and it responds well to the right cream used for long enough.
Three things are worth knowing.
1. It is not always itchy skin between the toes. There is a second, much less recognised pattern — dry, scaly, slightly pink skin across the sole and up the sides of the foot, in a moccasin distribution. It is regularly dismissed as dry skin and moisturised for years. If one foot is scalier than the other, think fungus rather than dryness.
2. Your feet are the reservoir for other infections. Groin ringworm and fungal nail infection usually start here. Treating the groin while ignoring the feet produces a cycle that repeats indefinitely.
3. If you have diabetes, this matters more than it looks. Cracks between the toes are a genuine entry point for bacteria, and athlete's foot is a recognised precursor to cellulitis. It is worth treating properly rather than tolerating.
The commonest reason treatment fails is stopping the moment the skin looks normal — keep going for one to two weeks beyond that.
Sudden crops of small itchy blisters, usually on the instep. More inflamed, and often mistaken for eczema.
The same dermatophyte family that causes ringworm. It thrives on warm, damp skin and spreads by:
Worth knowing, because these do not respond to antifungal cream:
Diagnosed by appearance, and a clear photograph of the toe webs and soles is usually all that is needed — which makes this well suited to a remote consultation.
Skin scrapings for laboratory confirmation where the picture is unclear, where it has not responded to treatment, or before starting oral treatment — which should never be started on a guess.
If your toenails are thickened and discoloured, they are a permanent reservoir and the skin will keep being reinfected. See our fungal nail page — and note that nails need confirming before committing to months of oral treatment.
Where both are affected, treat both together. Groin infection almost always comes from the feet, and treating one alone guarantees recurrence.
Extensive or moccasin-type infection, the blistering type, or anything that has failed proper topical treatment. Usually oral terbinafine, after confirming the diagnosis.
Cracks in the skin let bacteria in. Where there is spreading redness or the toe web is boggy and malodorous, antibiotics are needed alongside — and spreading redness with fever needs seeing in person, not a remote prescription.
Seek urgent medical attention for:
Seek same-day advice if you have diabetes and:
Book an appointment for:
Dry between every toe, every time. The web spaces are where infection starts and where towels do not reach. A separate corner of the towel, or a hairdryer on cool, works well.
Dry your feet last, or use a separate towel, so you are not spreading fungus onto the rest of your body — particularly the groin.
Put your socks on before your underwear. Pulling underwear up over infected feet transfers fungus straight to the groin — which is exactly how jock itch keeps returning in people who never connect the two.
Terbinafine and clotrimazole creams are available over the counter for a few pounds and are the treatment. A pharmacist can supply them without an appointment. Your NHS GP treats it free.
We would not charge you for this, and for straightforward athlete's foot the pharmacy is the right answer.
The free advice matters more than the cream, and it is what gets skipped: dry thoroughly between the toes, rotate footwear so shoes get 24 hours to dry out, wear cotton socks, and keep applying for a week or two after it looks clear — stopping the moment it looks better is why it comes straight back.
Where a consultation is worth it is the case that keeps returning, or is not responding. The usual explanations are worth knowing: it is not fungal at all — eczema and psoriasis of the feet look similar; a steroid cream has been used on it, which masks and spreads a fungal infection; or an untreated toenail is reinfecting the skin every time.
Athlete's foot matters more if you have diabetes or poor circulation, where cracked skin between the toes is a route for cellulitis. That is a reason to treat it properly rather than tolerate it.
NICE Clinical Knowledge Summary, Fungal skin infection — foot, is the principal reference. It recommends a topical antifungal as first-line, typically terbinafine for one to two weeks or an imidazole for four, and advises continuing treatment beyond apparent clearance.
CKS advises against topical corticosteroids alone, which suppress inflammation while allowing the fungus to spread — producing tinea incognito, the atypical appearance referred to above.
CKS recommends oral terbinafine for extensive, resistant or moccasin-type infection, and covers the association with fungal nail infection as a reservoir for reinfection.
NICE CKS and NG141 (cellulitis) identify interdigital fungal infection as a recognised portal of entry for bacterial cellulitis, particularly in diabetes, lymphoedema and peripheral vascular disease — the basis for treating it as more than cosmetic in those groups.
Usually one of three things. Stopping treatment as soon as the skin looks normal — keep going a further one to two weeks. Untreated fungal toenails, which act as a permanent reservoir. Or fungal spores living in your shoes, which survive for months — alternate your shoes and use an antifungal powder inside them.
Very possibly. The moccasin pattern — fine silvery scaling across the sole and up the sides, mildly pink, often not itchy — is regularly moisturised for years. A useful clue is asymmetry: genuinely dry skin is usually the same on both feet. Another is the classic two feet and one hand pattern.
Terbinafine generally works better and needs only one to two weeks, compared with four or more for clotrimazole. The shorter course matters practically, because people actually finish it. Apply to the whole foot including all the toe webs, not just the visible patch.
Yes. Wear flip-flops in the changing room and shower, dry thoroughly afterwards, and do not share towels. There is no reason to stop exercising — just do not walk barefoot on communal floors.
Yes, considerably more. The cracks between the toes are an entry point for bacteria, and athlete's foot is a recognised precursor to cellulitis and to foot ulceration. Check your feet daily, treat it promptly rather than living with it, and get any break in the skin looked at rather than waiting.
Because your feet are the source. Treat both at once — and put your socks on before your underwear, since pulling pants up over infected feet carries the fungus straight to the groin. That single change breaks a cycle a lot of people repeat for years.
August 23, 2026
Ongoing
Time to be seen
Appointment length
Your NHS record in the room
Written treatment plan
Told when a test isn’t needed
Cost
Same day, usually
20 minutes
Yes, with your consent
Included
Yes, and told why
£40 for 20 minutes
Varies by practice
Typically 10 minutes
Yes, your full record
Not routinely
Usually
Free
Same day
Often 10 to 15 minutes
Usually not
Sometimes charged
Varies by provider
Often a subscription
Same-day access is usually available, from 6am to 10pm, seven days a week. You choose a time that suits you rather than waiting on hold at 8am.
Yes. Care is led personally by Dr Mohammad Khan, so you are not passed between clinicians. Continuity is the point of a small practice: someone who knows your history and is listening attentively rather than working through a checklist.
Yes, with your consent. We can access your Summary Care Record during the consultation, so your current medications, allergies and significant history are in the room. That means fewer questions you have already answered elsewhere, and safer prescribing.
No. We are not here to replace GPs, only to support them. Your NHS practice remains responsible for your ongoing care, and with your consent we write to them after the consultation. We are useful when you need to be seen sooner, or want more time than a standard appointment allows.
Twenty unhurried minutes and a comprehensive assessment. A written treatment plan is included, along with any prescription, sick note or referral letter arising from the consultation, at no extra charge.
£40 for 20 minutes, self-pay. Membership is optional and never required. Priced for fairness, because we are not here to charge extortionate amounts for access to a doctor.
It means the diagnosis can usually be made from your history and photographs, and that treatment can be arranged safely without examining you. Where a condition is not marked treatable online, it is because examination is the diagnosis — listening to a chest, feeling an abdomen, examining an ear or a joint — or because a procedure or device is needed.
Yes, where there is a genuine bacterial infection — cellulitis, impetigo, bacterial urine infections, confirmed strep throat. We will also frequently tell you that you do not need one. Most sore throats, coughs, colds and earaches are viral, and an antibiotic gives you the side effects with none of the benefit.
If your problem turns out to be genuinely outside what we can do remotely, the doctor will tell you straight away, point you to the right service, and refund your fee in full. We would rather do that than fill twenty minutes to justify the charge.
Call 999 or go to A&E — do not book an online appointment and do not wait for a reply to an email. For urgent problems that are not emergencies, NHS 111 is available 24 hours a day, online or by phone, and can direct you to the right service.
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