Do you have chronic itching or peeling on your feet, often between your toes? A diagnosis of athlete's foot is made by taking a scraping of skin and looking for fungus under a microscope. If nothing is seen, scrapings of skin are placed in a culture bottle to see if fungus grows. Drugs such as Lamisil or Nizoral usually will clear fungal infections of the skin unless there is fungus in the nails. This can easily be the reason for recurring athlete's foot infections because the nails will not respond to topical medicines or the short course of oral medicine used to treat skin infections.

If you get recurring fungal skin infections and your toenails are thick, discolored yellow or white, and have debris underneath them, you will need to treat the toenail infection with Lamisil or Sporanox for 3 months to have any chance of curing the fungus problem. Also be aware that fungus loves dark, wet environments. If your feet are always sweaty, have your doctor prescribe Drysol to stop the sweating, and use anti-fungal powder in all of your shoes so that you do not reinfect yourself. Avoid going barefoot in public places where you may get reinfected.

If neither the microscopic or culture reveal fungus, then your doctor must rule out eczema or psoriasis which cause thickening of skin. Some bacterial infections also can cause chronic peeling of the skin. These can be diagnosed with a black light or bacterial culture.

Note: My son, Dr. Gene S. Mirkin, DPM, contributed to this report. He practices podiatry in the same office building as my medical practice, Mirkin Medical Consultants, in Kensington, Maryland.