(Oct 24) Q I have been suffering from fungal infection/itch on the soles of my feet for years. Whenever it itches, I scratch

and the skin breaks. After a few days, the skin heals, and the itch is back. I have tried using all brands of antiseptic creams but the itch doesn't stop. The problem is made worse by the fact that I have sweaty feet, and I am required to wear socks and shoes during work. How can I cure this once and for all?

A Based on your description, it does not appear to be a fungal infection. Fungal infections of the feet usually present initially as itchy, cracked and scaly skin in the web spaces between the toes. It affects the soles eventually only if left untreated. You mentioned that only your soles were affected by the itch, hence it is highly unlikely your condition is a case of fungal infection.

If your problem is indeed due to fungus, it may lead to bacterial infection when untreated, causing a foul odour, pus and considerable pain on walking. It is also highly unlikely that the skin would heal without antifungal treatment if it were a fungal infection.

Your problem is likely to be caused by eczema. Eczema is a collective term for a range of skin conditions characterised by red, itchy and flaky rashes. Unlike in fungal infection, eczema does not normally occur at the web spaces, which fits the description of your problem.

It is possible that your problem started due to sensitivity to certain substances such as detergents, causing the repeated cycle of itch-scratch-itch to ensue. The resulting skin damage reduces your feet's ability to retain moisture and the dryness on your soles worsens the itchiness.

You should stop using antiseptic cream as it may further irritate your skin. Your problem can be managed by using moisturisers to soothe the skin and reduce irritation. The moisturisers should be applied as often as needed (especially after bathing) to keep the skin hydrated.

As itching is detrimental to the condition, oral antihistamines, calamine lotion or steroid cream may be used to counteract it. Do note that use of steroid cream should not exceed the duration given by your pharmacist or doctor.

Do consult your health-care professional for the appropriate choice of treatment.

More information and advice can be obtained from your pharmacist. Send your questions to sthealth@sph.com.sg

JOSHUA WONG, PHARMACIST, PHARMACEUTICAL SOCIETY OF SINGAPORE