Chances are good that the next discussion you have with someone about hiking the Appalachian Trail won’t be about fungal infections. Could be because it’s more fun to talk about sleeping bags and stoves (it is!). Could also be because bringing up your nasty toe fungus or crotch rot makes people say ick and not be friends with you. So Distancehiking is here to tell you about fungal infections.
They’re miserable and can make your hike completely unpleasant. So let’s dig in (ew).
Fungal infections can thrive in any place on the body that is consistently damp and warm, so for hikers this means the feet, crotch and inner thigh, and the underarms. Long distance hikers are susceptible to a specific category of fungus called a dermatophyte. According t the US Centers for Disease Control (CDC), dermatophytes are fungi that cause skin, hair, and nail infections. They go by many names: athlete’s foot, jock itch, crotch rot, tinea cruris, tinea pedis, and ringworm are most commonly known. Ringworm is actually a misnomer since there’s not actually a worm involved.
Fungal infections are unsavory guys because besides smelling bad (yeasty), they also itch and burn if they get bad enough. Hiking with an active fungal infection is a miserable experience. So what to look out for? Here’s a list:
- Scaly or flaky skin
If you notice any or all of these in an area of your body that is routinely warm and moist from sweat or body moisture, you might have a fungal infection.
Sometimes it’s hard to tell an area that is just chafed from rubbing from an area that is infected. The best way to tell the difference is that fungal infections often smell yeasty. Regular chafing does not smell this way.
The best way to prevent a fungal infection is to make sure you give routinely moist areas a chance to dry out. If you tend to sweat a lot when you hike and you’re hiking all day, this can be tough to do, but the consequences of not drying out are unpleasant. Here are a few tips to try:
- Wear clothing that provides adequate ventilation to your feet, crotch, and underarms. It can sometimes take a few tries to find a clothing system that works, but believe me, it’s worth the effort. I prefer synthetic wool socks, trail runners, shirts made from some kind of moisture wicking material, and extremely lightweight shorts with a liner (running shorts). If the weather’s cold, I’ll throw some tights/leggings under the shorts.
- Though prevention through the right clothing is the best method, if you know that you’re especially susceptible to fungal infections as I am, you might want to consider carrying a small tube of off-the-shelf antifungal cream to dab on at night before getting in the sleeping bag.
- Remove socks and allow your feet to completely dry at several points during the day. This is especially important in warm, wet weather.
- Maintain good hand hygiene. Carry a little bottle of alcohol-based hand rub close at hand. This is for your protection as well as for others you meet. Use the hand rub after urination and defecation, before putting your hands in your mouth, and if feasible, before/after shaking hands with other hikers.
If you think you’ve got a fungal infection, the best thing to do is get off the trail and pick up some medication. If the infection appears small and reasonably contained, you can try any of the off-the-shelf products, which come in 1-2oz sizes. You can usually find the right products in the foot care section of drug stores and Wal Marty kinds of places. Follow the recommendations on the tube. Continue to practice all of the prevention tips listed above.
If you’ve got a large, spreading infection that smells terrible and is painful, you should seek a physician who will be able to prescribe something more powerful that what can be bought off the shelf. A big bottle of Ketoconazole cream prescribed through the Santa Clarita Walk-In clinic pretty much saved by PCT thru hike in 2007. Make sure you follow-through with using the cream, which typically means application long after the symptoms of the infection go away. Continue to follow the prevention steps noted above.