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Why does athlete's foot repeatedly occur on only one foot?

Nov 28, 2025 Source: Cainiu Health
Dr. Liu Wenmin
Introduction
In general, athlete's foot recurring on only one foot may be caused by factors such as excessive sweating on one side, differences in shoe and sock hygiene, incomplete treatment of unilateral tinea pedis, eczema complicated by fungal infection, or diabetic peripheral neuropathy. If symptoms persist, it is recommended to seek timely medical attention at a正规 hospital. In daily life, keep the feet dry and maintain proper cleaning and disinfection of shoes and socks.

Generally, athlete's foot recurs on only one foot due to factors such as excessive sweating on the affected side, differences in shoe and sock hygiene, incomplete treatment of unilateral tinea pedis, fungal infection secondary to eczema, or diabetic peripheral neuropathy. If symptoms persist, it is recommended to seek timely medical attention at a reputable hospital. Specific causes are analyzed below:

1. Excessive Sweating on One Foot

Increased activity of the sympathetic nervous system on one side leads to overactive sweat glands, creating a moist environment conducive to fungal growth. Choose breathable, moisture-absorbing cotton socks and wear open-weave, ventilated shoes. Wash feet daily with warm water and dry thoroughly afterward to keep feet dry.

2. Differences in Shoe and Sock Hygiene

Inadequate cleaning of frequently worn shoes or socks on one side may leave residual fungi that repeatedly infect the same foot. Socks should be changed and washed daily and dried under high temperature or sunlight. Shoes should be regularly disinfected using ultraviolet light, and sharing footwear or socks with others should be avoided.

3. Incomplete Treatment of Unilateral Tinea Pedis

Fungal infection on the affected foot has not been fully eradicated, allowing rapid fungal regrowth after discontinuation of medication. Follow medical advice to use terbinafine hydrochloride cream, miconazole nitrate powder, or bifonazole solution for the full prescribed course. Continue treatment for 1–2 weeks after symptoms resolve.

4. Eczema Complicated by Fungal Infection

Eczema on one foot damages the skin barrier first, making it susceptible to secondary fungal invasion. Under medical guidance, apply halometasone cream or tacrolimus ointment externally, combined with ketoconazole cream. Avoid scratching the affected area.

5. Diabetic Peripheral Neuropathy

Poor blood glucose control leads to reduced nerve sensation in one foot, causing abnormal sweating and increased susceptibility to fungal infection. Follow medical instructions to take metformin tablets, gliclazide modified-release tablets, or insulin injections to manage blood sugar. Use antifungal medications concurrently and inspect the feet daily for any wounds or breaks in the skin.

In daily life, maintain dry feet and ensure proper cleaning and disinfection of shoes and socks; avoid walking barefoot in public baths; manage underlying conditions and monitor blood glucose regularly; promptly address symptoms such as peeling or itching, and do not discontinue medication prematurely.

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