Fungi are microscopic organisms, many of which live in harmony with our body, but as our immunity weakens, they flourish and may invade a certain skin area leading to a visible infection. There are also other types of fungus that we acquire from the outside.
The fungi causing skin infections thrive on keratin, the outermost protein layer of our skin, hair and nails. Thus, a fungal infection can affect any part of our skin from the scalp to the toenails. Aside from the skin, some fungi (the yeast group) infect the mucous membranes inside our mouth and genitals.
A fungal infection may be hard to differentiate from an allergic rash, and many times both co-exist.
Fungal infections of the skin are usually named after their location on the skin, such as:
Athlete’s foot (Tinea Pedis) is a very common fungal infection, affecting about 25% of the population. It involves the skin of the feet and may spread to the hands where it is termed Tinea manum.
It is caused by multiple strains of fungi and bacteria, which are acquired through contact with infected skin scales. The most common fungus involved is Trichophyton rubrum.
These fungi love warm, dark and moist environments. Walking barefoot in public swimming pools, locker rooms and saunas, or keeping sweaty feet cramped in tight shoes may lead to athlete’s foot.
As fungi thrive on the skin, fungal infections lead to cracking and scaling of the skin. The outer layer peels off, leaving behind a red, softened and broken skin layer that feels itchy.
Athlete’s foot can produce various clinical presentations:
The most common presentation of the disease is interdigital, i.e., it appears between two of the small toes where it is also known as toe web infection. It may spread to the sole of the foot.
The Moccasin type starts from a mild irritation or dryness of the skin. With time, the skin becomes thick and cracks. It may spread to cover the sole of the foot and the sides as well.
The Vesicular type occurs very rarely, it commences with the appearance of blisters on the sole, sides of the foot or between the toes.
Jock Itch (Tinea cruris):
The folds of the groin area also present favorable growth spots for fungi if not kept dry and well ventilated. The lesion is of reddish-brown color and leads to severe itching and burning of the skin. The skin over the scrotum, pubic area and the inner side of the thighs becomes red and starts peeling off.
It spreads through direct contact or through use of objects contaminated with infected skin scrapings.
Ringworm of the Skin (Tinea corporis):
Initially thought to be caused by a parasite, the infection is actually of fungal origin. The lesion may involve any part of the exposed skin on arms, legs and face. It starts as small red spots, which spread to form a red-coloured ring surrounding a clearer itchy area.
Ringworm of the Scalp (Tinea capitis):
Poor hygiene, excessive sweating and/or using contaminated combs and brushes may expose you to ringworm of the scalp. Minor scalp injuries or a pre-existing rash increase the chances of infection.
The infection destroys the hair, leaving the infected area bald. The skin is itchy, appears red with round scaly areas or with blisters containing pus.
Systemic involvement is also seen as fever and swollen lymph nodes.
Ringworm of the Face (Tinea faciale):
It involves the skin of the face, except the beard area. The lesions are itchy and appear as red, slightly elevated with flaky margins.
Ringworm of the beard area is known as Tinea barbie. There is swelling and crusting of the skin with loss of hair in the affected area.
Fungal skin infections are usually only mildly contagious.
Direct or indirect contact (through use of contaminated objects) with an infected person causes the disease to spread. A decreased immune response or poor general health enhances the risk of acquiring fungal infections.
Fungal rash is often difficult to distinguish clinically from an allergic rash and other skin conditions. Definitive diagnosis is usually based on microscopic examination of the skin scrapings, hair or nail clippings.
Skin culture (growing the fungi from skin scrapings) in the lab or a skin biopsy may also be performed.
As these infections are limited to the skin, they respond well to topical application of anti-fungal creams, lotions and sprays that contain ketoconazole (Nizoral), terbinafine (Lamisil), miconazole, clotrimazole, etc.
However, for nail or scalp infections where it is not easy to deliver the drug to the infected area, or where the infection has spread to cover a large area, oral anti-fungal drugs are prescribed such as Itraconazole (Sporanox) and Fluconazole (Diflucan).
Over-the-counter drugs are also available such as miconazole, clotrimazole, etc., but you must be sure of having a fungal infection before buying one. If the rash does not respond to two weeks of treatment, you should consult your doctor.
The treatment may last from a few weeks to a year or more, as in case of fungal nail infection.
Keeping the skin dry and clean, also washing and disinfecting the laundry properly helps to combat the infection.
Yeast is a type of fungus that grows through “budding”. The most common infective organism in this group is Candida albicans. Common yeast infections include:
Thrush affects the mucous membranes of the mouth and the genital area. It appears as small white patches that can be easily scraped off leaving behind a red mark. Vaginal thrush is associated with itching and a thick, whitish discharge.
Intertrigo occurs between the skin folds in armpits, groin, below heavy breasts and between fat folds in the abdomen. There is redness, itching and scaling of the skin.
The colour of the infected skin varies (versi-color) from the rest. There are lighter patches on darker skin and vice versa. It appears as spots and flaking of the skin at the margins. The itching is much less than with other fungal infections.
These infections are also treated with topical antifungals such as miconazole or clotrimazole. Oral drug therapy may sometimes be required.
Orthotics that will help to treat Skin fungus can be found below.