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Skin Fungal Infections: Symptoms and Treatment

Skin Fungal Infections: Symptoms and Treatment

Fungal skin infections are caused by fungi such as dermatophytes and Candida. Some common types of skin infections in this category are ringworm infections and yeast infections. This article gives you an insight into some of the common skin infections caused by fungi, along with their symptoms and treatment.
Reshma Jirage
Last Updated: Apr 13, 2018
Fungi (plural of fungus) are a microorganism that lives in our environment and may be found in the air, soil, water, plants, and even human beings. Yes, our body contains a certain type of fungi, which are usually harmless. However, when due to certain causes, it grows and multiplies excessively in our system, a fungal infection may occur. 

Fungi that lead to skin infections strive on a protein called keratin in our body. This protein is present in the outer layer of the skin, as well as the nails and hair. There are different types of the fungus responsible for different skin infections, the most common ones being Candida albicans and dermatophytes. Fungal infections may occur anywhere in our body, including areas like the feet, nails, scalp, and groin. These infections are mostly controllable through topical and oral medications. However, they may cause some serious complications in some cases, especially when the immune system of the body is weak.
Ringworm Infections
Though the term "ringworm" may include "worm" in it, this type of infection is not caused by a worm, but a group of fungi called dermatophytes. These microorganisms live on the top layer of the skin which contains keratin. The medical term used for ringworm is tinea. Based on the location of the tinea, different terminologies are used to describe the infection caused by these fungi. Some of the commonly found ringworm infections are:
  • Tinea corporis (ringworm of the body)
  • Tinea capitis (ringworm of the scalp)
  • Tinea pedis (ringworm of the foot, also known as Athlete's Foot)
  • Tinea cruris (ringworm of the groin, also known as Jock Itch)
  • Tinea unguium (ringworm of the nails, or nail fungus infection)
Tinea corporis (ringworm of the body)
Tinea corporis is characterized by the formation of a circular ring-shaped rash on the upper layer of the skin. The outer lining of the rash appears to be red in color, while the area within the lining seems to appear normal.

Symptoms may include -
  • Scaly skin on the edges of the rash
  • Redness and inflammation around the edges of the rash
  • Itchiness on the patches
  • Severe cases may include additional symptoms like fever and drainage

This infection begins with a small pimple, or elevated red spots on the area, and slowly transforms into a bigger circular patch. Most commonly affected areas are the face, arms, and legs.
Treatment Options for Ringworm of the Body
Skin scrapings are collected from the affected area to be examined under a microscope for the presence of fungi. This test is known as the Potassium Hydroxide (KOH) test. After confirming the cause of infection to be fungus-related, the following treatment options may be considered depending upon the condition -
  • Over-the-counter (OTC) Treatment - For mild cases of tinea corporis, using over-the-counter medications - topical antifungal lotions, ointments, or creams - may suffice. Applying these once or twice every day for 2 weeks (or more) would help.
  • Prescribed Medications - If the OTC medications do not prove to be effective, the doctor may prescribe certain medications which may include a combination of topical and oral medication.

* Note: Side effects may be observed after using antifungal oral medications. They may also alter the effect of certain medications (such as warfarin) consumed for specific health concerns. Kindly consult with a trusted medical practitioner before opting a treatment plan.
Tinea capitis (ringworm of the scalp)
When ringworm affects the scalp, it also affects the shafts of the hair, causing itchy and scaly bald patches. The infection may either occur in a limited area of the scalp, or on the entire scalp. It is most common in school-going children.

Symptoms may include -
  • Round bald patches with itchy and scaly skin on the scalp
  • Brittle hair that tends to come out of the scalp with a slight pull
  • Redness or grayness in the affected area
  • Pain and tenderness in the affected area
This infection begins with a small bump, or with a tiny scaly patch on the scalp, which may be mistaken as dandruff. Slowly, the infection spreads and creates single or multiple bald patches. Severe cases may also lead to permanent hair loss.
Tinea pedis (ringworm of the foot)
Also known as Athlete's Foot, this infection is most commonly found in young men and is likely to occur in the space between the toes. Wearing damp or tight-fitting socks and shoes makes the skin of the feet warm and moist - the ideal environment for fungi to thrive!

Symptoms may include -
  • Extremely dry skin on the feet, especially on the edges of the feet, or at the bottom
  • Cracked skin which peels from the surface, appearing at the sole, or in between the toes
  • A burning sensation accompanied by itching and stinging in the affected area - mainly the soles or in the gap between the toes
  • Occurrence of itchy blisters on the site
  • The infection may spread to the toenails in severe cases
Tinea pedis usually starts from being a small itchy rash on the skin. Early treatment may prevent it to grow into a severe infection, which may also cause fever. The infection can also spread to the hands (tinea manuum).
Treatment Options for Ringworm of the Foot
The doctor would be able to diagnose the infection by examining the scalp. For testing purposes, samples of the hair, or scaly skin of the scalp may be collected. After proper diagnosis, the following treatment options may be used -
  • Antifungal Medications - Medications for oral consumption may be used for treating the infection. They could either be in the form of a tablet, or liquid. These may be consumed for a period of 6 weeks, as directed by the doctor.
  • Medicated Shampoos - You are likely to be advised by your doctor to wash your scalp with medicated shampoo at least 2-3 times a week, depending upon the condition.

* Note: Ringworm of the scalp mostly affects young children. Consumption of certain antifungal medications may cause side effects such as diarrhoea, headaches, vomiting, pain, etc. Make sure that the treatment plan is as per the doctor's suggestion.
Tinea cruris (ringworm of the groin)
Also known as Jock Itch, tinea cruris affects the groin area of the human body. It mostly occurs in young men (although women may also get it) who are engaged in sports and exercise and tend to sweat a lot. Even obese people fall under the risk zone. This is because the accumulation of sweat in this region makes the area moist, which is ideal for the growth of fungus causing infections. Not washing the groin or genital area properly, or wearing tight-fitting underwear or athletic supporters that are unwashed can cause this infection.

Symptoms may include -
  • A rash accompanied by redness and itchiness
  • Spreading of the infection to the surrounding areas, including the genitals, buttocks, and the inner thighs
  • Symptoms such as dryness, burning, flaking, and cracking of the skin
Many times, ringworm of the groin occurs in people with Athlete's foot. Touching the groin area after touching the foot may cause the infection to spread. It can also occur through sexual intercourse with a partner who has the infection.
Treatment Options Ringworm of the Groin
Some skin of the affected area is scrapped and sent to the laboratory for testing to determine the exact cause of infection. The KOH test also helps in diagnosis through a microscopic evaluation. The following treatment options may be considered -
  • Over-the-counter Medications - If the infection is mild in nature then over-the-counter powder, lotion, ointment, or spray with antifungal properties may prove to be helpful. These medications are usually applied for approximately 10 days.
  • Prescribed Medications - In severe cases, doctors may prescribe certain topical/oral medications for treatment.
  • Cleanliness - It is important to keep the area clean and dry. Using a clean and dry towel, and changing the underwear daily is advised.

* Note: Certain oral medications used to treat jock itch may cause certain side effects. People with a weak immune system may take longer to get rid of the infection. Please consult your medical practitioner for accurate treatment.
Tinea unguium (ringworm of the nails)
Also known as nail fungus, it is a common infection, collectively known as Onychomycosis. If the infection is caused by dermatophytes, then it is known as Tinea unguium. It may be a result of the infection spread from athlete's foot, or may also occur due to the presence of excessive moisture for the fungi to thrive. Nail fungus is more common in toenails as compared to the fingernails. This is because our toes are mostly covered with socks and shoes, preventing proper ventilation. Having an injury around the nails may also make them susceptible to nail fungus.

Symptoms may include -
  • Change in the texture of the nails, they may appear to be more thickened
  • The nails may appear malformed and dull, without any lustre
  • Nails may appear to be darker in color
  • Brittleness - pain may also be experienced
This infection usually begins with the appearance of a tiny white/yellow spot at the tip of the nails. Immediate treatment is necessary to avoid further complications such as a condition called onycholysis - which separates the nail from the nail bed.
Treatment Options Ringworm of the Nails
A physical examination by the doctor will confirm the nature of the infection. The doctor may also collect some debris from the nail as a sample, and send it to the laboratory for testing to confirm the exact cause. The treatment may include the following -
  • Topical Ointments - Usually, topical ointments are used in combination with oral medications, as they may not prove to be as beneficial otherwise. Over-the-counter creams and lotions are prescribed to be applied to the affected area.
  • Oral Medications - Oral antifungal medications may be prescribed by the doctor depending upon the nature of the nail infection. These medications may have to be taken for 6-12 weeks to heal the infection completely.
  • Antifungal Lacquer - It is an antifungal nail polish which is applied to the affected area at least once a day. Long-term usage has proved to be effective in eliminating nail fungus.
  • Surgical Treatment - In severe cases, the doctors may need to remove the infected nail surgically to remove the infection completely.

* Note: The treatment may vary depending upon your individual condition. Antifungal medications may also have certain side effects and may prove to be dangerous for people with heart and liver diseases. Please consult with your medical practitioner for accurate treatment.
Yeast Infections
Yeast Infections
Oral Thrush
Most commonly found among infants and toddlers, this fungal infection occurs in the lining of the mouth. The fungus Candida albicans grows abnormally and accumulates in and around the mouth. Adolescents and adults may also get this infection - especially if they have a weak immune system. Usually, people with conditions like diabetes mellitus, HIV/AIDS, cancer, or people who wear dentures, consume antibiotics or corticosteroids, or who smoke are at the risk of developing this infection.

Symptoms may include -
  • Creamy white lesions on the lining of the mouth. These lesions may also appear on the tongue, the roof of the mouth, gums, tonsils, and inner cheeks
  • Absence of the sense of taste accompanied with a cottony feeling in the mouth
  • Pain in the affected area
  • Bleeding when the lesions are scratched
  • Cracked skin at the corners of the lips accompanied with redness
When an infant has this infection, it is likely to be passed to the mother during breastfeeding. The nipples and the areolas may get infected. The following symptoms may be observed -
  • A sharp stabbing pain in the breast
  • Itchiness in the nipples along with pain, especially during breastfeeding
  • Redness and sensitivity around the nipples
  • Flaky or shiny skin on the areolas
Though it is unlikely for oral thrush to cause a serious health complication among toddlers and infants, it may prove to be of serious nature in people with chronic health conditions mentioned previously.
Treatment Options for Oral Thrush
Diagnosis can be made upon physical examination. If needed, a sample of the skin lesion may be collected for accurate diagnosis. The treatment would depend upon the cause of the infection. If the infection is a consequence of a medication, the intake may be stopped. If a weak immune system is causing oral thrush, relevant treatment is applied to cure the infection. The following treatment methods may be used -
  • For Infants - Doctors are likely to prescribe the mild form of antifungal medication. Rinsing the milk bottles or pacifiers used by the baby with equal parts of vinegar and water helps in prevention of fungus infections. Make sure that the bottles are air-dried well.
  • For Nursing Women - The doctor may prescribe an antifungal cream for topical application on the breasts. The breast pump in use should also be rinsed with equal parts of water and vinegar to prevent fungus from growing.
  • For those with Weak Immunity - Antifungal medications in the form of tablets or liquids may be prescribed. In case of an HIV infection, when the antifungal medications are not effective, a medication called Amphotericin B may be recommended.
  • For Healthy Adults - Home remedies like eating yogurt (unsweetened) may help in restoring the 'good' bacteria in the body to balance the abnormal growth of the fungus. Rinsing the mouth with warm saltwater (about half a teaspoon of salt in a cup) may be beneficial. Make sure that you don't swallow the water. Antifungal medications may also be prescribed based on the severity of the infection

* Note: Usage of certain antifungal medications may cause side effects including liver damage. Consult with your doctor for suitable treatment.
Vaginal Yeast Infection
Candida albicans is the most common reason for vaginal yeast infection. This microorganism is present normally in the body, in areas including the skin, digestive tract, mouth, and vagina. However, there are other germs that help maintain a balance to avoid problems. When the fungi in the vagina increase, an infection occurs.

Symptoms may include -
  • Itchiness and irritation in the vagina
  • A thick white discharge from the vagina
  • The texture of the discharge may appear to be like that of cottage cheese
  • Burning while urinating or sexual intercourse
  • Soreness, pain, and redness in the vagina
  • Sores, cracks, and tears in the vagina (in case of severe yeast infection)
Women who are pregnant, or have a compromised immune system are more susceptible to this infection. The prevalence of this type of infection is very common. Statistics show that every 3 women out of 4 suffer from a vaginal yeast infection at some point in life. It is not a sexually transmitted disease but may spread during the act.
Treatment Options for Vaginal Yeast Infection
The treatment would depend based on the nature of infection. Vaginal yeast infection can either be mild, or severe and complicated in nature. Mild infections are those that occur once in a while with mild to moderate symptoms, but many women have recurrent infections with bothersome symptoms. A visual examination is done by the doctor to see the infection. A sample of the vaginal discharge may be collected to be examined under a microscope. If the infection is recurrent in nature, the doctor may send the sample for laboratory testing. The following treatment options may be considered.
  • Infrequent Infections - A short-course vaginal therapy and a single-dose of oral medication may suffice for mild to moderate infections. The therapy may include the application of an antifungal ointment, tablet, or a cream. An antifungal suppository may also be suggested.
  • Frequent Infections - A long-course vaginal therapy along with multiple dosage of oral medication may be suggested to cure the infection completely. The therapy may be done for 7-14 days involving the application of antifungal cream, ointment, suppository, or tablet. Also, to prevent the recurrence of these infections, oral medication, or suppository may be suggested at regular intervals.

* Note: Some medications are not advisable for pregnant women. Also, certain treatment medications may cause certain side effects. Consult with a trusted medical practitioner for suitable treatment plan.
Diaper Rash
Though there are various causes for babies to deal with problems related to diaper rash, one of the causes is yeast infection due to Candida albicans. When the buttocks, groin, thighs, and the genital of the baby are covered with diaper most of the time, the area tends to become moist and warm - the ideal place for the fungi to thrive. This infection is common among babies under 15 months of age.

Symptoms may include -
  • Changes in the texture of the skin around the diaper area
  • Redness, tenderness, and puffiness in the area including the genitals, thighs, and buttocks
  • Irritated behavior and excessive crying of the baby while changing the baby's diaper, or when touching the area
  • Severe infection may cause blisters and boils with pus
  • Fever and excessive sleepiness may also be observed
It is a very common skin infection among babies, and mild cases may not really require medical assistance as simple home remedies may suffice. However, in case of severe cases, do not fail to contact your doctor.
Treatment Options for Diaper Rush
The treatment includes physical examination done by the doctor. The most important step is to keep the area as dry and clean as possible. Changing the diapers more frequently would help. However, if the infection continues to exist, the following treatment options may be considered.
  • Antifungal Cream - There are various over-the-counter medications available, but it is best to consult with your doctor beforehand as babies tend to have sensitive skin. The doctor is likely to prescribe an antifungal cream that needs to be applied on the affected area for healing.
  • Home Treatment - As mentioned earlier, changing the diapers frequently to ensure cleanliness is a must. It is advisable to use large-sized diapers to allow proper ventilation. Also, make sure that tight-fitting or plastic diapers are not being used. Do not use scented soaps, wipes, and talcum powder on the affected area. Try to give your baby a little time off the diapers.

* Note: Consult with your doctor before using any form of medication on your baby. Certain medications may contain elements that can adversely affect your baby's skin.
Intertrigo
Intertrigo is a skin infection which mostly occurs in people who are overweight. A rash occurs in between the skin folds, where the skin ends up rubbing against skin. This infection usually occurs in the areas including the armpits, fat folds in the abdomen, neck, underside of the breasts, groin, and genital area. These areas tend to become moist due to the constant friction and lack of ventilation. The heat and moisture enables the growth of fungus causing infection.

Symptoms may include -
  • Itchy and scaly rash which may be reddish brown, or completely red in color
  • Crusty texture of the skin
  • Foul smell from the infected area
  • A whitish-yellowish discharge from the affected region
Intertrigo may also affect people who wear devices such as braces, splints, and artificial limbs causing the skin to be surrounded with moisture, instigating the fungi growth.
Treatment Options for Intertrigo
The first and foremost step is to make sure that the area beneath the skin folds remains clean, dry, and well ventilated. A combination of home remedies and use of medications may be required to keep the infection at bay. The following methods may prove to be effective for treatment.
  • Lose Weight - Being overweight causes skin folds to develop and make room for this infection. Losing the extra folds will prevent the infection in the long run.
  • Maintain Personal Hygiene - Make sure that you use a dry and clean towel to wipe the excess moisture/sweat within the skin folds.
  • Wear Loose Clothes - Avoid wearing tight-fitting clothes, it prevents ventilation. Make sure your clothes allow your skin to breathe.
  • Antifungal Medications - Topical application of antifungal cream or ointment may be suggested by the doctor. Depending upon the nature of the infection, oral medications may also be prescribed.

* Note: The appropriate treatment depends upon various factors. Also, certain oral antifungal medications may have certain side effects. Consulting a doctor is advisable.
Tinea Versicolor
This fungal infection is also called Pityriasis versicolor. The term 'Versicolor' means 'of various colors'. As the term suggests, this fungal skin infection results in the formation of patches on the skin. People with a tanned skin tone tend to have light patches on the skin, and people with light skin tone tend to have darker patches. This infection mostly occurs among teens and young adults in the areas include the back, shoulders, and regions of the trunk, although, it may occur in any area of the body.

Symptoms may include -
  • Occurrence of small spots on the skin that look like a rash
  • The color of the spots may vary from red, brown, white, pink, salmon, or tan
  • Spots may have an itchy, dry, and scaly skin
  • The infection prevents the skin to tan, which is why when the surrounding skin is tanned, the spots become more noticeable
  • The infection may recur during warm and humid climate, and disappear during cold climate
This condition is likely to occur among those who live in warm and humid climatic conditions. Most of the time, tinea versicolor may be mistaken for another skin condition called vitiligo where the skin loses its color.
Treatment Options for Tinea Versicolor
The treatment for tinea versicolor depends upon the nature of infection. Diagnosis can be made through a medical examination, where the doctor visually observes the changes in the skin. A sample may be taken for microscopic evaluation. If needed, diagnosis may be made using a Wood's lamp. It is a special lamp which is held 4-5 inches away from the infected skin. If the skin under the light of the lamp appears to be yellowish green, it confirms the diagnosis. The following treatment options may be used.
  • Topical Medications - Usage of topical antifungal medications in the form of creams, lotions, soaps, or shampoos may be suggested depending upon the area affected by the infection.
  • Antifungal Pills - Prescribed antifungal pills for oral consumption may be advised by the doctor in severe cases.
  • Medicated Cleansers - For people who are highly prone to this infection, it is important to take necessary steps to keep the infection at bay. Using medicated cleansers at regular intervals - usually once or twice a month - would help your skin become free from yeast infections.

* Note: Antifungal pills may alter the effectiveness of other medicines consumed, and may also cause certain unwanted side effects. Kindly consult with your doctor for appropriate treatment.
Our skin, the largest organ in our body, protects our internal organs. Thus, it is essential that the skin is kept in perfect form. Our body needs some fungi and bacteria to a certain extent for healthy functioning. It's when their numbers get out of hand that it becomes a problem. As you must have noticed, fungal infection of the skin mostly occurs when the skin is chronically exposed to a moist environment, other reasons being preexisting health conditions, or certain medications. Most of the infections listed above can be controlled and prevented by taking some simple steps towards maintaining hygiene.
Disclaimer: This article is for informative purposes only, and should not be used as a replacement for expert medical advice.