Fungal Skin Infection: Types and Treatment

What are fungal skin infections? 

A fungal skin infection, or mycosis, is any skin infection caused by fungi, primarily affecting the skin. 

Fungi can be found from the surfaces you touch to the food and water you consume. They are microscopic organisms and thrive well in moist, dirty places, including areas of the body like the groin, feet, and skin folds. They are generally harmless unless they enter deep into the body through a cut or injury. 

What are the types of fungal infections and their associated symptoms?

According to the Centres for Disease Control and Prevention (CDC), out of the million fungi species worldwide, only a few hundred can affect humans and lead to fungal skin infections. These infections can occur on different body parts, including the feet, groin, scalp, nails, and skin folds.

The most common fungal skin infections include:

1. Tinea pedis (Athlete’s foot)

   Athlete’s foot is a fungal infection that primarily affects the feet, especially between the toes and the soles. It typically affects teens, adult males and, less often, children before puberty.

   Some contributing factors include sweating, not properly drying the feet after swimming or bathing, wearing tight socks and shoes for long hours, and warm weather conditions.

   Symptoms include:

   • Itching
   • Peeling of the skin between the toes
   • Redness
   • Burning and stinging sensation on the feet
   
   

   The infection is contagious and can be transmitted through direct contact with contaminated surfaces or when you share personal items such as towels or shoes.

2. Tinea corporis (Ringworm) 

   Despite its name, worms are not the cause of ringworm. Instead, dermatophytes are the causes. It affects all ages but is mostly common among children and also in warmer climates. It can occur on various body parts, including the arms, legs, face, and trunk. 

   Symptoms are characterised by:

   • Red, circular patches that typically appear as ring-shaped lesions with clear or scaly centres.
   • The edges of the lesions are often raised and may be redder than the surrounding skin.
   • The skin within the ring may be dry, flaky, or scaly.
   • The affected areas can be very itchy.

   Ringworm spreads through contact with infected individuals, pets, or contaminated objects, and from public places with sweaty people, like the gym.

3. Tinea capitis (Scalp ringworm) 

   Scalp ringworm affects the scalp and hair follicles. It can possibly progress to kerion, a big, pus-filled lesion over the initial ringworm. 

   This condition is caused by fungal hypersensitivity and may be accompanied by a rash elsewhere and sensitive lymph nodes in the neck. It commonly affects children but can also occur in adults.

   Common symptoms of scalp ringworm include:

   • Severe itching and scaling on the scalp.
   • Scaly or red bald patches.
   • Pain in the patches.
   • Permanent hair loss in severe cases.

   Scalp ringworm spreads through contact with infected individuals or contaminated objects such as combs or hats. The infection is similar to severe dandruff. Hence, you need to consult your doctor to diagnose the condition correctly.

4. Tinea cruris (Jock itch)

   Jock itch is a fungal infection that primarily affects the groin area. It is more common in males and happens typically in warmer weather.

   Symptoms include:

   • Itchiness that starts from the groin and spreads to the upper inner thighs.
   • Redness.
   • Rash with a well-defined border.
   • Sweat may cause the rashes to worsen and spread to the buttocks and lower abdomen.
   • As the rashes on the skin worsen, the area becomes scaly, flaky, and cracked. 

5. Onychomycosis (Nail fungus) 

   This fungal infection affects both fingernails and toenails, but mostly the toenails and is often challenging to treat.

   Symptoms include:

   • Thickening of the ends of the nails.
   • Nails become discoloured and brittle.
   Nail fungus can spread from person to person or through contact with contaminated surfaces, such as public swimming pools or nail salons. 

6. Yeast infection (Candida) 

   Yeast infections, caused by the Candida species, can occur on the skin, mouth, throat, and vagina. It often results from an overgrowth of yeast due to a weakened immune system, hormonal changes, or prolonged antibiotic use. 

   Yeast infections develop in moist areas of the skin, such as skin folds, armpits, groin, and under the breasts. 

   Symptoms include:

   • Red, itchy rash with possible satellite lesions (small lesions surrounding the main rash).
   • The skin may become cracked and sore.

How are fungal skin infections diagnosed? 

Diagnosing fungal skin infections involves a combination of clinical evaluation and laboratory tests. Your doctor will take a detailed medical history, including any symptoms, their duration, and possible exposure to sources of infection.

The affected area is then visually examined for characteristic signs of fungal infection, such as redness, scaling, itching, and specific patterns like ring-shaped lesions.

Diagnostic tests include: 

• KOH (Potassium Hydroxide) preparation: A sample of skin scrapings, nail clippings, or hair is collected from the affected area. The sample is placed on a slide and treated with a few drops of potassium hydroxide (KOH). KOH dissolves the keratin in the sample, making it easier to see fungal elements like hyphae (branching filaments) or yeast cells under a microscope.

• Fungal culture: This involves growing the fungi in a controlled environment to determine the specific species.

• Skin biopsy: A small piece of skin is removed from the affected area and examined under a microscope, often after staining with special dyes. This is used for deeper or more complex infections, or when the diagnosis is uncertain.

How are fungal skin infections treated? 

The treatment of fungal skin infections depends on the type and severity. Mild cases of fungal infections can often be managed with over-the-counter antifungal creams, powders, or sprays. These medications usually contain active ingredients such as clotrimazole, miconazole, or terbinafine, which help to eliminate the fungi and relieve symptoms.

For more severe or persistent infections, prescription-strength antifungal medications may be necessary. These medications may be available in various forms, like oral tablets, topical creams, or medicated nail lacquers. Follow the prescribed treatment that your doctor recommends.

How to prevent fungal skin infection?

Preventing fungal skin infections involves adopting good hygiene practices:

• Clean your skin and keep it dry, especially in areas prone to sweating.
• Change out of wet or damp clothing promptly.
• Avoid sharing personal items like clothing, towels, or shoes.
• Wear breathable fabrics and choose shoes that allow air circulation.
• Use antifungal powders or sprays in shoes or on feet to prevent athlete’s foot.
• Practice proper foot hygiene, including wearing clean socks.
• Avoid walking barefoot in public areas, especially around swimming pools or locker rooms.
• Keep nails clean and trimmed and avoid sharing nail clippers or files.
• Maintain a healthy immune system through regular exercise, a balanced diet, and adequate sleep.

Make an appointment at Pantai Hospitals

Consult your doctor if your fungal infection symptoms worsen or if you notice new symptoms. A dedicated and expert team of dermatologists at Pantai Hospitals is available for consultation to provide the best care and assistance.

Pantai Hospitals has been accredited by the Malaysian Society for Quality in Health (MSQH) for its commitment to patient safety and service quality.