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Fungal skin infections

Fungal skin infections are caused by different types of fungi, including dermatophytes and yeasts.

Fungi invade and grow in dead keratin. Keratin is a protein that makes up your skin, hair and nails. There are several different types of fungal infections. They are divided into different groups depending on what type of fungus is involved. 

An image showing ringworm

Details

  • Types Types of fungal skin infections

    Some common fungal skin infections are listed below.

    Dermatophyte infections

    Athlete’s foot (Tinea pedis)

    Around one in five people in the UK have athlete’s foot. It's caused by a fungus that grows in warm, damp areas of skin, such as between your toes. The fungal infection makes your skin itchy, flaky and red. It also causes white cracks to appear, especially between your toes and on the side of your foot. Occasionally it causes blisters.

    You can pick up athlete’s foot if you walk bare foot on damp, contaminated floors such as communal shower facilities, swimming pools or saunas. If you don’t wash your hands after you touch a contaminated area, it can spread to other parts of your body. See our frequently asked questions for more information.

    Nail infections (Tinea unguium)

    Fungal nail infections usually start at the edge of your nail and spread slowly down to the base. They tend to take a long time to develop. They cause your nail to discolour and become crumbly. The surrounding tissue may also thicken. Later, your nail can become so thick that it's painful to wear shoes. Toenails are usually affected more than fingernails.

    You can get a fungal nail infection if you have athlete’s foot and it spreads to your nails. You can also get an infection if your nail is weak, for example from a previous injury.

    See our frequently asked questions for more information.

    Ringworm of the body (Tinea corporis)

    This often affects exposed parts of your body, such as your arms, legs or face, and causes a red, ring-shaped rash. Ringworm is contagious. You can catch it by coming into contact with somebody who already has ringworm or touching contaminated items, such as clothing or bedding. Domesticated animals, such as sheep, cattle and pets can also carry the fungi that cause ringworm.

    Ringworm of the groin (Tinea cruris)

    This is also called ‘jock itch’ because it’s more common in young men. This is because the scrotum and thigh are in close contact and create conditions in which fungi can thrive. It can also affect women if they wear tight clothing. It can cause an itchy, red rash in your groin and the surrounding area.

    Like ringworm of the body, ringworm of the groin is contagious and can be passed on in the same ways. You may also get ringworm in your groin if you have athlete’s foot and touch your groin after touching your foot without washing your hands.

    Ringworm of the scalp (Tinea capitis)

    This can occur at any age, but mostly affects children before they reach puberty. Ringworm can affect any part of your scalp but you usually get patches of it. Symptoms can be similar to those of ringworm on your groin and body and your scalp will look scaly and feel itchy. You may also develop pus-filled areas on your scalp, called ‘kerions’. During the infection your hair may fall out and leave bald areas but this usually grows back once the infection has been treated.

    You can get ringworm on your scalp by sharing a contaminated comb or clothing used by somebody with the infection.

    Yeast infections

    Some fungal skin infections are caused by yeast infections, such as the following.

    Intertrigo

    Intertrigo is a yeast infection that you can get in the folds of your skin, such as on your abdomen (tummy), if you're overweight. It's often caused by the yeast Candida albicans. It affects areas where your skin presses or rubs together and can cause chafing. If you have intertrigo, your skin may turn red or brown and if it’s very moist, it can start to break down.

    Pityriasis versicolor (Tinea versicolor)

    This condition is caused by a type of yeast called Malassezia. It’s quite common and usually affects young adults after they reach puberty. If you have pityriasis versicolor, your back, upper arms and torso may have patches of scaly, itchy and discoloured skin. This is usually a pink, brown or red colour. If you have darker skin, it may lose some of its colour.

    Thrush (Candida albicans)

    C. albicans is a common fungus that often lives in your mouth, stomach, skin and women’s vaginas. Usually it doesn't cause any problems. However, if you’re unwell, pregnant, take antibiotics or have diabetes, the yeast can multiply and cause the symptoms of thrush.

    A thrush infection often looks like small white patches, which leave a red mark if you rub them off. In women, vaginal thrush can cause itchiness and a white discharge.

    Thrush can also affect newborn babies in their mouth and this is called oral thrush. It's easy to mistake the white patches for milk. It isn't usually serious, but babies with thrush in their throats may stop feeding properly. Babies may also develop thrush in the nappy area.

  • Symptoms Symptoms of fungal skin infections

    The symptoms and appearance of a fungal skin infection depend on the type of fungus that has caused it. They will also depend on which part of your body is affected. Fungal rashes are sometimes confused with other skin conditions, such as psoriasis and eczema.

    Fungal skin infections can cause a variety of different skin rashes. Some are red, scaly and itchy. Others may produce a fine scale, similar to dry skin. The fungus can affect just one area, or several areas of your body. If you get a fungal infection of your scalp, you may lose some hair.

    If you have any of these symptoms, see your GP for advice.

  • Diagnosis Diagnosis of fungal skin infections

    Your GP will ask about your symptoms and examine you. He or she may also ask you about your medical history.

    Your GP will usually diagnose fungal skin infections by looking at the appearance of your skin and the location of any rash. He or she may take a scrape of your skin or a fragment of your nail or hair. Your GP will send this sample to a laboratory for testing to confirm the diagnosis.

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  • Treatment Treatment of fungal skin infections

    Self-help

    Your GP will advise you to make sure you dry the affected area thoroughly after washing, especially in the folds of your skin.

    Medicines

    You will usually need to use an antifungal treatment that you put directly onto the affected area of your skin. These are known as topical treatments. There are a variety of treatments available in the form of creams, lotions, paints, shampoos and medicated powders. Some of these are available over the counter from a pharmacist, without prescription. Always read the patient information leaflet that comes with your medicine and if you have any questions, ask your pharmacist for advice.

    If you have a rash that covers a large area of your skin or affects your nails or scalp, you may need to take tablets. Your GP may also prescribe you tablets if you have used a topical treatment that hasn’t worked. These treatments can occasionally cause side-effects, which include skin irritation and stomach problems.

    Your symptoms may return, even if they seem to have cleared up. It's important to continue with your treatment for up to two weeks after your symptoms disappear.

    You may need to take some treatments for a few weeks, or up to four to 12 months for toenail infections.

  • Dermatology treatment

    At our Bupa Health Centres, we offer self-pay health services for a wide range of conditions, including dermatology treatment.

  • Causes Causes of fungal skin infections

    You’re more likely to get a fungal skin infection if you:

    • are overweight
    • don’t dry your skin fully after bathing
    • come into contact with a person or animal with a fungal skin infection
    • come into contact with contaminated items, for example, clothes, towels and bedclothes
    • walk barefoot in shower and pool areas
    • wear tight clothing that doesn’t allow sweat to evaporate
    • have poorly controlled diabetes
    • have recently taken a course of antibiotics
    • are pregnant
    • have a weakened immune system, for example, HIV/AIDS
  • Prevention Prevention of fungal skin infections

    There are steps you can take to reduce your risk of getting a fungal skin infection and stop an infection from spreading. Some examples are listed below.

    • Dry your skin thoroughly after you have a bath.
    • Wash your socks, clothes and bed linen frequently to remove any fungi.
    • Wear clean flip-flops or plastic shoes in damp, communal areas, such as showers, saunas and swimming pools.
    • Wear loose fitting clothes that are made of cotton or a material designed to keep moisture away from your skin.
    • Don't share towels, hair brushes and combs that could be carrying any fungi.
    • Alternate pairs of shoes every two or three days to give them time to dry out.
    • If you have diabetes, keep your blood sugar under control.
    • Soak pillows, hats, combs or scissors with bleach and water if someone in your family has scalp ringworm.

    Children can still go to school, and adults to work, but it's important to practise good hygiene to prevent fungal infections spreading to others.

  • FAQs FAQs

    Can herbal remedies, such as tea tree oil, help with fungal infections?

    Answer

    There isn’t currently enough scientific evidence to say whether or not herbal remedies can help to treat fungal infections.

    Explanation

    Some people who try herbal remedies, such as tea tree oil, to treat fungal infections find that they help. Early research has shown that tea tree oil may help against some types of fungi. However, there isn’t enough evidence to recommend using tea tree oil to treat fungal infections.

    You can try herbal remedies to help treat your fungal skin infection if you wish, but don’t delay seeking help from your pharmacist or GP.

    You may find herbal remedies helpful, but it’s important to remember that natural doesn’t mean harmless. Herbal remedies contain active ingredients and may interact with other medicines or cause side-effects. Don’t start taking any herbal remedies without speaking to your GP or pharmacist first.

    If I have a fungal nail infection, how long will it take for my nail to get back to normal?

    Answer

    It can take up to 12 months, but it will depend on whether it’s your fingernail or toenail that is affected. It will also depend on how well you respond to treatment.

    Explanation

    Treatment with antifungal medicines may get rid of your fungal nail infection. Your fingernails are more likely to get better with treatment than your toenails. However, treatment doesn’t always cure the infection. Your GP may refer you to a dermatologist (a doctor who specialises in identifying and treating skin conditions) for assessment and treatment. Alternatively he or she may refer you to see a podiatrist (a health professional who specialises in conditions that affect the feet).

    Treatments for a fungal nail infection include lotions that you paint on your nail. These work best if you treat the infection early. You can buy these over the counter. Another option is antifungal tablets. You may need to take tablets and paint your nail with a lotion to cure your infection.

    Tablets often work better than treatments you put on your nail, especially if the infection has taken over more than the edge of your nail. There are three types of tablets available that you will need to take for various periods of time. It can sometimes be for up to 18 months if you have a bad infection in your toenail.

    It can take up to six months after you start treatment for your fingernails to look normal again. It can take up to 12 months for your toenails. However, sometimes your nail’s appearance won't return to normal.

    Fungal nail infections come back in about one in four people.

    Will improving my foot hygiene get rid of my athlete's foot?

    Answer

    Improving your foot hygiene may help to control an infection, but it won’t usually be enough to get rid of athlete’s foot.

    Explanation

    You might find that your athlete’s foot gets better if you improve your hygiene but there isn't enough scientific evidence to know for sure. However, it’s a good idea to make sure you follow good hygiene practices anyway. This can prevent the infection spreading to other parts of your body, for example, your toenails and groin. It can also help to prevent athlete's foot coming back.

    Good hygiene measures include:

    • keeping your toenails clipped short and clean
    • wearing clean flip-flops or plastic shoes in damp communal areas, such as showers, saunas and swimming pools
    • drying your feet thoroughly after you wash them
    • washing towels frequently and not sharing them
    • wearing cotton socks and changing them every day
    • alternating your shoes every two or three days
    • intermittently treating your feet with antifungal powder if you often get athlete’s foot
  • Resources Resources

    Further information

    • The British Association of Dermatologists
      0207 383 0266
      www.bad.org.uk

    Sources

    • Introduction to fungal infections. DermNet NZ. www.dermnetnz.org, published 22 May 2013
    • Overview of dermatophytoses (ringworm, tinea). The Merck Manuals. www.merckmanuals.com, published June 2013
    • Athlete's foot. BMJ Clinical Evidence. www.clinicalevidence.bmj.com, published 20 July 2009
    • Athlete's foot. The Merck Manuals. www.merckmanuals.com, published June 2013
    • Tinea pedis. DermNet NZ. www.dermnetnz.org, published 22 May 2013
    • Fungal infections of the nails. British Association of Dermatologists. www.bad.org.uk, published April 2010
    • Fungal nail infection. NICE Clinical Knowledge Summaries. cks.nice.org.uk, published May 2009
    • Tinea cruris. The Merck Manuals. www.merckmanuals.com, published March 2013
    • Fungal skin infection. NICE Clinical Knowledge Summaries. cks.nice.org.uk, published May 2009
    • Tinea cruris. Medscape. www.emedicine.medscape.com, published 18 November 2013
    • Body ringworm. The Merck Manuals. www.merckmanuals.com, published June 2013
    • Higgins EM, Fuller LC, Smith CH. Guidelines for the management of tinea capitis. Br J Dermatol 2000; 143:53–58. www.bad.org.uk
    • Tinea capitis. Medscape. www.emedicine.medscape.com, published 14 May 2013
    • Intertrigo. Medscape. www.emedicine.medscape.com, published 27 March 2012
    • Intertrigo. DermNet NZ. www.dermnetnz.org, published 28 June 2013
    • Candida – skin. NICE Clinical Knowledge Summaries. cks.nice.org.uk, published June 2013
    • Pityriasis versicolor. NICE Clinical Knowledge Summaries. cks.nice.org.uk, published November 2010
    • Candidiasis (vulvovaginal). BMJ Clinical Evidence. www.clinicalevidence.bmj.com, published March 2009
    • Candida. DermNet NZ. www.dermnetnz.org, published 18 August 2013
    • Cutaneous candidiasis. Medscape. www.emedicine.medscape.com, published 13 February 2013
    • Tinea pedis. Medscape. www.emedicine.medscape.com, published 18 November 2013
    • Laboratory tests for fungal infection. DermNet NZ. www.dermnetnz.org, published 11 September 2012
    • Joint Formulary Committee. British National Formulary (online) London: BMJ Group and Pharmaceutical Press. www.medicinescomplete.com, accessed 22 November 2013
    • Bell-Syer SEM, Khan SM, Torgerson DJ. Oral treatments for fungal infections of the skin of the foot. Cochrane Database of Systematic Reviews 2012, Issue 10. doi: 10.1002/14651858.CD003584.pub2
    • Topical antifungal medications. DermNet NZ. www.dermnetnz.org, published 3 June 2012
    • Roberts DT, Taylor WD, Boyle J. Guidelines for treatment of onychomycosis. Br J Dermatol 2003; 148:402–10. www.bad.org.uk
    • Crawford F, Hollis S. Topical treatments for fungal infections of the skin and nails of the foot. Cochrane Database of Systematic Reviews 2007, Issue 3. doi: 10.1002/14651858.CD001434.pub2
    • Fungal nail infections. PatientPlus. www.patient.co.uk/patientplus.asp, published 2 October 2012
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    Reviewed by Rachael Mayfield-Blake, Bupa Health Information Team, December 2013.

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