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Fungal skin infections

Fungal skin infections are caused by different types of fungi and can be a common culprit of itchy skin.

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

Read on for descriptions of the common fungal skin infections.

An image showing ringworm

Details

  • Athlete’s foot (Tinea pedis) Athlete’s foot (Tinea pedis)

    Around one in six 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 infection makes your skin itchy, flaky and red. The soles of your foot can also become dry and scaly. You might get blisters too.

    You can pick up athlete’s foot if you walk barefoot on damp, contaminated floors such as communal shower areas, swimming pools or saunas. If you don’t wash your hands after you touch your feet, Athlete’s foot can spread to other parts of your body.

  • Nail infections (Tinea unguium) Nail infections (Tinea unguium)

    A fungal nail infection usually starts at the edge of your nail and spreads 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 get thicker. Eventually, 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 injuring it.

    See our FAQ: 'How long will it take for my nail to get back to normal after a fungal nail infection?' for information about nail infections.

  • Ringworm Ringworm

    Ringworm on your body (Tinea corporis)

    This usually affects parts of your body that are exposed, such as your arms, legs or face, and it causes a red, ring-shaped rash. Ringworm can spread with close contact. You can catch it by touching somebody who already has ringworm, or by touching contaminated items, such as clothing or bedding. Farm animals such as sheep and cattle carry the fungi that cause ringworm, as well as domesticated pets like cats and dogs.

    Ringworm in your 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, which can create conditions in which fungi can thrive. It can also affect women who wear tight clothing. It can cause an itchy, red rash in your groin and around the top of your legs.

    Like ringworm on your body, ringworm in your groin can spread with close contact and you can pass it on in the same ways. You may also get ringworm in your groin if you’ve had athlete’s foot and touch your groin after touching your foot without washing your hands.

    Ringworm on your scalp (Tinea capitis)

    You can get this at any age, but it mostly affects children. Ringworm can affect any part of your scalp but you usually get patches of it. Symptoms can be similar to those of ringworm in your groin and body and your scalp will look scaly and can feel itchy. You may also develop a pus-filled area on your scalp, called a ‘kerion’. During the infection, it’s possible that your hair may fall out and leave bald areas but it usually grows back once you treat the infection.

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

  • Intertrigo Intertrigo

    Some fungal skin infections are caused by yeast infections. 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. If it affects an area where your skin presses or rubs together, then it may 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) Pityriasis versicolor (Tinea versicolor)

    This is caused by a type of yeast called Malassezia. It’s quite common and usually affects young adults, particularly men. If you have pityriasis versicolor, you may get patches of scaly, mildly itchy and discoloured skin on your back and torso. This is usually a pink or brown colour. If you have darker skin, it may lose some of its colour.

  • Thrush (Candida albicans) Thrush (Candida albicans)

    C. albicans is a common fungus that often lives in your mouth, stomach, skin and vagina (in women). It doesn’t usually cause any problems. But if the conditions are right, the yeast can multiply and cause the symptoms of thrush. This can happen if:

    • you wear tight clothes
    • you don’t wash every day
    • you’re taking antibiotics
    • you’re immune system isn’t working as well as normal because you’re pregnant or have diabetes, for example

    A thrush infection often looks like small white patches, or areas of red skin. In women, vaginal thrush can cause itchiness and a white discharge.

    You can also get thrush in your mouth – oral thrush, which most often affects babies and older people (particularly if you wear false teeth). It can look like white patches, which leave a red mark if you rub them off. Oral thrush can be quite painful which can make eating and drinking difficult.

  • Symptoms Symptoms of fungal skin infections

    The symptoms of a fungal skin infection depend on the type of fungus that’s caused it, and where it is. Fungal rashes can sometimes be 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.

    You might not need to see your GP if you have a fungal infection. You might be able to manage it at home with medicines that you can buy over-the-counter. If you need advice about medicines, ask a pharmacist. If it gets worse or isn’t helped by over-the-counter medicines, contact your GP for advice.

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  • Diagnosis Diagnosis of fungal skin infections

    If you see your GP, they will ask about your symptoms and examine you. They may also ask you about your medical history.

    Your GP will usually diagnose a fungal skin infection by looking at your skin and the location of any rash. They 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

    After you have a shower or bath, make sure you dry the affected area of your skin thoroughly, especially in the folds of your skin.

    You can spread some types of fungal infections to other people. It’s important to wash your clothes, bedding and towels often to get rid of the fungus. You might find it helps to wear loose-fitting clothes made of cotton too, or a material that’s designed to keep moisture away from your skin.

    Medicines

    You’ll usually need to use an antifungal treatment that you put directly onto your skin. These are known as topical treatments. There are a variety of treatments available in the form of creams, lotions, paints, shampoos, pessaries and medicated powders. Some of these are available over the counter from a pharmacist so you don’t need to see your doctor to get a prescription. Always read the patient information leaflet that comes with your medicine to see how to apply them the right way, and for how long. 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 some tablets if you’ve used a topical treatment and it hasn’t worked. Tablets can sometimes cause side-effects, such as irritating your skin.

    Sometimes your symptoms can return, even if they seem to have cleared up. It’s important to keep using your treatment for up to two weeks after your symptoms disappear. You may need to take some treatments for two to eight weeks, or for up to a year and a half for toenail infections.

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  • 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 a bath or shower
    • come into contact with a person or animal with a fungal skin infection
    • touch contaminated items, such as clothes, towels and bedclothes
    • walk barefoot in shower and pool areas
    • wear tight clothing that doesn’t allow sweat to evaporate
    • have diabetes
    • have recently taken a course of antibiotics
    • are pregnant
    • have a weakened immune system, for example, if you have 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. Here are some tips.

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

    If you have a fungal infection you can still go to work, and your child can still go to school. But remember to practise good hygiene to prevent spreading it to others.

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

    Answer

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

    More information

    Some 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 yet.

    Try herbal remedies if you wish but don’t let this delay you seeking help from your pharmacist or GP. Another point to remember is 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.

  • How long will it take for my nail to get back to normal after a fungal nail infection? How long will it take for my nail to get back to normal?

    Answer

    It can take up to a year, sometimes longer. But it depends on whether it’s your fingernail or toenail that’s affected and how well treatment works for you.

    More information

    Treatment with antifungal medicines may get rid of your fungal nail infection. Usually they work better on fingernails than toenails, but don’t always cure the infection. Your GP may refer you to a dermatologist (a doctor who specialises in identifying and treating skin conditions) for more treatment.

    You can buy some fungal nail infection lotions that you paint on your nail, over the counter. These work best if you treat the infection early. Another option is antifungal tablets. Or you might need to take both.

    Tablets often work best, especially if the infection has spread past the edge of your nail. You might need to take tablets for up to a year and a half if you have a bad infection in your toenail.

    It can take up to six months after you start treatment for fingernails to look normal again – and up to a year for your toenails. Sometimes your nails won’t return to normal.

    Fungal nail infections can also come back – this happens to about a quarter of people.

  • Will improving my foot hygiene get rid of my athlete’s foot? Will improving my foot hygiene get rid of my athlete’s foot?

    Answer

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

    More information

    You will need to take medicines to treat athlete’s foot. But it’s a good idea to make sure you follow good hygiene practices too. This can prevent the infection spreading to other parts of your body, such as your toenails, or groin. It can also help to prevent athlete’s foot coming back.

    Good hygiene measures include:

    • wearing clean flip-flops or plastic shoes in damp communal areas, such as showers, saunas and swimming pools
    • drying your feet well after you wash them, especially between your toes
    • washing towels frequently, and not sharing them with others
    • wearing a clean pair of cotton socks every day
    • alternating your shoes every two or three days
    • intermittently treating your feet with antifungal powder if you often get athlete’s foot
  • Other useful websites Other useful websites

    Further information

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

    Sources

    • Dermatophyte infections. BMJ Best Practice. www.bestpractice.bmj.com, published 3 September 2015
    • Candidiasis (mucocutaneous). The Merck Manuals. www.msdmanuals.com, published March 2013
    • Athlete’s foot: oral antifungals. Systematic review 1712. BMJ Clinical Evidence. www.clinicalevidence.bmj.com, published September 2015
    • Fungal skin infection – foot. NICE Clinical Knowledge Summaries. cks.nice.org.uk, published September 2014
    • Fungal nail infection. NICE Clinical Knowledge Summaries. cks.nice.org.uk, published September 2014
    • Fungal skin infection – body and groin. NICE Clinical Knowledge Summaries. cks.nice.org.uk, published September 2014
    • Tinea corporis. DermNet NZ. www.dermnetnz.org, published 13 December 2014
    • Tinea cruris. The Merck Manuals. www.msdmanuals.com, published March 2013
    • Fuller LC, Barton RC, Mohd Mustapa MF, et al. British Association of Dermatologists’ guidelines for the management of tinea capitis 2014. Br J Dermatol 2014; 171(3):454–63. doi: 10.1111/bjd.13196
    • Tinea capitis (or scalp ringworm). British Association of Dermatologists. www.bad.org.uk, published August 2014
    • Intertrigo. Medscape. www.emedicine.medscape.com, published 4 September 2015
    • Candida – skin. NICE Clinical Knowledge Summaries. cks.nice.org.uk, published January 2014
    • Tinea versicolor. The Merck Manuals. www.msdmanuals.com, published March 2013
    • Pityriasis versicolor. DermNet NZ. www.dermnetnz.org, published September 2014
    • Candida – female genital. NICE Clinical Knowledge Summaries. cks.nice.org.uk, published December 2013
    • Oral candidiasis. BMJ Best Practice. www.bestpractice.bmj.com, published 3 September 2015
    • Joint Formulary Committee. British National Formulary (online) London: BMJ Group and Pharmaceutical Press. www.medicinescomplete.com, accessed 28 October 2015
    • Fungal infections of the nails. British Association of Dermatologists. www.bad.org.uk, published March 2014
    • HIV-related opportunistic infections. BMJ Best Practice. www.bestpractice.bmj.com, published 26 August 2015
    • Fungal skin infection – scalp. NICE Clinical Knowledge Summaries. cks.nice.org.uk, published September 2014
    • Fungal nail infections. PatientPlus. www.patient.info/patientplus, reviewed 12 October 2015
    • Tinea pedis. The Merck Manuals. www.msdmanuals.com, published March 2013
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    Reviewed by Rachael Mayfield-Blake, Bupa Health Content Team, December 2015.

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