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Fungal skin infections


Expert reviewer, Dr Anton Alexandroff, Consultant Dermatologist
Next review due March 2021

Fungal skin infections are caused by many different types of fungi, including yeasts. They’re quite common, and may be the cause of that itchy rash you’ve had for a while.

We describe some of the most common fungal skin infections and what you can do, with the help of your pharmacist or GP, to treat them. We also talk about ways to lessen the chance that you’ll get them and spread them to others.

Woman sitting on the bed embracing her legs

Types of fungal skin infections

Athlete’s foot

This is a really common infection. It’s thought that around seven in 10 people have athlete’s foot (tinea pedis) at some time in their lives. It’s caused by fungi that grow in the skin between your toes and on the soles of your feet. They grow easily here because of the moisture formed when your feet sweat.

The infection can make the skin between your toes itchy, flaky and red. You may get painful cracks, or fissures, in the skin there. The sole of your foot can also become itchy, thickened and scaly. You might get blisters too.

Athlete's foot
 

You’re more likely to get athlete’s foot if your footwear makes your feet sweaty, and you’re in a warm, humid environment. You can pick up athlete’s foot if you walk barefoot on damp, contaminated floors such as in communal bathing or swimming areas. After scratching the affected area, you can spread the infection, causing athlete’s foot in other parts of your body.

Nail infections

The medical name for a fungal nail infection is onychomycosis. It can affect any part of your nail, and your toenails are much more likely to be affected than your fingernails. Fungal infections of your nail tend to take a long time to develop. They cause your nail to discolour and become rough and crumbly. The surrounding tissue may also get thicker.

Fungal nail infection

Having a fungal nail infection can make you feel uncomfortable about showing your feet, for instance, when swimming, or sharing changing rooms. It can also sometimes become painful and cause problems with standing or exercising.

You’re more likely to get a fungal nail infection if you have other fungal skin infections, such as athlete’s foot.

Ringworm

Despite its name, ringworm is an infection with a fungus, not a worm. Its name comes from the way it often causes a ring-shaped rash. Ringworm infections are very common and can affect different parts of your body.

Ringworm on your body

This usually affects parts of your body that are exposed, such as your arms, legs or trunk, and it causes a red, scaly, 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 cattle carry the fungi that cause ringworm, as well as pets like cats and dogs.

Ringworm in your groin

This is also called ‘jock itch’ and 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 happen if you’re very overweight or often wear tight clothing. Ringworm can cause an itchy, red rash in your groin and around the top of your legs.

You’re most likely to get ringworm in your groin if you have other fungal skin infections of your hands, feet or nails. Like ringworm on your body, ringworm in your groin can spread with close contact and you can pass it on in the same way.

Ringworm on your scalp

You can get this at any age, but it mostly affects children. Ringworm usually appears in patches on your scalp, which are scaly and may itch. In some people the patches become inflamed and red, with pustules forming. 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.

Scalp infection
 

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

Candida (yeast) infections

Candida is a yeast, which means it’s a kind of fungus. It may live harmlessly inside the gastrointestinal tract (gut) and vagina. However, if the conditions are right, candida can multiply and start to cause symptoms of infection. These infections are often around the genitals (vagina and penis), in the mouth or where there are folds of skin. A common name for candida infections is ‘thrush’.

Thrush makes the affected area sore and itchy. The skin is usually red and moist, and small pustules appear. In women, vaginal thrush can cause itchiness and a white discharge. Oral thrush (in the mouth) 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.

Pityriasis versicolor

This is caused by a type of yeast called Malassezia, which usually lives harmlessly on the skin. It typically affects teenagers and young adults. If you have pityriasis versicolor, you may get patches of scaly, mildly itchy and discoloured skin on your back, chest and upper arms. This is usually a pink, brown or red colour. In some cases, the skin becomes paler than the surrounding skin. You may notice this especially after being out in the sun, as the affected area will not tan as much as the rest of your skin.

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. You may notice changes in your skin, hair or nails, which may or may not cause you some discomfort. The fungus can affect just one area, or several areas of your body.

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. With some infections your skin may become red and sore, with pustules. Fungal rashes can sometimes be confused with other skin conditions, such as psoriasis and eczema.

If you get a fungal infection of your scalp, you may lose some hair.

Diagnosis of fungal skin infections

If you see your GP, they’ll 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.

Treatment of fungal skin infections

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. The pharmacist will be able to give you advice. If it gets worse or isn’t helped by over-the-counter medicines, contact your GP.

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 might find it helps to wear loose-fitting clothes made of cotton, or a material that’s designed to keep moisture away from your skin. If you have toenail infections, try to keep your feet dry and your nails short. Wear breathable, well-fitting shoes and cotton socks (which should be changed every day).

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. See our section below on the prevention of fungal skin infections and our FAQ below on athlete’s foot.

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 necessarily need to see your doctor to get a prescription.

Commonly used topical antifungal treatments include the medicines clotrimazole, miconazole or econazole. Your pharmacist will be able to advise on the best treatment for you. 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. Ask them to explain any possible side-effects that the tablets may cause.

It’s important to follow the instructions that come with your medicine, or those your GP gives you. This may include using your treatment for up to two weeks after your symptoms disappear. Be aware that some fungal infections need much longer treatment – for instance up to a year for toenail infections. See our FAQ below on how long it takes to treat a nail infection.

Sometimes your symptoms can return, even if they seem to have cleared up.

Causes of fungal skin infections

There are many different fungi which can cause infections of your skin, hair and nails. These may be spread from person to person, from animals to people or, rarely, to a person from the soil. Some fungal skin infections, like candida (yeast infections), usually come from an overgrowth of your own, previously harmless fungi.

You can pick up fungi which might cause infection if you come into contact with an infected person or animal. That’s why people who play contact sports are more likely to get fungal skin infections. You can also pick up fungi by sharing contaminated items such as clothes, towels, hairbrushes or bedclothes. Walking barefoot in shared showers and pool areas may mean you pick up fungi on your feet.

Fungi like warmth and moisture so you’re more likely to get an infection if you:

  • wear tight clothing, or shoes that don’t let your feet ‘breathe’ in a warm, humid environment
  • are overweight and so have skin folds which rub against each other

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


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.
  • Don’t walk barefoot 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 stop it spreading to others.

Frequently asked questions

  • You may see herbal remedies, such as tea tree oil, being promoted as treatments for some fungal skin infections. Some people choose to use these, but at the moment there isn’t enough scientific evidence to say whether they work or not.

    If you decide to try herbal remedies, 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. Ask your pharmacist if you want to know more about herbal remedies and how they might affect you.

  • Fungal nail infections can take a long time to treat. Treatment doesn’t always work, and it’s not unusual for the infection to come back later.

    If you have a mild fungal nail infection you may be able to treat it with topical medicines applied to the nail. You’ll probably need to use these every day for up to a year. Using topical treatment lets you avoid the possible side-effects you can get with oral treatments (tablets). Follow the instructions that come with your medicine.

    Your doctor may recommend treating fungal nail infections with tablets because this works better than topical treatment. You may need to take the tablets for six to eight weeks for fingernails, or three months for toenails. Your doctor will discuss the possible side-effects with you.

    Treatment with antifungal medicines may get rid of your fungal nail infection. If not, your GP may refer you to a dermatologist (a doctor who specialises in identifying and treating skin conditions) for more treatment.

    It can take between six months to a year after your treatment finishes for your nails to look normal again. Fingernails clear up more quickly than toenails. However, you should be aware that your nails may not return to normal after a fungal infection.

  • If fungal skin infections aren’t treated, they can last a long time. During this time they may:

    • spread to other parts of your body
    • allow bacteria to grow and invade, so causing a bacterial infection
    • cause a bald patch if they’re affecting your scalp
    • be passed to your family and other people

    Fungal nail infections don’t necessarily need treatment. The infection won’t go away on its own, but it won’t usually make you unwell. You may choose to put up with the change in the appearance of your nail and so avoid the possible side-effects of treatment. Treatment takes a long time and isn’t always successful (see our FAQ above on how long it takes to treat nail infections).

    If you don’t treat your fungal nail infection, it may spread to other nails. You may eventually find the nail interferes with walking and you may become embarrassed because of the way your nail looks.

    Your doctor may recommend treatment for your fungal nail infection if:

    • you have a medical condition like diabetes, or a lowered immune system
    • you’re finding it uncomfortable or difficult to walk or exercise
    • the nail infection seems to be causing fungal infection elsewhere on your body

    Ask your doctor to discuss the pros and cons of treating your fungal nail infection.

  • Doctors don’t think so – you’ll probably need to use topical medicines. But there are several good reasons to follow good foot hygiene. 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. And it will help stop the infection spreading to others.

    If you have athlete’s foot, good hygiene includes:

    • drying your feet well after you wash them, especially between your toes
    • alternating your shoes every two or three days
    • wearing a clean pair of cotton socks every day
    • avoiding scratching the skin so you don’t spread the infection to other parts of your body
    • making sure you don’t go barefoot in damp communal areas, such as showers, saunas and swimming pools
    • washing towels frequently, and not sharing them with others


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  • Reviewed by Dr Kristina Routh, Freelance Health Editor, Bupa Health Content Team, March 2018
    Expert reviewer, Dr Anton Alexandroff, Consultant Dermatologist
    Next review due March 2021



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