Fungal Infection
About Fungal Infection: A fungal infection, also called mycosis, is a skin disease caused by a fungus. There are millions of species of fungi. They live in the dirt, on plants, on household surfaces, and on your skin. Sometimes, they can lead to skin problems like rashes or bumps.
Fungal Infection Symptoms - A fungal skin infection might cause:
- Irritation
- Scaly skin
- Redness
- Itching
- Swelling
- Blisters
Types of Fungal Infections: Fungal skin infections can happen anywhere on your body. Some of the most common are
- Athlete's foot
- Jock itch
- Ringworm
- Yeast infections
Athlete's Foot: Picture of Ringworm of the Foot (Tinea Pedis) Athlete's foot, also called tinea pedis, is a fungal infection of your foot.
The fungi grow best in warm, moist places such as shoes, socks, swimming pools, locker rooms, and public showers. They’re often found in the summer and in hot, humid climates. It happens more often in people who wear tight shoes, who don’t change their sweaty socks, and who use public baths and pools.
Athlete's foot causes: The fungi behind athlete’s foot live on the dead tissue of your hair, toenails, and outer skin layers. At least four kinds of fungus can cause the infection. The most common is Trichophyton rubrum.
Athlete's foot symptoms - Signs of athlete's foot vary from person to person. You might have:
- Peeling, cracking, and scaly feet
- Blisters
- Skin that’s red, softened, or broken down
- Itching
- Burning
Types of athlete's foot - Interdigital. This is also called toe web infection. Most people with athlete’s foot have this form. It usually occurs between your two smallest toes. The infection can spread to the sole of your foot.
Moccasin. This form can begin with irritation, dryness, itching, or scaly skin. Over time, your skin may thicken and crack. This infection can involve your entire sole and extend onto the sides of your foot.
Vesicular. This is the rarest kind of athlete's foot. It usually begins with a sudden outbreak of fluid-filled blisters, often on the underside of your foot. They also can appear between your toes, on your heel, or on top of your foot.
Diagnosis of athlete's foot: In some cases, your doctor may be able to diagnose athlete's foot simply by looking at it. To help confirm the diagnosis and rule out other conditions, your doctor might take a skin scraping or skin sample from your foot for testing in a lab.
Treatment of athlete's foot: If your athlete's foot is mild, your doctor may suggest using an over-the-counter antifungal ointment, cream, powder or spray.
If your athlete's foot doesn't respond, you may need a prescription-strength medication to apply to your feet. Severe infections may require antifungal pills that you take by mouth.
Jock itch (tinea cruris) is a fungal infection that causes a red and itchy rash in warm and moist areas of the body. The rash often affects the groin and inner thighs and may be shaped like a ring. Jock itch gets its name because it's common in athletes. It's also common in people who sweat a lot or who are overweight.
It’s a common problem for male athletes, which is how it got its name. But you don’t have to play a sport or be a guy to get it.
Jock Itch Symptoms: It’s typically found on your groin, inner thighs, or anus.
Symptoms include:
- Itching and burning
- A red, scaly, circular rash with raised edges
- Cracking, flaking, or peeling skin
Jock Itch Risk Factors
- You might get jock itch if you:
- Wear tight clothes that irritate your skin
- Have moisture in your groin area from sweating
- Wear a wet bathing suit for a long time
- Share damp towels or sweaty clothing with other people
- Have close contact with someone who has jock itch
- Are overweight
- Have a weakened immune system or diabetes
Jock Itch Diagnosis: Your doctor may be able to diagnose it by looking at the skin rash and hearing about your symptoms. Rarely, they might take a sample of skin so a technician can look at it under a microscope.
Jock Itch Treatment: If you don’t treat jock itch, it can last months. But over-the-counter medicines called antifungals can usually clear it up in a few weeks. They’re available in creams, powders, and sprays.
Keep the area clean and dry. Take these steps for faster healing:
- Wash the area and then dry using a clean towel.
- Use a different towel on the rest of your body.
- Read the medicine label, and apply the medicine as directed.
- Use it for as long as recommended; the infection may come back if you stop sooner.
Talk to your doctor if you aren’t feeling better in a couple of weeks. You might need stronger medicine.
Jock Itch Prevention
Good habits can lower your risk of getting jock itch:
- Bathe - Shower or take a bath daily and again after playing sports or working out.
- Stay dry - Pat your groin area dry with a clean towel. Ask your doctor about using an antifungal powder.
- Don’t share - Don’t let others use your towels or other personal items.
- Wear clean clothes - Wash workout clothes or sports uniforms after each use. Change your underwear every day, or more often if you sweat a lot. Make sure athletic supporters and cups are clean.
Other fungal infections, like athlete’s foot (tinea pedis), can also spread to your groin and cause jock itch.
Take these steps to avoid that:
- Treat the infection with an antifungal medicine for athlete’s foot.
- Use a separate towel to dry your feet, or dry your groin before your feet.
- Put on socks before you put on underwear so it doesn’t touch your bare feet.
What is ringworm?
Ringworm, also known as dermatophytosis, dermatophyte infection, or tinea, is a fungal infection of the skin.
“Ringworm” is a misnomer, since a fungus, not a worm, causes the infection. The lesion caused by this infection resembles a worm in the shape of a ring — hence the name.
Ringworm is usually specifically used to describe tinea corporis (ringworm of the body), although it can sometimes be used to describe tinea infection in other locations, such as tinea cruris (ringworm of the groin).
Ringworm infection can affect both humans and animals. The infection initially appears as red patches on affected areas of the skin and later may spread to other parts of the body. It may affect the scalp, feet, nails, groin, beard, or other areas.
Recognizing ringworm symptoms: Symptoms vary depending on where you’re infected. With a skin infection, you may experience the following:
- Red, itchy, or scaly patches, or raised areas of skin called plaques
- Patches that develop blisters or pustules
- Patches that may be redder on the outside edges or resemble a ring
- Patches with edges that are defined and raised
If you’re experiencing dermatophytosis in your nails, they may become thicker or discolored, or they may begin to crack. This is called dermatophytic onychomycosis, or tinea unguium. If your scalp is affected, the hair around it may break or fall off, and bald patches may develop. The medical term for this is tinea capitis. Find out more about scalp ringworm and its effects.
Causes of ringworm:
Three different types of fungi can cause ringworm: Trichophyton, Microsporum, and Epidermophyton. It’s possible that these fungi may live for an extended period as spores in soil. Humans and animals can contract ringworm after direct contact with this soil.
The infection can also spread through contact with infected animals or humans. The infection is commonly spread among children and by sharing items harboring the fungus.
Different types of fungi cause ringworm. Doctors call ringworm different names depending on where it affects the body:
- Ringworm of the scalp (tinea capitis) often starts as isolated scaling in the scalp that develops into itchy, scaly bald patches. It’s most common among children.
- Ringworm of the body (tinea corporis) often appears as patches with the characteristic round ring shape.
- Jock itch (tinea cruris) refers to ringworm infection of the skin around the groin, inner thighs, and buttocks. It’s most common in men and adolescent boys.
- Athlete’s foot (tinea pedis) is the common name for ringworm infection of the foot. It’s frequently seen in people who go barefoot in public places where the infection can spread, such as locker rooms, showers, and swimming pools.
Getting a ringworm diagnosis: Your doctor will diagnose ringworm by examining your skin and possibly using a black light to view your skin in the affected area. Depending on the type of fungus, it may sometimes fluoresce (glow) under black light.
Your doctor may confirm a suspected diagnosis of ringworm by requesting certain tests:
- If you’re getting either a skin biopsy or fungal culture, your doctor will take a sample of your skin or discharge from a blister and send it to a lab to test it for the presence of fungus.
- If you’re getting a KOH exam, your doctor will scrape off a small area of infected skin onto a slide and place drops of a liquid called potassium hydroxide (KOH) on it. The KOH breaks apart normal skin cells, making the fungal elements easier to see under a microscope.
Ringworm treatment: Your doctor may recommend both medications and lifestyle adjustments to treat ringworm.
Your doctor may prescribe various medications depending on the severity of your ringworm infection. Jock itch, athlete’s foot, and ringworm of the body can all be treated with topical medications, such as antifungal creams, ointments, gels, or sprays.
Ringworm of the scalp or nails may require prescription-strength oral medications such as griseofulvin (Gris-PEG) or terbinafine.
Over-the-counter (OTC) medications and antifungal skin creams may be recommended for use as well. These products may contain clotrimazole, miconazole, terbinafine, or other related ingredients.
Lifestyle adjustments: In addition to prescription and OTC medication, your doctor may recommend that you care for your infection at home by:
- Washing bedding and clothes daily during an infection to help disinfect your surroundings
- Drying areas thoroughly after bathing
- Wearing loose clothing in affected areas
- Treating all infected areas (not treating tinea pedis can lead to recurrence of tinea cruris)
Ringworm home remedies: People have used home remedies for ringworm for many years before researchers invented antifungal treatments. Support for use of these remedies is mostly anecdotal. There is no scientific data to support their use over OTC antifungals.
These treatments include:
Apple cider vinegar: Some people apply apple cider vinegar-soaked cotton balls over affected areas of skin three times a day to treat ringworm.
Coconut oil: Coconut oil isn’t just for cooking — people apply it to their skin to reduce the incidence of ringworm infections. If you want to try this remedy, apply coconut oil one to three times a day.
Turmeric: Turmeric is a spice you can mix with water to make an antifungal paste. Apply the paste directly to your skin and allow it to dry.
A caution about home remedies: Home remedies shouldn’t be used in place of known antifungal treatments. Instead, discuss any you might like to try alongside proven treatments with your doctor
Ringworm stages: You won’t see ringworm right away when the fungus has infected you. It can take up to 2 weeks before you start noticing symptoms. Some of the stages you may see include:
- Initial stage - During this stage, you may notice a pink or red irritated patch of skin. Sometimes, it just appears very dry and scaly — not necessarily like ringworm.
- Second stage - During this stage, you’ll notice the lesion starts to grow in size. The center of the rash may resemble healthy skin with a surrounding scaly area.
Because ringworm is so contagious, you’ll want to start treatment at the first signs you notice. If you don’t, it may spread and grow.
Is ringworm contagious?
Anyone can develop ringworm. However, the infection is very common among children and people who own cats or dogs. Both cats and dogs can catch ringworm, and then pass it on to humans who touch them.
Signs to be aware of in pets include:
- hairless patches of skin that appear circular
- crusty or scaly patches
- patches that may not be completely hairless but have brittle or broken hairs
- opaque or whitish areas around the claws
If you suspect your pet has ringworm, bring them to your veterinarian to have them looked at.
You may be more likely to develop dermatophytosis if you come into contact with the fungi when your skin becomes soft and wet from prolonged water exposure (macerated) or if you have minor skin injuries or abrasions. Using a public shower or public pool may also expose you to the infective fungi.
If you’re often barefoot, you may develop ringworm of the feet (athlete’s foot). Those who often share items such as hair brushes or unwashed clothing also have an increased risk of developing the infection.
Ringworm vs. eczema: Ringworm can closely resemble another condition, nummular eczema. Doctors also call nummular eczema discoid eczema or nummular dermatitis.
What’s similar between the two conditions is they both cause round or coin-shaped lesions on the skin. The lesions are often itchy and scaly.
A person with ringworm usually has fewer ring-like patches than a person who has nummular eczema. Also, nummular eczema usually doesn’t have clearing in the center, while ringworm does.
Ringworm may also have pustules associated with it, while nummular eczema doesn’t.
Sometimes the two conditions look so much alike that the only way to tell the difference is to see your doctor. A doctor can take samples of the skin cells and send them to a laboratory for testing.
Doctors treat nummular eczema in different ways from ringworm. They use topical steroids, which if used for ringworm infections, can mask as well as worsen the infection. Antifungal ointments won’t help nummular eczema.
Ringworm essential oils: Essential oils are highly concentrated extracts from flowers, herbs, and other plant types. Often, people purchase these oils and dilute them with a carrier oil, such as olive oil or coconut oil, before applying to their skin.
There is no scientific data to support the routine use of essential oils in treating antifungal infections like ringworm, only anecdotal evidence. Essential oils should be discussed with your doctor before use and shouldn’t replace conventional treatments.
Some of the essentials oils people use to treat ringworm include:
Oregano oil: Oregano oil is potent and can potentially act as an antifungal. You can purchase oregano oil as an extract, but don’t apply it directly to your skin as is. You’ll need to mix it with coconut or olive oil to slightly dilute it first.
These are just some examples of essential oils used to relieve ringworm symptoms.
Ringworm vs. psoriasis: Psoriasis is another skin condition that can sometimes resemble ringworm. Plaque psoriasis is a disorder due to immune dysfunction that produces inflammatory plaques on the skin. It appears as pink plaques with heavy white scales. Small isolated plaques can sometimes look similar to ringworm.
Both ringworm and psoriasis can cause red patches of skin as well as skin itching and scaling.
However, ringworm on your trunk or limbs (tinea corporis) will usually have a circular appearance with clearing in the middle. It will also usually be an isolated spot (or limited to only a few lesions).
Plaque psoriasis skin lesions are usually larger, involve more areas of the skin, and occur in distinct locations (lower back, elbows, knees). Psoriasis lesions also don’t have clearing (normal-appearing skin) in the middle of its lesions.
The conditions have different underlying causes as well. A fungus causes ringworm, while a dysfunctional immune system causes psoriasis
Ringworm left untreated: If left untreated, ringworm can spread to other areas of the body. A person can also risk spreading the infection to someone else. Other potential areas of complication include:
- Hair loss and scarring
- Nail deformities
The complications of tinea capitis (ringworm of the scalp) are especially worrisome, since it can produce life-long permanent hair loss. When considering these potential complications, it’s best to treat ringworm as quickly as possible.
Preventing ringworm: Practicing healthy and hygienic behaviors can prevent ringworm. Infections may come from contact with animals and lack of proper hygiene. Here are several tips to avoid ringworm:
- Wash your hands after interacting with an animal.
- Disinfect and clean pet living areas.
- Avoid people or animals with ringworm if you have a weakened immune system.
- Wear shoes if showering or walking in community areas.
- Avoid sharing personal items like clothing or hair brushes with people who might have ringworm.
- Keep your skin clean and dry.
Ringworm during pregnancy: If you get ringworm during pregnancy, there are medications you can use to destroy ringworm-causing fungi that aren’t known to cause any problems to a baby. Examples of these drugs (fine to use when applied topically) include:
- Ciclopirox (Loprox)
- Clotrimazole (Lotrimin)
- Naftifine (Naftin)
- Oxiconazole (Oxistat)
- Terbinafine
However, it’s always best to talk to your doctor before using any medications while pregnant. Most medications can’t be properly studied in pregnant women due to the ethical implications of these studies. So it’s nearly impossible to say with full certainty that a medication, whether topical or oral, will be safe to use.
As well, you should talk to your doctor before using any medications if you are breastfeeding.
Doctors don’t recommend taking some medicines because they have the potential to cause known unwanted side effects. Examples include:
- Oral ketoconazole
- Oral miconazole
Doctors don’t usually recommend taking oral medications to treat fungal infections during pregnancy.
Regardless of the medication of choice, if you’re pregnant and have ringworm, it’s best to ask your doctor first before using any kind of medication or home remedy to treat your condition.
Ringworm from dogs: You can get ringworm from your dog. Dogs can pick up fungus spores from the environment, and the spores get left behind on whatever the dog’s hair touches. Examples include:
- Bedding
- Carpeting
- Clothing
- Dog brushes
- Food bowls
Watch your dog regularly for signs that they may have ringworm. They will usually have a loss of fur on their skin, often in a circular pattern. If you observe this, contact your dog’s veterinarian.
You should also wash your hands frequently after petting your dog to reduce infection risk whenever possible.
Ringworm from cats: According to the American Kennel Club, cats are more prone to getting ringworm than dogs are. They can pass the condition along to their human owners as well.
Like ringworm in dogs, if you spot ringworm in cats, call the veterinarian. They can prescribe antifungal treatments. You should also always wash your hands after petting your cat and try to clean all of the items they come in contact with, such as brushes and water bowls.
If you do get ringworm from your cat, you can treat it the same as you would any fungal infection. This includes topical antifungals.
Outlook: Skin medications may clear ringworm on your trunk and limbs in 2 to 4 weeks.
If you’re experiencing severe dermatophytosis that isn’t responding to OTC treatments or treatment at home, or you suspect tinea infection of the scalp or hair follicles, your doctor may prescribe antifungal pills to clear up the infection.
Most people respond positively to treatment.
Yeast infection: Candidiasis is an infection caused by a yeast (a type of fungus) called Candida. Candida normally lives inside the body (in places such as the mouth, throat, gut, and vagina) and on skin without causing any problems. Sometimes Candida can multiply and cause an infection if the environment inside the vagina changes in a way that encourages its growth. Candidiasis in the vagina is commonly called a “vaginal yeast infection.” Other names for this infection are “vaginal candidiasis,” “vulvovaginal candidiasis,” or “candidal vaginitis.”
Symptoms: The symptoms of vaginal candidiasis include:
- Vaginal itching or soreness
- Pain during sexual intercourse
- Pain or discomfort when urinating
- Abnormal vaginal discharge
Although most vaginal candidiasis is mild, some women can develop severe infections involving redness, swelling, and cracks in the wall of the vagina.
Contact your healthcare provider if you have any of these symptoms. These symptoms are similar to those of other types of vaginal infections, which are treated with different types of medicines. A healthcare provider can tell you if you have vaginal candidiasis and how to treat it.
Risk & Prevention:
Who gets vaginal candidiasis?
Vaginal candidiasis is common, though more research is needed to understand how many women are affected. Women who are more likely to get vaginal candidiasis include those who:
- Are pregnant
- Use hormonal contraceptives (for example, birth control pills)
- Have diabetes
- Have a weakened immune system (for example, due to HIV infection or medicines that weaken the immune system, such as steroids and chemotherapy)
- Are taking or have recently taken antibiotics
How can I prevent vaginal candidiasis?
Wearing cotton underwear might help reduce the chances of getting a yeast infection. Because taking antibiotics can lead to vaginal candidiasis, take these medicines only when prescribed and exactly as your healthcare provider tells you. Learn more about when antibiotics work and when they should be avoided.
Sources: Scientists estimate that about 20% of women normally have Candida in the vagina without having any symptoms.2 Sometimes, Candida can multiply and cause an infection if the environment inside the vagina changes in a way that encourages its growth. This can happen because of hormones, medicines, or changes in the immune system.
Diagnosis & Testing: Healthcare providers usually diagnose vaginal candidiasis by taking a small sample of vaginal discharge to be examined under a microscope in the medical office or sent to a laboratory for a fungal culture. However, a positive fungal culture does not always mean that Candida is causing symptoms because some women can have Candida in the vagina without having any symptoms.
Treatment: Vaginal candidiasis is usually treated with antifungal medicine. For most infections, the treatment is an antifungal medicine applied inside the vagina or a single dose of fluconazole taken by mouth. Other treatments may be needed for infections that are more severe, that don’t get better, or that keep coming back after getting better. These treatments include more doses of fluconazole taken by mouth or other medicines applied inside the vagina, such as boric acid, nystatin, or flucytosine.
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