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What are fungal skin infections?

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Think of them as really tiny mushrooms. Well, not quite. But the same group of organisms that mushrooms belong to causes fungal skin conditions. Only don’t expect tasty truffles or shitakes any time soon. Also known as: Jock Itch, Athlete’s Foot, Ringworm, Tinea pedis, Tinea cruris, Tinea captis, Tinea corporis, Tinea uguium, Tinea versicolor. Unfortunately, you don’t have to be a jock to get jock itch, or an athlete to get athlete’s foot. Almost everyone will have a fungal skin condition at some point in his or her life. From your head to your toes, fungi will thrive in pretty much any warm moist area on (and sometimes, in) your body. A number of very common skin ailments are caused by fungal infections. In most cases, and in most people, they amount to little more than a frustrating irritant. A fungal infection can be embarrassing (what would you call constantly scratching your crotch in public?), humiliating and in some rare situations, a serious health concern. It is important that you treat any fungal condition promptly because without treatment, it will worsen and may become chronic and much more difficult to deal with and cure. If you have a healthy immune system, you will probably be able to treat yourself in about a month. Tinea is the medical term used to describe a number of mold-like fungi, together known as dermatophytes. These organisms live off of dead tissues on the skin and on any structures that grow out of the skin including your nails and hair. The species of fungus affecting you can be different from somebody else displaying the same symptoms. For example, Trichophyton tonsurans is the name of the fungus that currently causes over 90 percent of cases of ringworm in North and Central America. The other 10 percent can be other species of Trichophyton and Microsporum, but will display identical symptoms. Luckily, you don’t need to identify the exact type of dermatophyte infecting you because they all will probably respond similarly to treatment.

A second qualifying term is used to describe where on the body the infection is occurring, not the actual fungus that is infecting you. For example, tinea pedis is athlete’s foot (from Latin ‘pedis’ for ‘foot’) while tinea captis is ringworm when it appears on the scalp.

Tinea infections can sometimes be confused with yeast-like fungal infections such as Candida. A physician can usually distinguish the two. If not, a simple skin biopsy and lab test can tell you what you have.

What are the symptoms of fungal skin infections?

The signs of tinea vary depending on the area of the body affected. However, they do have several symptoms in common: itching, redness of the skin and sometimes a circular patchy area that spreads while clearing at the center. This spreading can cause rings to appear. The symptoms displayed vary from person to person.

  • Athlete’s foot (tinea pedis) causes intense itching on the feet, particularly between the toes (often between the two littlest piggies). More advanced cases can cause the skin to become thick, white and scaly. The infection can spread to the nails, even destroying the nail plate.
  • Jock itch (tinea cruris) can cause the skin to have a whitish appearance. It also usually causes intense itching around the pubic area, but rarely on the scrotum and penis. Skin can also become inflamed, or a rash can occur. Jock itch can spread to the anal region, causing a nasty case of anal pruritus.
  • Ringworm on the scalp (tinea capitis) is characterized by patchy discolored areas on your head, with dandruff-like scaling and hair loss with broken stubbles of hair where the shafts have broken at their base (“black dot ringworm”). Sometimes a swollen, inflamed area (called a “kerion”) can occur.
  • Ringworm on the body and nails (tinea corporis and tinea uguium) can occur on any part of the body, but particularly on the limbs. On palms, the only indication can be a reddening of the skin. On the soles of the feet, the redness may be accompanied by deep-seated blisters, which over time may dry up and become brown crusts. Nails can turn thick and white, warp in shape and eventually crumble if untreated.
  • Tinea versicolor commonly causes a patchy discoloration of the skin, confined to the shoulders and upper torso.

How are fungal skin infections acquired?

The fungi that cause the various forms of Tinea are extremely common and we probably come in contact with them on a daily basis. They are contagious but how they are transmitted from person to person is not well understood. The fungi can be transmitted in public areas that are warm and moist — including gym showers, saunas and locker rooms. Soil and juvenile animals may also transmit fungi.

The spores that carry the fungus can be passed through direct person-to-person contact as well as through shared clothing, towels, combs and bedding.

For people with robust immune systems, symptoms usually only appear when you give the fungus a chance to grow by not thoroughly drying potential areas of infection after showering, sweating or other contact with water. Continual use of unventilated footwear (such as tennis shoes), particularly when wet socks are not changed provides an ideal location for the fungus to flourish.

How are fungal skin infections treated?

In most cases, while the condition is still mild or superficial, treatment is relatively easy with the help of antifungal ointments, shampoos, and creams. The most effective are those containing miconazole (Micatin). Other common over-the-counter remedies include tolnaftate (Aftate, Tinactin), clotrimazole (Desenex, Cruex), and terbinafine (Lamisil). Black walnut extract from your local health food store has natural anti-fungal properties, but it will probably not be as fast and effective as the drugs.

In chronic or extensive cases, intervention by a dermatologist may be required. Treatment may then involve prescription tablets or creams often containing ketoconazole or sulconazole. However, the old adage about an ounce of prevention is well advised in this case. Contrary to popular belief, chances are that wearing open footwear (sandals, thongs) in public showers won’t prevent the spread of the fungus: fungal spores are microscopic and are easily carried in water as it splashes around. Unless you are going to cover your feet completely, you’ll probably be exposed with or without those faaaabulous Prada flip-flops.

How can I prevent fungal skin infections?

In many cases, conscientious attention to good drying habits will prevent an occurrence or reoccurrence of these fungal parasites. Here are some tips to follow:

Make sure that you shower after any athletic activity or on very hot days when you have been sweating.

  • Do not put on socks, underwear or other clothes that are damp or wet from perspiration. Make sure that after showering you put on a clean, dry set of clothing.
  • Thoroughly dry yourself after exercise and showers. Pay particular attention to areas where the skin folds between the toes, the groin, armpits and between your fingers. Using a blow dryer can be helpful.
  • Loose fitting clothes in the summer and in situations where you sweat will help lessen the wetness of the skin and the conditions in which tinea thrive.

Of particular concern to people with compromised immune systems:

In people with compromised immune systems, fungal skin infections can be more widespread and more difficult to get rid of. However, in most cases, the over-the-counter remedies will work just fine. Since the fungal spores can live on (or in) your skin for a very long time without causing any symptoms, there can be little relationship between the time that you were exposed and the onset of symptoms. Because the fungi can be passed through direct contact, sex is (from the fungus’ point of view) a good place to be to hop to a new victim. However, this is no more dangerous than from any other source. Also, unless you provide them with a good place to grow, chances are they won’t take hold. Being the considerate person that you are, you might want to advise your partner if you have a fungal skin condition, so that you don’t rub it in their face (literally).

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