The conditions that most of us know as “ringworm”, “athlete’s foot”, “white spots” and “sun fungus” all boil down to one root cause – fungus. There are many different types of fungal infections, affecting different parts of the body. These include: Tinea Pedis – Fungus of the feet, also known as athlete’s foot. Tinea Corporis – Fungus of the body. Tinea Cruris – Fungus of the groin area (jock itch). More often in males than females because of scrotal skin folds. Tinea Capitis – Fungus of the scalp. Beware of spreading among family members through sharing of hair accessories and brushes. Tinea Versicolour – This is characterised by white, yellow or brown spots on the skin. These spots do not tan the same way as the rest of the skin, earning them the name “sun fungus”. Onchomycosis – Fungus of the nails. This usually affects toenails more often than fingernails. Oral Candidiasis – Oral thrush, caused by yeast infection in the mouth. This happens more often to young children and older adults. Genital Candiasis – Vaginal and penile thrush. This infection is more common in women, but can occur in men too. It can also be passed through sexual contact, so abstain from having intercourse until the infection has been resolved.
Signs & Symptoms
- Scaly rash, especially in between the toes
- Weeping sores of the feet
- Intense itching
- Red patches with clearly-defined border
- Scaly rash
- Burning itch
- Red or brown patches on groin area, thighs, stomach and buttocks
- Rash has well-demarcated borders
- Skin might peel and crack, and hurt on contact with sweats
- Itching of the scalp
- Brittle hair at site at infection. Could result in loss of hair
- Patches with well-defined borders
- Flaky scalp
- Skin inflammation
- Patches of white, pink or brown spots appear slowly on the skin
- Spots might feel dry and scaly and could itch
- Thickened, discoloured nails
- Separation of nail from nail bed
- Brittle nails
- White sores in the mouth that resemble milk curds. On scrapping off, sores might bleed.
- Painful, bleeding gums
- Cracking at sides of mouth
- Painful tongue
- White, cloudy discharge with consistency similar to that of cottage cheese. This discharge should not have a foul odour. If so, see a doctor.
- Vaginal Itching and burning sensation
When to Seek Medical Attention
- If you are not sure if your condition is due to fungus
- If you experience repeated reinfections despite lifestyle modifications
- If you have lower immune function than normal
- If there is a secondary bacterial infection, with symptoms such as thick discharge, pain, increased swelling
- If you present with severe symptoms that affect your daily life
- If your condition does not improve after over-the-counter options
Fungus is always present on your skin. However, they thrive in moist and warm conditions. Some common species of fungus are
- Candida species
- Malassezia species, which is also implicated in Dandruff
Some factors that can predispose you to fungus are:
- Conditions like obesity, diabetes and having a poorly functioning immune system
- Having wet skin for a period of time, e.g. military enlistment
- Being in a warm, humid environment
- Having superficial injuries to skin or nails
- Sharing personal items such as towels with others
- Steroid, antibiotic or hormonal therapy
The key is preventing fungus is in keeping skin cool and dry. Dry skin thoroughly after bathing, especially in between toes and skin folds. Use a different towel for infected areas to prevent transfer of the fungus to other body parts. Do not share articles of clothing or footwear that came into contact with infected areas. For athlete’s foot, change socks and shoes every day. Rotate shoes to allow thorough drying and airing. Cotton socks can help to keep foot dry. Opt for slippers or sandals whenever possible. When bathing in public baths, wear slippers to prevent spread of infection. For thrush in the genital regions, use cotton underwear and refrain from wearing tight fitting pants. Clean pubic areas and dry thoroughly, but do not use harsh soaps or perfumed products. Women should also avoid douching. If you get fungus in between folds of skin, consider losing weight. Skin folds trap moisture, and are good environments for fungus to thrive in. Avoid contact with unfamiliar animals as fungus can spread from animals to humans. Probiotics could be of use in people to prevent Candida infections, especially after a course of antibiotics.
Castellani paint is used as a drying agent and anti-fungal treatment for mild fungus infections on the skin, nails and foot. Salicylic acid is a keratolytic agent, which means that it is able to soften and remove the top layer of skin. Salicylic acid is often used to aid penetration of other antifungal preparations, especially if the skin of the affected area is hard and thick. Do not use on large areas or on broken skin. Topical antifungal therapies come in the form of creams, powders, lotions or vaginal tablets (pessaries). Some over-the-counter ingredients include miconazole, clotrimazole and terbinafine. Follow the instructions on the packaging carefully as most antifungals creams would require you to continue usage for about two weeks after your symptoms have resolved.
After your fungus infection is better, consider the use of an antifungal powder to prevent reinfection. Onchomycosis is more difficult to treat as the medication applied needs to penetrate into the nail. Clotrimazole or miconazole preparations can be used. If that is not effective for you, a nail lacquer containing amorolfine is available from your pharmacist. In more severe cases, oral medications are available from your doctor.
Steroidal creams such as hydrocortisone can be used to control itch and swelling. However, it must not be used on its own as it can mask symptoms of fungus while allowing further colonisation. Always use steroid creams with antifungal therapy. Miconazole oral gel is available for oral thrush. Because the gel is sticky, do not use on infants younger than 6 months of age, as it could cause choking.
For those who are not suitable for miconazole therapy, a prescription item called nystatin solution can be considered. An oral medication called fluconazole, which comes in a single dose, is available from the pharmacy for treatment of vaginal candiasis. This medication can interact with other drugs, such as cholesterol, blood thinners and pain medications, so be sure to inform your pharmacist or doctor accordingly if you are on other medications or supplements. For severe or persistent fungal infections, see your doctor for an evaluation. If necessary, oral medications might be prescribed.