Skin fungus infections can be difficult to identify. The itching, flaking, redness, and thickened skin of fungal infections can look just like other types of dermatitis or skin allergies. In fact, eczematous skin often becomes infected with fungi, so both are present simultaneously.
Doctors use microscopes to help them diagnose skin fungus infections, but there’s no way you can really be sure you’re making an accurate diagnosis at home. This Self-Care Advisory will focus on the five most easily recognized fungus infections of the skin, but even after looking at the pictures don’t be too confident. If the recommended treatment doesn’t work after two weeks, see your doctor.
Athlete’s Foot (tinea pedis). Every year, over 10% of the U.S. population develops this problem. Probably 75% of us will have athlete’s foot at some time in our lives. It commonly occurs between the third, fourth, and fifth toes; sometimes it spreads to the sole of the foot. Between the toes, your skin becomes white, moist and easily rubbed off; the tops of the toes may be red, dry, and flaky. Intense itching and burning are the rule. Athlete’s foot usually occurs with hot, moist conditions or if you wear shoes all the time.
Jock Itch (tinea cruris). The same conditions that lead to athlete's foot (heat, moisture and poor ventilation) also cause fungus infections of the groin, like jock itch. As its name implies, intense itching and burning are the usual symptoms. You will also find redness, flaking and peeling on the inner thighs, pubic area, and scrotum.
Ringworm (tinea corpora). This is caused by a microscopic fungus, not a worm. It’s commonly referred to as ringworm, though, because of its ring-like appearance. The infected area spreads out slowly from its central starting point and creates a slightly raised, intensely red ring surrounding a less red, flaky, itchy area. Over weeks, the ring slowly enlarges. It can occur anywhere on the body and in multiple sites at once, so it’s often confused with other kinds of dermatitis.
Candidiasis (candida albicans). This brownish-red, itchy discoloration affects the underarms, corners of the mouth, rectal area, and beneath the breasts. The same type of fungus causes vaginal yeast infections.
Tinea Versicolor. This fungus actually changes the color of the skin it infects; the patches may be lighter or darker than your normal surrounding skin. This spotted pattern and the fine scaly flakes at the margins make this fungal infection the easiest to identify. Since itching and irritation are mild, it’s also the least bothersome in that regard, though the appearance does disturb some people.
Warmth, humidity, sweating, and poor air circulation all help bring about these fungal infections. But they are contagious, too. Athlete’s foot is believed to be passed on locker room and shower floors, and by sharing footwear and socks; you can acquire tinea versicolor from vinyl surfaces of weight lifting benches; and of course ringworm is contagious through direct contact (usually with kids).
Because of all these factors, prevention is a matter of both personal hygiene and minimizing contact with potential carriers or contaminated objects. See the chart below for guidelines on prevention.
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There are several effective OTC anti-fungal medications. Because different fungi affect different locations, medications are sometimes specific for those locations. The recommendations below should help you sort it out.
Athlete’s Foot - Tolnaftate is the only OTC medicine approved for both prevention and treatment of athlete’s foot. Be patient, though. It could take a month or more of daily treatment for it to completely clear. Consider preventive use if the condition recurs.
Tinea Versicolor - Although not a Category I agent, selenium sulfide shampoo is universally recognized by dermatologists as an effective OTC remedy for tinea versicolor. Since it often affects large areas of the trunk, applying this shampoo once a day for five minutes, then washing off, is a lot easier and cheaper than using a whole tube of anti-fungal cream twice daily. Tinea versicolor also tends to recur easily, but this shampoo can prevent it if used once a week after the initial 2-4 week treatment cycle.
Candidiasis, Ringworm, and Jock Itch - Miconazole or clotrimazole are effective in just 1-2 weeks for each one of these conditions and come in creams, lotions and sprays. Avoid alcohol-based products since they can sting chafed and delicate skin.
There are situations where self-treatment of fungus infections is inappropriate:
As mentioned before in Basics, many different skin conditions mimic the appearance of fungal infections. If following the treatment guidelines above with appropriate medications doesn’t resolve the suspected fungal infection, have a doctor evaluate your rash. Examination and further testing may reveal something completely unexpected.