Breast Fungus

What is a breast fungus?

A breast fungus is a skin infection over or under the breast. This infection may be isolated to the breast, spread elsewhere on the trunk and surrounding regions or even occur in isolated spots on various sites. A breast fungus is one of the more common types of fungal infections that mainly arises in women, especially women with larger busts.

However, it is often under-reported due to embarrassment about the condition or diagnosed along with a fungal infection elsewhere and there is usually no specific focus on the breast area. Fungal infections of the breast are superficial infection meaning that it only involves the outermost layers of the skin.

Breast Fungus Medical Names

There are two medical terms that refers to a breast fungus :

  1. Tinea mammae which is a rarely used term to describe a dermatophyte infection of the skin of the breast.
  2. Submammary candidiasis which is an yeast infection under the breast. Another term that may be used is intertriginous candidiasis as it is the area under the breast which is more likely to become peeled and raw due to chaffing (intertrigo) thereby allowing for naturally occurring yeasts on the skin to infect the area. This is also known as cutaneous candidiasis (skin thrush).

Breast Fungus Meaning

A breast fungus simply means that the skin on or under the breast is infected with a fungus. Fungal infections of the skin are not uncommon. In fact fungal infections are one of the most common type of skin infections globally. Many common skin problems like athlete’s foot (tinea pedis), jock itch (tinea cruris) and some types of scalp dandruff (tinea capitis) are fungal infections of the skin. It is not usually a life threatening ailment as it is restricted to the superficial layers of the skin. The infections can persist for months or years where it causes severe discomfort and scarring. Sometimes the area may become infected with bacteria (secondary bacterial infection) which needs to be quickly treated to prevent complications.

Fungi, the plural of fungus, are small microorganisms that mainly live off dead material. The outer layers of the skin are made of dead skin cells. Usually the skin is resistant to fungi but once the skin barrier is broken, a fungal infection can quickly set in. Some types of fungi naturally occur on human skin but are kept in check by various factors which play a role in preventing infection. It is usually the skin on the areas of the body that are shielded from light and moist that are more likely to encourage fungal growth.

The ideal living conditions for fungi is one that is warm, dark and moist. The breasts being covered through most of life, and especially the folds which are warm and moist, are more likely to encourage fungal growth. These are the main reasons it occurs in women with bigger busts. Furthermore, a bigger bust is more likely to be prone to chaffing and injury is often easier when tight fitting brassieres are used that may cut into the skin over time.

Breast Fungus Causes

Types of Fungi

A breast fungus can be caused by various fungi. Two types of fungal infections that commonly involve the chest and may therefore involve the breasts includes tinea versicolor and tinea corporis. Tinea versicolor is an yeast infection caused by a group of yeasts known as Malassezia. The two most common types of Malassezia involved in tinea versicolor are Malassezia furfur and Malassezia globosa. Tinea corporis is a dermatophyte infection (ringworm) caused by the Trichophyton species of fungi, and most commonly by Trichophyton rubrum. It is also caused by a fungus known as Microsporum canis which is spread from cats and dogs. However, a breast fungus is most often due to an infection with the Candida species of yeasts.

Breast Candida (Thrush)

Candida is from a group of fungi known as yeasts. There are many different types of Candida yeasts but the most common is Candida albicans. These types of yeasts are known to cause infections such as vaginal candidiasis (thrush in women) or oral candidiasis (thrush in the mouth). The human skin is constantly exposed to Candida yeasts but is not infected. It is once there is a break in the skin and the existence of ideal living conditions for the fungi to thrive in, such as darkness, moisture and warmth, that the fungi will infect the skin. It usually does not extend beyond the superficial layers of the skin unless a person has a deficient immune system as is seen with HIV/AIDS and uncontrolled diabetes mellitus.

Breast Fungus Risks

Women are more at risk due to the difference in the breast size compared to males. Although men may have fungal infections of the chest that also involves the breast area, they do not develop conditions such as submammary candidiasis. This is largely due to the fact that there are no folds with chaffing as the skin of the breast rubs against the skin of the chest wall just underneath it. However, men with gynecomastia where the breasts are abnormally large and developed may be at risk.

Factors that increase the risk of developing a breast fungus includes :

  • Larger busts.
  • Wearing bras that are too tight or poorly designed.
  • Living in a hot and humid environment.
  • Skin irritation from the textiles used to make certain brassieres.
  • Injury to the skin on or under the breast.
  • Other skin diseases on or under the breast such as atopic dermatitis or psoriasis.
  • Constantly rubbing or scratching the breasts.
  • Irritants and abrasives like talcum powder applied on or under the breast.
  • Deficient immune system like with HIV and uncontrolled diabetes mellitus.
  • Excessive sweating (hyperhidrosis).

Breast Fungus Symptoms

The symptoms of a breast fungus largely depend on the severity and duration of the skin condition. Location and type of fungus involved in the infection can also play a role in the symptoms.

Fungus on the Breast

The symptoms of a fungal infection on the breast are similar to the symptoms of tinea versicolor and tinea corporis. This includes :

  • Dry itchy skin rash.
  • Redness of the skin.
  • Cracking, peeling or flaking skin.
  • Patches of pink, brown or whitish scales or skin discoloration.
  • Tiny pustules which may be oozing.

Fungus under the Breast

The symptoms of a fungal infection are largely due to the clinical presentation of submammary candidiasis.

  • Itching under the breast.
  • Redness of the skin.
  • Tiny cuts or abrasions on the skin.
  • Moisture with a slightly musty and foul odor.
  • Darkening of the skin (hyperpigmentation) over a period of time.
  • Peeling of the skin.
  • Skin colored or dark brown to black speckles when scratching.
  • Tiny pustules oozing a foul smelling thick fluid.

Breast Fungus Diagnosis

A breast fungus can be diagnosed by the clinical examination along with the patient’s medical history. Further testing may be done to confirm the diagnosis. The main test requires the collection of a skin sample, through skin scrapings, and examining it under a microscope with a potassium hydroxide (KOH) mount. Fluid from a pustule or flaking skin can be used for a culture to confirm the type of microorganism involved in the infection.

Breast Fungus Complications

The fungal infection can spread over time. However, these are superficial infections of the skin and usually do not extend deeper into the body.

Bacterial Infections

One of the main complications is a secondary bacterial infection. This tends to occur with excessive scratching which creates tiny abrasions on the skin surface. Although bacteria from the skin can then infect the area, it is bacteria carried to the site by the fingers and on the clothes and underwear that may cause more severe infections. This can have dire consequences unless the infection is treated quickly.

Darkening of the Skin

Prolonged fungal infections and constant scratching can cause darkening of the skin at the affected area. This hyperpigmentation is common in chronic fungal infections of the skin. It is almost always permanent although the darkening may lighten slightly once the infection is treated and the patient stops repeatedly scratching the area.

Breast Fungus Treatment

The main approach to treatment is topical antifungals in the form of creams and ointments as well as a powder. Antifungal topical agents that may be used includes :

  • Nystatin
  • Clotrimazole
  • Miconazole

A corticosteroid cream may be considered if the symptoms such as itchiness and a rash are severe and not resolving. However, these creams should only be used for a short period of time. If a bacterial infection is present, then it should be treated first with antibacterial creams and antibiotics.

Oral antifungals in the form of tablets and capsules are rarely used for this type of fungal infection. In severe cases and where the infection is extensive, the following oral antifungals may be used :

  • Fluconazole
  • Itraconazole

Breast Fungus Prevention

One of the key measures to preventing a fungal infection on or under the breast is to treat intertrigo (chaffing) at an early stage and prevent it as far as possible. Some of the other measures to consider once the fungal infection has developed includes :

  • Use appropriately fitting bras that are not too tight or cutting into the skin.
  • Discard all brassieres and other undergarments that are making direct contact with the infected skin as it may contain fungal spores.
  • Try to ventilate the area as often as possible and use light clothing that allows air flow.
  • Do not scratch the area even when itchy as it will create abrasions in the skin which can then be infected.
  • Apply thick layers of petroleum jelly on the affected area at night to prevent injury from scratching during sleep.
  • Keep the area clean with a topical disinfectant. Although it will not eradicate the fungus, it will help to prevent secondary bacterial infections.
  • Avoid using perfumes, deodorants or scented powders on or under the breast.

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