Fungal infections of the skin are a common problem that may also involve the nails and hair. The reason for this is that fungi which hav a predilection for human skin are abundant in our environment, from objects within the home, to the air, on pets and even in the soil. Most of the time these fungi are transmitted from one person to another, especially when personal items are shared.
Most fungal skin rashes are not considered to be serious because these fungi are limited to the outermost layers of the skin. It does not extend deeper into the skin where it can damage vital organs or cause a widespread infection in the body. Nevertheless, fungal skin rashes can spread to skin elsewhere on the body, lead to permanent discoloration of the skin and even lead to secondary bacterial infections of the skin which can be serious if left untreated.
What is a Fungal Rash?
A fungal rash is irritation, inflammation and damage to the skin caused by an infection with fungi. It is important to note that these are superficial fungal infections. While it is more common, some species of fungi can cause deeper infections in the body, like within cavities (such as the mouth, ears or sinuses), may cause infection of vital organs (like the lungs) or even lead to overgrowths in the gut (as may be seen in immune compromised people). A fungal rash is often referred to as ringworm due to the red ring rash caused by certain fungi (dermatophytes).
Read more on ringworm infections.
Medical Terms and Location
A fungal infection of the skin is referred to as dermatomycosis. However, this term does not describe which part of the body is affected, nor does it describe the type of fungus that causes this skin infection. The following terms are therefore important to know when considering the type of fungal skin infection:
- Dermatophytosis: Fungal skin infection caused by dermatophytes.
- Cutaneous candidiasis: Skin infection caused by Candida species of yeasts.
The following terms specify the location of the fungal skin infection:
- Tinea pedis = foot/feet
- Tinea cruris = groin/genitalia
- Tinea corporis = torso
- Tinea manuum = hand
- Tinea faciei = face
- Tinea barbae = beard area
- Tinea capitis = scalp
Other terms may describe the color of the skin rash, such as:
- Tinea nigra = black fungal rash
- Tinea versicolor = fungal rash of changing color
Causes of Fungal Rash
Of the two types of fungi that may cause a skin infection in humans, dermatophytes are by far the most common. These fungi have a predilection for human skin. It contains enzymes known as keratinases that allow it to digest the outer layer of the skin composed mainly of the protein known as keratin. The fungi can then invade the superifical layers of the skin where it survives and even grows to extend wider areas of the skin.
Skin fungi tend to cause infections on areas of the body that are warm and moist. Dark areas of the body are also more prone. Therefore dermatophyte infections tends to be more common in areas like the feet (tinea pedis, also referred to as athelete’s foot) and the groin (tinea cruris, also referred to as jock itch). There are many different species of dermatophytes but the Trichophyton species, particularly Trichophyton rubrum, tends to be the most common globally.
Yeast infections of the skin are less common. It tends to arise when there is a break in the skin and usually causes deeper infections than dermatophytes. Areas where there are repeated breaks in the skin like with chaffing,in addtion to the warmth, moisture and darkness tend to be more prone to these yeast infections. Most of these yeast infections are caused by the Candida species, particularly Candida albicans. Although these yeasts may be found in certain body cavities, normally the skin has defenses against yeast infections.
Read more on cutaneous candidiasis.
Other Signs and Symptoms
Apart from the fungal rash which can differ in appearance depending on the location and type of fungus, there may also be other signs and symptoms such as:
- Itching of the skin where the rash is located and surrounding skin.
- Tiny pustules in the center of the rash that may ooze a clear fluid when broken.
- Burning and pain, especially when there is a deep skin break or secondary bacterial infection.
- Flecks of skin that may be shed with scratching.
- Dark discoloration of the skin usually seen in long term fungal infections.
What does a fungal rash look like?
A fungal rash caused by dermatophytes is typically a red ring-like skin lesion. This is the reason that a fungal rash is described as a ringworm. The red border may also be spotted with tiny pustules. The center of the lesion may have normal skin although it usually dry, scaling or cracking and can sometimes be red in color. However, the rash may not always have this typical appearance depending on the location, severity and duration of the rash.
Pictures of Fungal Rash
The pictures below are mainly of dermatophyte infections on different parts of the body. As can be seen, the typical ringworm fungal rash is not always clearly evident.
Fungal Rash on the Scalp
Fungal Rash on Groin
Fungal Rash on Feet
Fungal Rash on Hand
Treatment of Fungal Rash
A fungal rash resolves once the underlying fungal infection is eradicated. In most cases this requires medical treatment. Topical agents (skin applications) are usually sufficient to treat and manage most fungal infections of the skin but sometime oral agents are necessary.
Topical medication used for treating a fungal rash may include:
- Allylamines, such as naftifine, terbinafine and benzylamines (butenafine).
- Imidazoles, such as clotrimazole, econazole, ketoconazole and miconazole.
- Pyridones, such as ciclopirox.
Oral medication for treating a fungal rash may include:
In addition to medical intervention, certain lifestyle factors may also help in treating and preventing fungal infections. These measures may include:
- Use light and airy clothing and footwear when these areas cannot be exposed.
- Do not share personal items like socks, shoes, underwear, towals and hair brushes or combs.
- Keep the area as dry as possible, like thoroughly drying the area after a bath.
- Use drying agents like powders for moist areas. Antifungal powders are more effective in preventing skin fungi.
Sourced from Dermatology Atlas (atlasdermatologico.com.br)