What To Do If There Is a Fungus Among Us

BY JAMES S BURKHARDT, D.O.

Through the years, I have written about a variety of health topics, some serious (heart disease and cancer) and some not so serious (beer).  This month, and by request, we will learn about a condition which is usually not very serious, but certainly bothersome: skin fungus.

Most types of fungus that affect humans are molds called dermatophytes.  These dermatophytes essentially live on the skin and feast on keratin which is a strong, fibrous protein that makes up much of our skin.  Other important things to keep in mind besides keratin, is that fungus loves areas that are wet and warm.  That is why fungal infections show up on sweaty feet.  Skin fungus is contagious and can be spread from person to person and you can also get it from clothing and animals.

Here are some common fungal infections:

Tinea Pedis (athlete’s foot)

Tinea pedis has affected humans for hundreds of years. Tinea pedis is the term used for a dermatophyte infection of the soles of the feet and in between the toes.  Tinea pedis is most commonly caused by Trichophyton rubrum, a dermatophyte initially endemic only to a small region of Southeast Asia and in part of Africa and Australia.  Interestingly, tinea pedis was not noted in these areas, possibly because these populations did not wear occlusive footwear.  The colonization to the T. rubrum-endemic regions by European nations helped to spread the fungus throughout Europe.  Wars with accompanying mass movements of troops and refugees, the general increase in available means of travel, the rise in the use of occlusive footwear have all combined to make T. rubrum the world’s most prevalent dermatophyte.

Tinea pedis is the most common type of skin fungus.  Your risk of getting athlete’s foot increases if you wear closed, occlusion shoes (especially if they are plastic lined), keep your feet wet for long periods of time or if your feet are wet a lot. 

Appearance-wise athlete’s foot can take on a few different guises.  It could cause scales or fissures to form in between toes. Or, it can also affect other areas of the foot causing blisters and other kinds of skin lesions on the heels, soles or along the sides.  In addition to peeling and cracking skin, it usually causes burning and itching. 

Over-the-counter anti-fungal powders or creams can help control the infection.  These generally contain miconazole, clotrimazole, or toinaftate.  Keep using the medicine for 1-2 weeks after the infection has cleared to prevent the infection from returning.

In addition, keep your feet clean and dry, especially between your toes.  Wash your feet thoroughly with soap and water and dry the area very carefully and completely.  Try to do this at least twice a day.  Wear clean cotton socks and change your socks and shoes as often as necessary to keep your feet dry. Athlete’s foot almost always responds well to self-care, although it may come back.

Tinea Cruris (jock itch)

This may be the most uncomfortable skins fungus.  While it is much more common in men, women can get it also.  This type of skin fungus is characterized by a rash developing around the groin areas and inner thighs (however, the penis and scrotum are not usually affected).  The center of the rash can be reddish-brown while the edges develop scales or bumps.  The skin gets scaly and will burn and itch, it may even develop blisters that ooze.   It is not unusual for jock itch and athletes foot to be present at the same time. Treatment is similar for jock itch and athlete’s foot.  

Tinea corporis

This is also known as ringworm of the body.  It’s important to note that although skin fungus can be called “ringworm” it has nothing to do with a parasitic worm.  Rather, it simply refers to the ring shape that the rashes form.  It usually affects the trunk, arms and legs.

This is contagious and is easily transmitted from person to person by direct contact.  That is why we see it so commonly on the wrestling teams. Usually it will start out as a small red patch of scale.  As it enlarges, the center will be clear, giving the classic “ring” appearance.

As previously discussed, anti-fungal creams, and ointments are usually effective treatments. 

Tinea Versicolor

This fungus is particularly marked by discoloration of the skin.  This is because it causes small spots on the skin that form into patches.  These patches can make the skin either lighter or darker, and they can appear white brown, tan or pink.  In fact, tinea versicolor means “the fungus of many colors.”  It is caused by an organism called Pytrospoum Ovale, once called Malassazia furfur (which is my all-time favorite name in medicine). 

This condition is often quite stubborn and frequently reoccurs.  There are topical treatments such as shampoos or lotions but prescription medication may be needed.

As always, if you or a family member have questions about your skin or other health concerns, your family doctor is a good source of information.