In this series of creating public awareness we shall improve our knowledge about fungal infection as 10-15 per cent of people have problem of this kind, especially in summer and rainy season, and due to shyness and ignorance they do not seek medical help. At times they keep itching in public, forgetting all etiquettes and manners of responsible public behaviour.
Most people are familiar with infections like tuberculosis, leprosy and common diseases caused by bacteria and viruses, but many are unaware that there is a whole set of disorders related to infections by fungi (singular: fungus). Many of these fungal infections affect the skin. This article attempts to highlight some of such fungal infections, which can help you in effecting from these infections and answers the frequently asked questions on fungi and fungal infections.
What are Fungi? Fungi are a unique group of organisms that have some plant like characteristics. Examples of fungi include mushrooms, mould, and yeast. Fungi lack the ability to make their own food by photosynthesis as plants; thus they grow directly on their food source. This food source can be the human skin.
Doctors give some fungal infections of the skin the general name ?tinea.? Superficial fungal infections are found in the top layers of the skin, mucous membranes, the hair, and the nails. Examples of fungal infections of the skin and other external surfaces include athlete'sfoot, jock itch, ringworm, and candida. These can affect the hair and nails as well. Deep fungal infections invade deeper layers of the skin and hair follicles and can spread to the blood or internal organs. Ladies are specially bothered by candida infection which present with itching discharge making them very uncomfortable when they have it.
The symptoms and appearances of a fungal skin infection depend on the type of fungus causing it and the part of the body affected.
Fungal infections can cause rashes with a variety of different appearances. Majority are red, scaly and itchy, whereas others can produce a fine scale similar to dry skin. The fungus may infect just one area of the body, or there may be several infected areas on body.
Fungal infections of the scalp or beard can lead to hair loss. Fungal rashes can sometimes be confused with other skin conditions, such as psoriasis and eczema (which are again very common and neglected).
The term eczema describe a typical skin disorders with a variety of common characteristics. The acute disease typically is characterised by inflammation, redness, swelling, and itching, some blistering and oozing (wet eczema).
Psoriasis: It is a chronic skin disorder that affects about 2-3 per cent of the population. It is characterised by red, elevated plaques that are often covered with thick, silvery white scales. The most commonly affected areas are the elbows, knees, scalp, lower back, and genitalia. Some people have psoriasis on their hands and feet. A condition called inverse psoriasis manifests plaques in folded areas, such as in the armpits and groin. But these do not spread through fungi.
Types of fungal skin infections: Fungal infections usually affect the skin, hair and nail. Fungal skin infections are divided into groups depending on what type of fungus is involved. The full name depends on the location of the infection on the body.
Some common fungal infections are listed below.
Dermatophyte infections: These are caused by dermatophytes?a type of fungi that cause skin, nail and hair infections. They are common, affecting between 10 to 20 per cent of people at some point in their life. They include:
Athlete'sfoot (Tinea pedis): This is a very common infection that occurs in one in five adults. It causes scaling and sogginess of the skin, commonly of the web spaces between the toes. Sometimes the skin becomes pale and can be itchy. The infection is often picked up from contaminated skin fragments in public places, such as swimming pools and shower facilities. Poor hygiene and rainy seasons are invitation to such fungal infection.
Nail infections: The nails become malformed, thickened and crumbly. Not all nails affected like this are caused by fungal infections, but it is the most common cause. Toenail infections are commonly linked with athlete'sfoot. Fingernails can be affected too.
Ringworm of the groin (Tinea cruris): Tinea cruris is a very common fungal infection. People of any age can have ringworm, but it is more common in children and young adults. This is also called ?jock itch? because it occurs in sportspeople. It causes an itchy, red rash in the groin and surrounding area and is commonly seen in men who have been sweating a lot. Often you also have athlete'sfoot, and scratching your feet followed by the groin may spread the infection.
Ringworm on the body (Tinea corporis): This affects the body, often in exposed areas like the abdomen or on limbs, causing red patches. They are scaly at the edge with clear skin at the centre. The patches spread out from the centre. It can be caught from domestic animals. Again very common infection.
Ringworm of the scalp (Tinea capitis): This tends to affect young children and can cause hair loss It is usually spread from person to person. Most infected people become carriers who can spread the infection to others, sometimes for years. Nearly 15 per cent people suffer from this.
Yeast infections: Fungal skin infections are caused by yeast infections. For example: Yeast infection of skin folds caused by Candida albicans. It affects areas of the body that have skin touching skin such as the armpits, groin, and under heavy breasts or fat folds, where the environment is warm and moist. Very common infection.
Pityriasis versicolor: This yeast infection causes increased dark patches on pale or untanned skin and light patches on tanned or darker skin. It derives its name ?of various colours?. Teenagers and young adults are most often affected by this in India. It is a very common problem and hardly anybody seeks treatment.
Thrush (Candida albicans): The fungus ?Candida albicans? is present in most people, and lives in the mouth and digestive system. It usually lives in harmony and rarely causes problems. However, in certain situations, such as during febrile illness or when using antibiotics, the fungi multiply and cause thrush symptoms.
Thrush can affect the mouth and tongue, vagina, and moist, folded skin. Thrush infection often looks like small white patches, which leave a red mark when rubbed off. In adults, vaginal thrush can cause itchiness and a thick, white discharge, again a very common problem seen in women.
Thrush sometimes affects men, causing a painful red rash on the head of the penis (glans). It also commonly affects newborn babies in the mouth (oral thrush). The white patches may be mistaken for breast or formula milk. Babies with thrush in their throats may stop feeding properly. Babies may also develop thrush in the nappy area.
Moist skin encourages fungal infections. This means fungal infections are more likely when skin isn'tdried properly after sweating or bathing, or when it is covered with a material that doesn'tallow sweat to evaporate. Damage to the skin surface, such as a cut or graze, can also encourage fungi to grow.
Recent course of antibiotics causes it: Sometimes these drugs can also reduce the helpful bacteria that live in the body. When this happens, fungi may take the opportunity to colonise. Similarly it follows oral steroids: Individuals with diabetes and some cancers, such as leukemia, are more susceptible to fungal infections.
Fungal infections are known to occur in people who have a weakened immune system caused, for example, by cancer or AIDS
Transmission: Fungal infections can be spread between humans. For example, athlete'sfoot is thought to be spread in communal areas, such as gyms and swimming pools. Contact with bed sheets or towels can also spread fungal infections.
It'salso possible to catch fungal infections from animals such as cats or dogs, and, more rarely, cattle. Ringworm is occasionally caught this way.
Diagnosis: Sometimes fungal infections are easy for doctors to diagnose from the appearance and location of the rash, such as athlete'sfoot. Sometimes your doctor will take a skin scraping, or a fragment of nail or hair, and send it to the laboratory to confirm the diagnosis.
Treatment: Since most fungal skin infections are surface infections, antifungal treatments are usually applied directly to the skin in the infected area (topical treatments).
There are a variety of treatments available in the form of creams, lotions and medicated powders. If the rash covers quite a large area of skin, or affects the nails or scalp, then tablets may be required.
Some treatments are available over-the-counter from a pharmacist, without a prescription. For example, sprays are available for treating athletes foot. Ask your pharmacist for advice.
Stronger forms of topical treatments and antifungals in tablet form are only available on prescription. You may also be prescribed antifungal shampoo for scalp infections.
These treatments are usually effective. Like any drug, they can occasionally cause side effects. These may include skin irritation or an upset stomach. It isn'tunusual for the rash to return, even when it seems to have been treated. The treatment may need to be used for at least four weeks to prevent the infection from coming back.
If you are buying an over-the-counter antifungal treatment, you need to be sure that you have a fungal infection. You may recognise the rash from a previously diagnosed fungal infection. But if there'sany doubt about your diagnosis, or if over-the-counter treatments don'twork, then you should seek advice from your doctor.
Some preventive tips
o Dry your skin carefully after bathing.
o Wear loose fitting clothes and underwear.
o Avoid sharing towels, hairbrushes, and combs, which could contain skin fragments that harbour fungal colonies.
o Change socks or tights daily.
o For athlete'sfoot, alternate shoes every two or three days so that they have time to dry out.
o Choose fabrics that allow the skin to ?breathe??natural fibres such as cotton are better than nylon or polyester for underwear.
o For sportspeople, synthetic fibres that ?wick? the sweat away from the body, helping to keep the skin dry, may be preferable.
o If you have diabetes you need to keep good control of your blood sugar.
In the end, we emphasise the importance of food as balance diet and a plenty of water for your body to remain healthy and to build strong immune power and make the resistance power more against such infections, which can help from affecting such infections easily and at last but not the least in healing early. For treatment of fungal infections, please contact your doctor and follow the advice meticulously. Seek professional consultation for more information on various aliments and their treatment.
(Dr Sharda Jain is secretary general, Delhi Gynaecological Society and can be contacted at [email protected])