Ringworm and tinea are fungal infections: common infections of the skin, hair, or nails which can occur at any age. These infections are contagious and can readily spread from person to person. The most common types affect the outer layers of the skin, hair, and nails. As described below, the name used to describe the infection is dependent on where (anatomic site) the infection occurs. Fungi can be normal flora of the skin but thrive in warm, moist areas. Under these conditions, there is an overgrowth of fungi and skin infections develop. Common surfaces for spread of fungal infections are contaminated combs, clothing, shower surfaces, pool areas, and gym mats or seats.
Dermatophytes are the group of fungi that infects the skin, hair, and nails.
The fungal induced rash is usually itchy, red, and scaly and may be ring-shaped. When located in a fold of skin, there may be no scale. The term ringworm refers to round or oval red scaly patches (there are no worms!), often redder around the outside with normal skin tone in the center.
Different types of fungal infections:
- Athlete’s Foot (Tinea Pedis) is spread by direct contact. Most people contract this by walking barefoot in a public place such as a locker room or pool area. The rash usually starts between toes and may then spread to involve the nails and skin. Itchiness is common. Topical preparations are typically used first; oral prescription therapy may be necessary in more severe cases.
- Ringworm (Tinea Corporis) can be spread by direct person to person contact, contact with an infected animal, usually a pet, or contact with soil.
- Jock Itch (Tinea cruris) can affect the groin of both men and women and is usually seen in individuals who sweat a lot.
- Nail Fungus (Onychomycosis) causes thickened, abnormal nails that become brittle. It’s usually seen on toenails, but fingernails can also be affected. Systemic treatment (oral medication) is usually necessary. Due to inherited susceptibilities, onychomycosis runs in families; not everyone is susceptible.
- Scalp Ringworm (Tinea Capitis) is a fungal infection of the scalp. It usually occurs in children, most often with an itchy rash that may cause some hair loss. Hair usually grows back normally after an adequate course of prescription therapy. Tinea capitis is seen in adults, though less frequently than in children.
- Tinea Gladiatorum is the name for fungal infections which occur in individuals who become infected due to close contact or direct skin-to-skin contact in activities such as wrestling, gymnastics and body building. These activities provide opportunities for certain skin disorders for which the dermatologist must be actively on the alert. The warmth, moisture, maceration and friction that are part of direct skin-to-skin contact accelerate the transmission and development of this disorder.
Diagnosis: Fungal infection is confirmed by microscopy and culture of skin scrapings. For some cases, testing can be done immediately by the dermatologist; other cases require laboratory analysis which may take several weeks to obtain results.
Treatment: Oral and topical medications are the mainstay of therapy. Depending on the area of skin involved, various lengths of treatments are necessary. Topical antifungal creams and shampoos are often used in conjunction with oral therapy. Nail involvement usually requires the longest therapy time.
Prevention:
- Wear sandals or a foot covering in public places such as gym locker rooms, public pools, hot tubs, and hotel bathrooms. Don’t walk barefoot on surfaces that easily harbor fungi: showers, bathmats, bathrooms or bedroom carpets.
- Don’t share shoes or sandals with another person who may be infected.
- Don’t share hats, head coverings, or clothing that may be infected with a fungus.
- Shower daily and wash skin and feet thoroughly and dry well; pay close attention between the toes.
- When wearing shoes that are enclosed, wear cotton or polypropylene socks that let the skin “breathe” to minimize sweating. If your feet or clothes become wet from perspiration, change to clean, dry socks or clothing.
- If the fungal infection becomes recurrent, then screening household family members and/or evaluating their sport activities may be helpful to help determine the cause of infection.
- If you have active fungus on your feet, always put your socks on prior to putting on your shorts or pants. This will help prevent further infection.
- Athletes should be warned not to share any type of athletic equipment or towels with anyone so as not to increase the risk of transmitting the fungal infection.