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Areas commonly affected by fungal infections include the skin, scalp, feet, fingernails and toenails, mouth and vagina. Fungi need a warm, wet place to grow and they thrive on hot, sweaty skin, especially between your toes, in your groin and under your armpits.
There are two common types of fungal skin infection; tinea and candida.
Tinea infections are known as ringworm when found on your trunk, limbs or scalp. Tinea is known as athlete’s foot when your feet are affected, or jock itch when your groin area is affected. Thrush is the name for candida infections in the mouth, vagina or nappy area in babies. It can also occur under breasts, armpits or in your groin.
Fungal infections can spread from person to person via bathroom or shower floors, towels or clothing, or from animals or soil to people. Public swimming pools are a common place to contract a fungal foot infection.
Athlete’s foot is also known as tinea pedis. It is a fungal infection of the skin between your toes, which can spread further on your foot if left untreated. It appears as a patch of soft, white, cracked skin, sometimes with red areas visible beneath. Athlete’s foot may cause itching, burning or stinging and can create an unpleasant odour. The infection can spread to the nails causing the nail to change colour and become thick. It spreads via wet floors and shared footwear or towels.
Fungal nail infections
Fungal nail infections (also called tinea unguium or onychomycosis) are often caused by the spread of athlete’s foot but can occur on their own. The nail looks thick and discoloured (white or yellowish). The nail may be brittle or crumbly and parts, or all of it, may fall off. Toenails are affected more than fingernails. Often the infection is really only a problem in terms of how it looks, but can become a problem if it causes pain or a risk of infection develops.
With jock itch (also known as tinea cruris) the groin and inner thigh become red and itchy. It is more common in men than women, and often occurs if you also have athlete’s foot, since the infection can be spread from foot to groin. You are more likely to develop jock itch if you sweat a lot, are overweight, have diabetes or a weak immune system.
Ringworm is also known as tinea corporis. It is not caused by a worm but has this name because it can look like there is a worm under the skin. Patches of ringworm are circular, red and itchy. They have a raised edge and an area of clear skin in the middle.
Thrush (vaginal thrush, oral thrush and nappy rash)
Thrush is also known as candidiasis (infection with candida).
Symptoms of vaginal thrush include itching, irritation or a burning sensation in your genital area. There may be a thick, white or creamy vaginal discharge which has no odour. The risk of vaginal thrush is increased by taking oral contraceptives, pregnancy, taking antibiotics, spending prolonged time in damp clothes including swimmers and workout wear, and diabetes.
Oral thrush causes your mouth to be sore and look red. There may be white patches visible on your tongue and inside your cheeks. If the white patches are scraped away the skin underneath will be red and sore. You may experience a ‘cottony’ feeling in your mouth and a lack of taste. Eating and drinking can be uncomfortable. It is more common in babies, people who wear dentures, and people with diabetes or with asthma who use steroid inhalers. It can also affect those who have conditions affecting their immune system, and can occur after a course of antibiotics.
Sometimes nappy rash can be due to a thrush infection. When this happens, the area looks bright red and shiny and there may be white spots. The rash may spread into the creases of the baby’s groin.
See Your Pharmacist or Medical Professional
- if the infection is in your mouth, vagina, nails, scalp or beard
- if you have blistered, broken or raw skin
- if the itching is very severe
- if you have had repeated infections or the area affected is large
- if you have been treated for a fungal infection and it has not worked
- if the infection started in a baby’s nappy area but has spread, or the baby has other symptoms (e.g. fever)
Athlete’s foot and nail infections
- bleach the shower and bath areas to prevent spreading and reinfection
- wash your socks and towels in hot water
- wear thongs in communal changing areas to prevent spreading the infection
- if you have sweaty feet, use an antiperspirant, or foot powders and sprays, such as Thursday Plantation Tea Tree Foot Spray, to help prevent athlete’s foot developing
Jock itch and ringworm
- keep the area of skin dry
- avoid sharing towels, bedding and clothing and wash them frequently
- if you have ringworm, have any pets checked for signs of infection
e.g. aluminium chlorohydrate (Neat Feet Roll On Deodorant, 3B Action Cream )
- as prevention, antiperspirants are used to reduce sweating, which makes the skin drier and less likely to grow fungi
- 3B Action Cream can be applied to the buttocks, between the legs or under the breasts.
Topical antifungals for tinea (athlete’s foot, jock itch, ringworm)
e.g. undecanoate and chloroxylenol (Gordochom Solution), tolnaftate (Tinaderm Power Spray for Tinea), terbinafine (SolvEasy Tinea Cream for Athlete’s Foot, SolvEasy Tinea Spray, Lamisil Once Solution), Excilor Protector Spray, melaleuca oil (Thursday Plantation Tea-Tree Antifungal Gel)
e.g. bifonazole (Canesten Once Daily Bifonazole Cream 1%, Mycospor), clotrimazole (Canesten Clotrimazole, Clonea),
econazole (Pevaryl Antifungal Cream, Pevaryl Foaming Solution),
ketoconazole (DaktaGOLD, Nizoral Cream),
miconazole (Daktarin, Resolve range, Eulactol Spray), terbinafine (Lamisil range, SolvEasy Tinea Cream, Chemists’ Own Tamsil, Pharmacy Action Pharmisil, Tinasil)
- topical antifungals are available as creams, gels, liquids, spray powders and powders; ask your pharmacist which product is most suitable
- most antifungal products stop the growth of fungi but do not kill them
- continue treatment for at least 14 days after the area has healed because the body needs to shed the infected skin for complete eradication of the fungi
- products such as terbinafine do kill the fungi, meaning treatment courses are shorter
- athlete’s foot can be treated with terbinafine for just one week, in most cases
- there are also products available which combine an antifungal agent with hydrocortisone (steroid) cream [Pharmacist Only products], such as Resolve Plus (miconazole + hydrocortisone) and Hydrozole and Canesten Extra and Canesten Plus (clotrimazole + hydrocortisone)
- these combination treatments can be useful if there is severe itching
- these combination products should be used for a maximum of 7 days, then a product containing an antifungal alone should be used for the rest of the treatment
- foot powders, such as Dermal Therapy Foot Odour Control Powder Spray, Odor-Eaters Foot Powder, can be used to prevent athlete’s foot from recurring; sprinkle into socks and shoes each day
- it’s a good idea to treat your footwear with antifungal medicine as well to avoid reinfecting yourself. You can place gauze or cotton between your toes if there are small blisters or the skin feels soggy. If appropriate, you may with to wear ‘open’ footwear as much as possible, to allow your feet to ‘breathe’.
Treatments for thrush infections of the skin
- for thrush infections of the skin, the same treatments may be used as for tinea infections but terbinafine is less effective for thrush
- nystatin (Mycostatin Topical (cream), Pharmacy Action Nystatin [Pharmacy Only] is also effective
- nystatin should be applied twice a day and be continued for 14 days after the area has healed
- nystatin may stain clothing
- if the thrush infection is vaginal, talk to your pharmacist; there are other specific products available to treat this
Treatments for thrush infections of the mouth
- it is best to use these oral drops and gels after your meals and drinks to prevent the medicine from being rinsed away
- these should be swirled around the mouth for as long as possible then swallowed
- continue treatment for 2 days after symptoms have cleared to ensure the infection is completely gone.
Availability of medicines
- GENERAL SALE available through pharmacies and possibly other retail outlets.
- PHARMACY ONLY available for sale through pharmacies only.
- PHARMACIST ONLY may only be sold by a pharmacist.