Living with fungal skin

Overview

Fungal skin infections are very common skin problems caused by tiny fungi such as yeasts or moulds. They can make your skin itch, flake, or become red and sore. Most fungal skin infections are mild and can be treated successfully with antifungal creams or medicines.

Yes, fungal skin infections are among the most common skin problems worldwide. Examples include athlete's foot, ringworm, and yeast infections such as thrush.

Anyone can get a fungal skin infection. You are more likely to get one if you sweat a lot, spend time in damp public places, wear tight clothing that traps moisture, or have a weakened immune system.

Symptoms

Common symptoms

• Itching, burning, or stinging on the affected skin
• Red, scaly, or flaky patches of skin
• A ring-shaped rash with a clearer area in the middle
• Cracked, peeling, or blistered skin
• Thickened, discoloured, or crumbly nails if the nails are affected
• Soreness or discomfort in skin folds

Symptoms in children

• Itchy red patches that may look like ringworm
• Scaly patches on the scalp with small bald areas
• Bright red nappy rash that does not improve with usual nappy care

Symptoms in older adults

• Dry, itchy, scaly skin that may be mistaken for dry skin
• Thickened, brittle, or yellow-brown nails
• Redness and itching in skin folds, such as under the breasts, in the groin, or in the armpits

Causes

Main causes

• Tiny fungi called dermatophytes, which live on the protein in your skin, hair, and nails
• Yeasts such as Candida, which normally live on the skin but can multiply too much when conditions change
• Direct contact with an infected person, animal, or contaminated surfaces like towels and shower floors

Risk factors

• Sweating heavily or wearing tight, non-breathable clothing
• Walking barefoot in damp public places such as swimming pools, showers, and changing rooms
• Sharing towels, clothing, or personal care items
• Having a weakened immune system due to illness or certain medicines
• Using antibiotics, which can upset the natural balance of skin and allow yeasts to overgrow
• Having poorly controlled diabetes

When to see a doctor

See a doctor urgently if:

• If the rash is extremely painful, spreading quickly, or looks infected
• If you have a fever or feel unwell alongside a skin rash
• If you have a weakened immune system and develop a fungal skin infection

Book a routine appointment if:

• If you have a scaly, itchy rash that lasts more than two weeks despite using pharmacy treatments
• If the infection keeps coming back after treatment
• If the infection affects your scalp, face, or nails
• If you are not sure what the rash is or how to treat it

Diagnosis

A doctor or nurse will usually recognise a fungal skin infection by looking at the affected skin and asking about your symptoms. Sometimes they will take a small sample of skin or nail to check under a microscope.

Tests that may be done

• A gentle skin scraping taken with a small blade and examined under a microscope
• A swab from the affected area, especially if a yeast infection is suspected
• A nail clipping sent to a laboratory if a fungal nail infection is possible

What to expect at your appointment

Diagnosis is usually quick and painless. The doctor may ask about recent activities, such as swimming or gym use, and may look at other areas of your skin. You may be given a diagnosis on the same day, and treatment can often start straight away.

Treatment

Fungal skin infections are usually treated with antifungal creams, sprays, or powders applied to the affected area. For more stubborn infections, a doctor may suggest a longer course of antifungal medicine taken by mouth. It is very important to continue treatment for the full length of time advised, even if your skin starts to look better, because this helps clear the infection completely and stops it returning.

Self-care at home

• Wash and dry the affected area gently every day, paying extra attention to skin folds and between the toes.
• Keep your skin cool and dry, and wear loose-fitting cotton clothing.
• Change your socks and underwear daily, especially if you sweat a lot.
• Avoid scratching, as this can damage the skin and make the infection worse.
• Use your own towel, flannel, and razor, and wash them regularly in hot, soapy water.
• If you are treating athlete's foot, dry your feet well after washing and apply the treatment as directed.

Medical treatments

Your pharmacist or doctor may recommend an antifungal cream, ointment, spray, or powder. Some are available without a prescription, while others require a prescription. If the infection is severe, affects the scalp or nails, or keeps returning, your doctor may prescribe a course of antifungal tablets. Always follow the instructions you are given, and ask your pharmacist if you have any questions.

When is surgery considered?

Surgery is rarely needed for fungal skin infections. In severe fungal nail infections that do not respond to treatment, a doctor may occasionally remove the nail or part of it, but this is uncommon.

Living with this condition

Fungal skin infections can be annoying and uncomfortable, but with consistent treatment and small changes to your daily habits, most people see a clear improvement. Treating the infection properly and keeping your skin dry will also help prevent it from coming back.

Lifestyle tips

• Dry yourself thoroughly after bathing, especially between your toes and in skin folds.
• Wear flip-flops or shower shoes in shared wet areas like public showers and swimming pools.
• Wash towels, sheets, and clothes regularly in hot, soapy water.
• Choose breathable footwear and rotate your shoes so they can dry out between wears.
• If you have athlete's foot, put socks on before underwear to reduce the chance of spreading the fungus to your groin.

Diet and exercise

There is no special diet that cures fungal skin infections, but eating a balanced diet and staying physically active helps support your immune system. After exercise, shower promptly and change into clean, dry clothes.

Mental health and emotional wellbeing

Living with a visible skin rash can be frustrating, embarrassing, or stressful, and itching can affect your sleep. These feelings are completely normal. If you are feeling low, anxious, or overwhelmed, talk to a healthcare professional. If you are in a mental health crisis, contact your local mental health crisis team or your local emergency number for immediate support.

Prevention

You can reduce the risk of fungal skin infections by keeping your skin clean and dry, avoiding sharing personal items, and wearing appropriate footwear in damp public places. It is not always possible to prevent them entirely, but these habits help a lot.

Vaccines

There is no vaccine for fungal skin infections at this time.

Screening programmes

There is no routine screening test for fungal skin infections. If you notice a new skin rash or changes to your skin or nails, it is best to get it checked by a healthcare professional.

Complications

If left untreated

• The infection may spread to other parts of your body or to people you live with.
• Cracked or broken skin can let bacteria in and cause a secondary bacterial infection.
• Fungal nail infections can become painful and more difficult to treat if left for a long time.
• In people with diabetes or weakened immune systems, fungal infections may take longer to clear and may cause more serious skin problems.

Long-term outlook

The outlook is very good. Most fungal skin infections clear up with proper treatment and good skin care. They can sometimes come back, but with simple daily habits you can learn to control them and reduce how often they happen.

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