What to Know About Fungal Infections That Affect the Skin
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Medically reviewed by William Truswell, MD
Fungal infections on the skin are common. They develop when tiny spores of fungi come into contact with your skin. Some types of fungi already live on your skin and usually cause no harm, but they can cause infection too if there are too many. Fungal skin infections can affect the top layer of the skin or deeper under the dermis.
Healthcare providers can usually determine your type of infection by looking at your skin. Fungal infections of the skin can affect anyone at any age but tend to happen among younger people more. Fungal infections can significantly impact your quality of life and, if left untreated, can lead to complications. Fortunately, treatment options are available.
Types of Fungal Infections on the Skin
There are many types of fungal infections that can affect the skin. They can be separated into two main categories based on which layer of skin is affected. The human skin has three layers. Some fungal infections will affect the top layer of the skin, the epidermis. Other fungal skin infections may go deeper, into the dermis and subcutaneous layers.
Superficial and Cutaneous
Infections that occur in the superficial and cutaneous tissues of the skin usually only affect the first layer of skin. Examples of fungal infection on the outermost layer of the skin include:
Athlete's foot: Also known as tinea pedis, this common infection affects the feet. An itchy, scaly rash can develop, usually starting between the toes.
Jock itch: Also known as tinea cruris, this infection develops at the groin. Because moisture can easily be trapped between the scrotum and thighs, the infection is more common among men. The rash can be itchy and possibly painful.
Ringworm: Also known as tinea corporis, this infection affects the face, trunk, arms, and legs. Ringworm is named because the rash forms a circle resembling a worm. It is not caused by an actual worm.
Barber's itch: Also known as tinea barbae, this type of infection develops in the beard area. It can cause ring-shaped lesions.
Scalp ringworm: Also known as tinea capitis, this infection affects the scalp by causing round patches of dry scale or areas of hair loss. It is highly contagious and most common among children.
Candidiasis: Candida is a type of yeast with about 150 species. When candida causes an infection, it is called candidiasis, or a yeast infection. The infection usually affects moist areas of skin, like the groin, armpits, the areas between your fingers and toes, and the skin under the breasts.
Tinea versicolor: This infection causes you to develop tan, brown, salmon, pink, or white scaly patches. It usually affects the skin of the abdomen, chest, and sometimes face. There are no other symptoms, and it's not considered contagious.
Tinea nigra: This less common infection shows as dark patches on the palms of the hand or soles of the feet. It thrives in warm, salty environments.
Subcutaneous
Fungal infections below the surface of the skin happen when the fungal spores get a little deeper in the layers. These spores infect the deeper skin layers through a cut or wound. The infection can impact the outer layer of the skin, too. Examples of these types of fungal infections include:
Chromoblastomycosis: This infection affects the tissue below the skin and the skin itself. It can cause warty patches of skin and lesions that look like cauliflower. The infection more commonly affects people who work on farms and is more common in tropical areas.
Mycetoma: Although it can affect part of the body, this infection is common on the feet. It causes firm masses under the skin that are usually not painful. Mycetoma is a rare infection in the U.S., but if you are visiting a country where the infection is more common, like Mexico, you should avoid walking barefoot.
Sporotrichosis: This fungal infection usually comes from decaying soil and vegetation. Also known as rose gardener's disease, the fungus that causes sporotrichosis likes to live in plant matter like hay and rose bushes. The infection affects the skin and the tissues underneath the skin. it causes a small, painless bump where the fungus entered a cut, usually on the hand or arm.
Symptoms of a Fungal Infection on the Skin
The symptoms of fungal infections on the skin will depend on what type of fungal infection you have and where on your body the infection has developed. Other things that affect how symptoms develop are how strong your immune system is and how harmful the fungus is.
Some possible signs of a skin fungal infection are:
Mild itching
Scaly patches
Redness and swelling
Ring-shaped rashes
Patches that come and go
Painless bumps under the skin
Painful rashes from inflammation
What Causes a Fungal Infection on Skin?
Fungus is an organism that can live in many places like the air, soil, and even on the skin. Fungi release particles called spores to reproduce. It are these spores that can get on or in your skin and cause a fungal infection.
Skin fungal infections can be passed from person to person, from animals, or contact with infected soil. Infections that go deeper develop when fungus enters an already-existing deep cut or wound. It's also possible to get an infection if the skin becomes damaged by clothing or shoes, allowing spores to enter.
Many fungi live on your skin normally and do not cause harm. These parts of the normal flora can sometimes become problematic when the immune system is weak. When your immune system is not as strong to fight off the fungi invaders—like if you are sick or taking antibiotics—the fungi have the opportunity to multiply and cause an infection.
How Is a Skin Fungal Infection Diagnosed?
Healthcare providers can often tell what type of infection you have by looking at your skin. During this physical exam, they will look at the affected area and the other regions on your body to check for any spreading. Some providers will use a dermatoscope, a handheld tool that provides magnified views of your skin.
Your healthcare provider may perform some laboratory tests to confirm the diagnosis These tests may include:
Skin scrapings: In this procedure, the healthcare provider scrapes off a small part of the infected skin. The sample is sent to a lab, where another provider views it under a microscope. The technician can see the structures of the fungi to help with the diagnosis.
Fungal culture test: During a culture test, your healthcare provider will place a sample of the skin scrapping into a dish. The sample will begin to grow after some time which will provide identification of the infection.
Swab test: When a fungal infection is inside the mouth or vagina, healthcare providers might use a special swab to collect tissue or fluid from these areas. The test is sometimes used for suspected skin infections too. They will swab fluid from the open skin sore.
Skin fungal infections don't usually cause serious complications. If your healthcare provider suspects you might have a severe infection, they may order blood and urine tests to as part of their diagnostic evaluation.
Treatments for Skin Fungal Infections
When your healthcare provider confirms your infection is fungal, treatment will focus on clearing the infection and preventing its spread. Treatment decisions will depend on what type of fungal infection you have and where on the body it is. Fortunately, many treatment options work well for fungal skin infections.
Healthcare professionals usually recommend antifungal medications to treat a fungal infection. You can apply these medications directly to the skin, or topically. Topical medications can be in the form of creams, lotions, gels, or shampoos. Antifungals may need to be taken by mouth for severe or widespread infections.
How to Prevent Fungal Infections on Skin
Even after treating the area, the infection can come back. The best way to prevent an infection from recurring is to keep your skin clean and dry and to protect yourself from damage like cuts. Prevention methods will depend on where the infection impacts your skin. Doing the following can help prevent most types of fungal infections:
Don't share hairbrushes
Wear shoes when at a public pool or shower
Change out socks when they become damp or dirty
Don't share towels or other clothing with other people
Wear open-toe shoes to keep feet dry from sweat
Keep your feet dry by using antifungal powders
Wear long sleeves and pants while gardening
Wear gloves to protect your hands if are digging in the soil
Complications
Fungal infections on the skin are usually mild and rarely severe. Following up with your healthcare provider is important if you have a weakened immune system from other conditions or medications to monitor for complications. Possible complications of a fungal infection on the skin include:
Cellulitis: Cellulitis is an infection of the tissue under the skin that can cause redness, swelling, and pain. The complication is likelier for people who are immunocompromised or have diabetes.
Foot ulcers: Ulcers, or an open wound, can develop between your toes and on your feet. It can develop from repeated breakdown and inflammation with a foot fungal infection.
Scalp alopecia: Alopecia can develop from damage to hair shafts. Alopecia is another name for hair loss that can occur when the scalp has a fungal infection.
Dermatophytid reaction: This can happen when your body has an allergic reaction to the fungus, causing a rash on a different part of the body.
A Quick Review
There are many types of fungal infections that can affect the skin. Most often, the infection affects only the outer layer of skin. Sometimes, a deeper level of the skin can be affected. Most fungal skin infections are mild and treatable. Common symptoms include swelling, redness, and itchiness, though symptoms can vary depending on the type of infection you have. The spread of fungal infections on the skin can occur through contact with other people or the soil. Sometimes an infection develops from the normal fungus that lives on our bodies. Healthcare providers can diagnose an infection by looking at your skin and collecting skin samples. Treatment plans will depend on where the condition affects your body and will usually consist of antifungal medications.
Frequently Asked Questions
How can you tell the difference between a fungal or bacterial skin infection?
A fungal infection like athlete's foot or a yeast infection might be more easily identifiable based on their location and symptoms. In other cases, a healthcare provider will be able to confirm whether the infection you have is being caused by a fungus or bacterium.
Does a fungal infection go away by itself?
Fungal infections usually require antifungals to go away and to prevent recurrence.
Is fungus on the skin contagious?
Most of the "tinea" skin fungal infections are highly contagious. Tinea capitis and ringworm, for example, are contagious. But not all are. For instance, tinea versicolor is not considered contagious.
Can you get sepsis from a fungal infection?
Invasive candidiasis is one type of fungal infection that can cause sepsis, especially in those with weak immune systems.
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