Tinea is the term for fungal infections of the skin caused by a group of fungi called dermatophytes. These fungal species are not normally found on the skin, but have the ability to live and multiply in the dead keratin layer on the skin surface, in the hair follicles and in the nails.
The fungal infection can be transmitted by direct contact (between people), or indirectly via clothing, towels, furniture, bathroom floors and the like. Tinea can also be caused by infection from domestic animals.
Tinea can be divided into different types based on which body areas are attacked; tinea corporis (body fungus), tinea capitis (scalp fungus), tinea barbae (beard fungus), tinea pedis (foot fungus), and more.
Tinea corporis (fungus of the body) usually gives the classic picture of flat, reddish and slightly scaly skin changes with the greatest activity at the edges and a paler centre. This gives a ring shape and consequently the name ringworm . The rashes can cause varying degrees of itching. If the fungus attacks the hair follicles, acne-like skin changes may occur. Severe forms of fungus on the scalp can also cause scarring with permanent hair loss.
The diagnosis is made based on the appearance of the rash, and can be confirmed by submitting skin scrapings, hair samples and/or biopsies (tissue samples). This is particularly important before starting systemic treatment (tablets/capsules), including to identify the type of fungus and map its resistance pattern. The issue of resistance is a growing problem internationally.
The treatment of tinea depends on, among other things, the patient (age, medicines, other diseases), the location and extent of the rash, the fungal species and resistance pattern in question, as well as previously attempted treatment. With classic ringworm, the body's inflammatory reaction is often so strong that the fungal infection can be fought by the immune system itself. Treatment is thus not always indicated. Lubrication with antifungal creams, on the other hand, will speed up the normalization of the skin. Lubrication over several weeks is often necessary for a full good response and to prevent relapse. If hair is affected, both in the scalp and beard, systemic treatment (tablets/capsules) over many weeks is necessary.
Nail fungus is a fungal infection of the nail plate. The condition is also referred to as onychomycosis and tinea unguium and is mainly caused by various dermatophyte species (as in tinea). The condition is harmless, but can cause embarrassment and discomfort. The condition lasts a lifetime without treatment.
The suspicion of nail fungus is based on how the nail looks. The nail plate often thickens, partially detaches from the substrate and acquires a yellowish-white discoloration. It often becomes brittle and crumbles - especially at the very end. In some cases, the nail breaks completely.
Nail fungus does not necessarily have to be treated, but embarrassment, soreness and other complaints indicate that treatment should be attempted. If only the outer third of the nail is affected, you can initially try local treatment (fungal nail varnish). Such treatment takes place over several months and relapse is unfortunately common. It is therefore often necessary to take a long-term course of tablets with an antifungal drug - especially if several nails are affected.
As part of treatment and prevention, it is important to reduce the well-being of the fungus in the skin and nails, for example by drying your legs well after a shower (possibly using a hairdryer) and using airy footwear. Frequent changes of socks (preferably non-synthetic) can also prevent relapse.
It is important to be aware that similar nail changes can also be seen in underlying skin diseases, such as psoriasis. The diagnosis can thus be challenging. In fact, only half of toenail changes are actually caused by fungus. It is therefore recommended to submit a nail sample to confirm the diagnosis (before any long-term treatment).
Pityriasis versicolor is a common fungal infection of the skin. The condition is caused by a naturally occurring fungus species on the skin surface called Malassezia furfur. The fungal infection is not dangerous or contagious, but can be seen as cosmetically unsightly.
In pityriasis versicolor, well-defined, whitish pigment spots are seen in the skin. Sometimes, often in the early stages, the spots are more brown and/or pink. The different and changing colors are the origin of the name versicolor. The whitish pigment spots often have sparse flaking. The skin can also appear thin and "cigarette paper-like".
The pigment spots are usually 0.5-3 cm in size. In some cases, especially with long-standing fungal infection, the pigment spots can grow large and form widespread, continuous skin changes. Common locations on the neck, upper body and upper arms - often corresponding to areas with oilier and moister skin.
Warm and moist skin, such as among people who sweat a lot, exercise/shower often or stay in hot climates, gives the fungus better growth conditions. Pityriasis versicolor is thus most often seen among active teenagers and young adults.
The treatment of pityriasis versicolor is aimed at the fungus in question. Fungal agents are most commonly used directly on the skin, for example shampoos with selenium (Selsun, Selukos) or ketoconazole (Fungoral). There is also a range of antifungal creams, gels and sprays with terbinafine. Propylene glycol is also used.
The pigment changes last for several months after the treatment has been initiated. New pigment must be produced in the skin, after the fungus has been removed, in order for the original skin color to return. Relapse is quite common and maintenance treatment 1-2 times a week for a long time is recommended.
Fungal infection in the vagina is most often caused by the yeast Candida. This fungus occurs naturally in the gastrointestinal system and genitals in both men and women, without causing any kind of discomfort. In some cases, the fungus can increase in quantity and establish a symptomatic fungal infection. The increase in fungi is usually due to an imbalance between normal bacterial flora and fungi, for example after a course of antibiotics. Other causes of fungal infection in the vagina are excessive washing, including the use of (intimate) soap. This can cause pH changes and changes in the natural bacterial flora. Other causes are pregnancy, diabetes, hormone therapy and a weakened immune system.
The condition is very common and as many as 50-75% of all women will experience one or more episodes during their lifetime. The condition has several names, including fungus in the abdomen, genital fungal infection, vulvovaginitis and candida vaginitis.
Acute fungal infections in the vagina can cause severe itching, burning/soreness and altered discharge. The itch can be located on the labia, the vaginal opening and the vagina. Red and inflamed mucous membrane is seen, often with a white coating. The discharge is typically seen as white, thicker and mushy - and is often described as "cottage cheese".
Chronic, or constantly recurring, fungal infections often produce less pronounced symptoms than acute fungal infections. There is a slight to moderately pronounced soreness and occasionally an unpleasant dryness in the vagina. Itching is absent or less pronounced. The discharge can vary – everything from watery discharge to thick, mushy discharge. Some experience the discharge as unchanged.
Fungal infection in the vagina can go away on its own and does not need treatment if it does not cause problems. In case of problems, fungicidal suppositories (vagitories) can be inserted into the vagina. The suppositories will dissolve and mix with the discharge. Such suppositories are often combined with antifungal cream, which is applied at the entrance to the vagina and on the labia. If the treatment with suppositories and cream does not provide sufficient effect, there may be an indication for systemic treatment (tablets/capsules).
Balanoposthitis is the term for inflammatory conditions and infections on the head of the penis and the foreskin. The most common cause of balanoposthitis is eczema conditions, but sometimes this condition can be caused by infection with the yeast Candida (such as with vaginal yeast infection).
In balanoposthitis caused by fungi, red points/spots are seen on the mucous membrane, sometimes combined with ulceration and/or a whitish coating. These mucosal changes cause varying degrees of soreness and itching.
Risk factors for such balanoposthitis are fungal infection in the partner, diabetes mellitus, immunodeficiency, antibiotic treatment, increasing age and excessive or insufficient hygiene.
To prevent and treat such a fungal infection, daily intimate hygiene with water and/or oil-based intimate wash products is recommended. Soap should be avoided. The foreskin is kept retracted until the head of the penis is dry. If there is no response to hygiene measures alone, it may be appropriate to apply antifungal creams. These are also available as combination creams with cortisone, which dampens the mucosal inflammation and reduces the pain.
