Sure Signs You Have a Fungus and How to Cure It, According to Dermatologist — Eat This Not That – Eat This, Not That

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Most people have a regular skincare routine for their face, but taking care of the rest of your skin is just as important otherwise fungal infections can happen. Anyone can get a fungal infection, especially people with weakened immune systems, says the Centers for Disease Control and Prevention and sometimes they can be tricky to get rid of. While environmental factors do play a part in getting a fungal infection, there are preventive measures to take that include, keeping skin dry and clean, washing your hands often after touching animals, avoiding using other people’s towels and personal products and wearing shoes in locker rooms and community showers, Eat This, Not That! Health spoke with experts who explain what a fungal infection, signs you have one and how to treat it. Read on—and to ensure your health and the health of others, don’t miss these Sure Signs You’ve Already Had COVID.
Dr. Jason Miller, board-certified dermatologist at Schweiger Dermatology Group in Freehold, NJ says, “Fungal infections occur when abnormal yeast, molds or dermatophyte (skin fungus) overgrow.  These infections commonly occur on the feet,  in the groin, and on the scalp, but may also be found anywhere on the skin.  Fungal infections can be transmitted from contaminated surfaces (i.e. shoes, carpets, towels), pets, or other infected people (i.e. ringworm spread among wrestlers).”
Dr. Emily Wood, MD, board-certified dermatologist, Westlake Dermatology, Austin adds, “Fungal infection are infections of the skin that typically cause skin to be red, flaky and itchy. It can also create the traditional “ringworm” rash that is in fact not due to a worm but rather a fungus. Fungus is found throughout our environment and humans constantly come into contact with fungus whether it be passed from other humans or animals. In general fungus often thrives in moist environments.”
Dr. Wood says, “Usually the redness is in a circular pattern and can be mild to very bright red.”
Dr. Nelya Lobkova, Board Certified DPM with Step Up Footcare adds, “Athlete’s foot presents in the bottom of the feet including the toes and typically symmetrically. It appears reddish with scaling or small red dots. Doctor’s refer to this as ‘moccasin distribution’ because it looks like the entire bottom of the foot is a different color compared to the skin on top of the foot.” 
Dr. Lobkova explains, “Toenail fungus may appear as white dots overlying the toenail, known as white superficial onychomycosis. This form can spread to the entire toenail and other toenails. In the summer months, many women paint their toenails with polish, hiding toenail infections. Toenail polish damages the top layer of toenail and prevents the nail from airing out properly, thus worsening toenail infection.”
According to Dr. Lobkova, “Once there is a fungal infection in the toenail, the fungus enters and flourishes under the nail plate (hard part of the nail). As the infection progresses, it thickens and deforms the nail plate to separate from the underlying nail bed. This also impedes healthy nail growth. Thus fungal toenails grow slower than healthy toenails. It is important to remember toenails grow much slower than fingernails, averaging at a rate of 2mm every month for healthy toenails. “
Dr. Wood states, “Fungus causes a localized itch reaction and can be quite miserable. If not improving with home remedies I recommend seeing a board certified dermatologist.”
“Fungal infections make the skin flake and can be very severe,” Dr. Wood states. 
Dr. Miller adds, “Scaly red rash with bright red border and central clearing are signs of a fungal infection. Fungal rash often spreads outward giving this particular appearance.  Symptoms are mild but can be a clue.” In addition, “Scaling and localized areas of hair loss in the scalp along with bumps (lymph nodes) in the neck can be a sign of scalp ringworm requiring systemic (oral) antifungals.”

​​Dr, Miller lists the following as common fungal infections:
“Athlete’s foot (tinea pedis)– a fungal  infection causing an itchy, scaly red rash on the feet, ankles, and web spaces of the toes.  Very common, easy to spread in gym settings, and treatable with topical antifungal creams.
Jock itch (tinea cruris) – scaly red rash that can itch or burn in the folds between the thigh and groin.  Usually treatable with topical antifungal creams.
Ringworm (tinea corporis) – scaly red rash often with some clearing in the center and a bright red edge – often transmitted by pets or contacts with other infected people (i.e. wrestlers).  Mild cases can respond to topical antifungal creams; more extensive cases can require oral antifungal pills.
Scalp ringworm (tinea capitis) – deep hair follicle fungal infection with scaling, redness and areas of hair loss in the scalp – usually requires oral antifungal medicines for several weeks to treat.
Yeast infections (candida) – often occur in areas where skin folds and moisture collects – can be very red with small red bumps around the main portion of the rash (satellite lesions) – often respond well to topical antifungals and preventative measures to keep the area dry.”


How are Fungal Infections Treated?

Dr. Miller says, “topical antifungals (over the counter or prescription) for mild skin infections; oral antifungals may be needed for widespread severe infections or hair follicle involvement on the scalp.”
Dr Wood says, “Fungus can be treated with topical creams in mild cases. Many effective fungal creams can be found over the counter such as terbinafine or clotrimazole. I recommend using twice daily until clear and then using two weeks beyond rash clearance to make sure there is no recurrence.”
Dr. Lobkova says, “Tinea pedis (athlete’s foot) treatment- There are various over the counter creams. The best over the counter topical medications are derived from the Allylamine family, such as topical terbinafine, because they are fungicidal and actually kill the fungus. Topical azoles, like clotrimazole, are fungistatic, meaning they limit fungal growth but they do not completely get rid of the athlete’s foot. Prescription-strength topical antifungals may work better for recalcitrant cases. I typically prescribe an antifungal foam because the foam is more drying than a cream and it is absorbed immediately without having to wait to put on socks.  I advise my patients to avoid foot creams with fragrance and other irritants as this will worsen Athlete’s foot. I also advise to regularly allow the feet to air out, whether it is at night or throughout the day. 
Toenail fungus treatment and cure has proven to be a challenge to healthcare professionals. Oral prescription drugs are somewhat promising however they are invasive and have harmful side effects. There are two types of oral medications: allylamines and azoles. Allylamines (i.e. terbinafine, naftin) are fungicidal, in other words, they kill the fungal elements. Azoles (i.e. itraconazole, fluconazole) are fungistatic and work by attacking the cell wall. The efficacy of these oral medications is about 70-80% cure rate. However, they have to be taken daily for 3 months and are metabolized entirely by the liver. They build up a level of toxicity in the body thus providers will typically screen the liver enzymes before starting on oral medication. 
Recently, laser technologies and topical prescription drug therapies have been introduced as a treatment for onychomycosis avoiding the disadvantages of systemic drug therapies, offering a rapid treatment for an often persistent nail condition. Prescription topical medications such as tavaborole (brand name Kerydin) and efinaconazole (brand name Jublia), have upwards of 35-54% cure rate. These topicals are alcohol-based so they are able to penetrate under the nail plate and better reach the fungus. However they rely on compliance, requiring daily application for 1 year. Laser therapy is FDA-cleared for the treatment of fungal toenails and clearing of discolored toenails. It is a newer treatment that emerged within the past 10 years. Laser therapy is safe and effective, with a cure rate of approximately and approximately 70-80% cure rate.”  
Dr. Wood suggests, “Home remedy for toenail or foot fungus is soaking feet in amber colored Listerine mouthwash for 15 minutes daily. It contains Thymol which has antifungal properties. Simple tip but patients find helpful: Put on socks before underwear to avoid spreading foot fungus to the groin region. Easy way to prevent jock itch.”
Dr. Lobkova recommends the following:
1-” Use foot powder (talc-free): Before you put on your socks, spray some foot powder. I like Arm & Hammer Foot Odor Control Powder which uses cornstarch to absorb moisture and prevent excessive sweating. 
2- Use UV-light shoe sterilizers for all shoes, especially leather since those cannot be washed in the washing machine. Air-out insoles (if removable). The shoe sterilizer dries out the inside of the shoe which can harbor unpleasant bacteria, viruses, and fungi. 
3- Make Domeboro Medicated soaks- has astringent properties, meaning it constricts sweat glands and reduces sweating. I recommend using an astringent soak to dry out the feet about twice a week.
4- Wear sneakers or shoes made of a breathable air mesh upper and/or breathable rubber soles. Sneakers could even have both features since athletic footwear is made to support heavy activity. 
Like most fungal infections, fungus prefers a moist and dark environment. Thus it is important to keep the feet and the surfaces touching the feet clean and dry. I advise you to wash sneakers, insoles, and socks regularly with color-safe bleach. If shoes are not washable, like leather loafers, open them, remove the insole if possible and place them to dry in the sun at least weekly. I also highly recommend using Smartwool or Darn Tough socks. The specially designed Merino wool material is a natural material (instead of synthetic like Microfiber) that wicks away moisture from the foot. Cotton socks absorb moisture and keep the foot moist all day. 
Remember to check your feet everyday. There are multiple conditions that flourish in moist and sweaty environments, like plantars warts, fungal infections, and bacterial skin infections. It is advised to seek medical attention from a podiatrist if something new arises, like a new red spot, scaling, or itching in the feet or ankles.”
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