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FUNGOUS INFECTIONS OF THE SKIN

Athlete’s Foot“Ringworm”Ringworm of the ScalpJock ItchCandidiasisTinea Versicolor


  ATHLETE’S FOOT

thlete’s foot does attack the feet, but it’s not limited to athletes. It’s also known as ringworm, but it’s not a worm. Having disposed of two popular misconceptions about an ailment that gets a toehold on so many of us, let’s get down to the facts.

Athlete’s foot is a nasty infection caused by a fungus. It occurs mostly among teenage and adult males. (You can call it a “guy” thing!) It is fairly easy to treat, but it can be stubborn, too. Although the majority of fungous infections of the skin are not life threatening, they can cause significant discomfort and embarrassment.

Fungous diseases, or disease caused by a fungus, are very common skin disorders. Fungi are living germs – actually miniature plants – that grow and multiply on the skin, in the hair, and in the nails of almost all living creatures.

(All fungi, by the way, are not harmful; many are beneficial and play a role in producing beer, cheese, and antibiotics such as penicillin. Other fungi, however, cause rust, mildew, and ringworm infections.)

Why certain people develop fungous infections and others do not are questions that have not yet been resolved. Why females have a lower incidence is also unknown. Perhaps women are cleaner, sweat less, wash more often, and wear looser footgear. Maybe their hormones have antifungal properties. We really don’t know. There is speculation that some people are immune to certain types of infections, and ringworm may be one of these.

Ringworm of the feet does not occur in primitive races accustomed to going barefoot, and it almost never appears in children under the age of twelve. Thus, if your child has a rash on his or her feet, it probably is not a fungous infection.

It is possible to be a host of the fungus of athlete’s foot without any infection or other symptoms. It is only when you lower the natural resistance of the skin that the fungi thrive, proliferate, invade the outer layers of the skin, and set up housekeeping. This lowered resistance may be the result of excessive moisture and sweating (particularly in the summertime, due to sweaty socks and not drying your feet after swimming and bathing), inadequate ventilation of the feet (tight shoes and socks), uncleanliness, or friction. Athlete’s foot is also very common in those who have diabetes.

Athlete’s foot, the most common fungous infection in man, affects people in different ways. For some it is characterized by peeling, cracking, and scaling of the skin between the toes (particularly between the last two toes). Other people experience redness, scaling, and blisters along the sides and soles of the feet. Occasionally there is intense itching. Still other people develop a dry, reddish, non-itchy, scaly eruption, covering the entire sole. This common infection is referred to as the moccasin, or sandal, type of athlete’s foot.

By the way, every rash on the feet is not necessarily athlete’s foot: it may be an allergy from shoes or dyes, it may be psoriasis, or any of a number of conditions that frequently attack the feet and toes.

If you have a persistent rash on your feet, consult your physician. Over-the-counter medications may only aggravate conditions that have been misdiagnosed as athlete’s foot. And, if left untreated, athlete’s foot can lead to infection by other organisms – bacteria – that may require antibiotic therapy, continuous wet dressings, and complete bed rest. Only doctors can diagnosis athlete’s foot with any certainty.

How do you treat athlete’s foot? No problem.

In the simple, uncomplicated cases, I recommend applying antifungal creams or gels to the affected areas twice daily. This will usually cure the condition in a matter of weeks. If there is weeping, oozing, and blisters, and if the toewebs are wet and soggy, you should soak your feet twice a day in Burow’s Solution before applying the antifungal medication.

If your athlete’s foot is stubborn and extensive, or if it has settled in and affected your toenails, or if you have an allergic spread on your fingers and hands in the form of itchy water blisters, your doctor will probably prescribe some newer topical creams and lotions and, perhaps, oral antifungal medications.

How can you prevent athlete’s foot?

Unfortunately, many people with athlete’s foot often have toenail involvement. About one third of all diabetics have toenail infection. If nail fungus is present in your toenails (and only your dermatologist or podiatrist can tell), you may have to treat these as well. If they are not taken care of, they act as a reservoir for subsequent foot infection.

If you follow all the suggestions mentioned above, you will never be tripped up by athlete’s foot.

    TREATING ATHLETE'S FOOT

In the acute stage, when your toewebs and toes are red, oozing, and blistered, do not apply any surface medication. The only helpful therapy at this stage is to soak your feet in antiseptic solutions every 4 o 6 hours. See pages (000) for the proper method to soak the feet. The following compress should be used:
Bluboro Powder or
Domeboro Powder

Directions: Dissolve contents of one packet in a pint (16 ounces) of warm water as soaks as directed on pages (000-000).

During the soaking process, keep your toewebs separated by thin strips of linen or cotton material, such as old washed sheets or shirts or handkerchiefs. Never use cotton balls or batting, as their wood fiber content can be irritating.

CREAM

After the soaking, or when the lesions have begun to dry up, apply any of the following to the affected areas:
Lamisil Cream
Tinactin Cream

POWDER

Dust the following powder on your feet and between your toes twice daily:
Zeasorb AF or
Tinactin Powder

While treating athlete's foot, it is important to keep your toes separated. Purchase lamb's wool from your drugstore, and use it day and night.

 

“RINGWORM”

ingworm,” – actually ringworm of the skin other than areas of the scalp, beard, hands, feet, and groin – is a worldwide disease. The scientific terms for this prevalent disorder is tinea corporis and tinea circinata.

While it may affect people of all ages, it is most frequent in children. The source of the infection is usually a house pet (kitten or puppy), farm animal, or other infected child or adult.

The classic representation of “ringworm” is a sharply bordered, red patch ringed with tiny, blisters within which there appears a band of clearing. Central replication of this process, usually the rule in long-standing cases, results in the typical concentric rings that are considered the hallmarks of “ringworm.”

As with other fungous infections of the skin – “athlete’s foot,” “jock itch,” etc. – this form of ringworm is very itchy and occurs more often in hot, humid weather. Diabetes, obesity, and immune deficiency may predispose to more extensive lesions.

If you suspect that you or someone in your family has ringworm, see your physician with all deliberate speed. Since ringworm of the skin is highly communicable, treatment should be initiated at once The application of an antifungal cream twice daily will often be sufficient to clear a mild infection in a matter of two or three weeks. When the lesions are more extensive and of long duration, your doctor will prescribe a course of oral antifungal medication.

If a household pet or other animal is suspected of having transmitted the ailment, it would be prudent to have it checked by a veterinarian.

In all cases of ringworm, you should avoid sharing towels, linens, and clothing to prevent transmission of the infection.

 

RINGWORM OF THE SCALP

ingworm of the scalp – tinea capitis – is the most common fungal infection in children.

Characterized by scaliness, crusting, itchiness and patchy hair loss, ringworm of the scalp is highly contagious, and sources of the infection are usually other children. In rare cases it can be caused by contact with a puppy or kitten. This common infection can be spread by hats, scarves, bandannas, headbands, pillowcases, and the like.

Topical (surface) medication is not effective for this condition and your dermatologist or pediatrician will more than likely prescribe an oral medication to cure it. First a definite diagnosis should be made; this involves “planting” a suspicious hair from one the patches onto a special type of medium – this is called a culture – and also looking at the suspected hair under a microscope to locate the culpable fungus organism. A prescription shampoo – Nizoral Shampoo (not the over-the-counter variety) – should also be used at least once daily.

 

JOCK ITCH

ock itch is one of those conditions, like hemorrhoids, that few people talk about in public. But there are a lot of people who suffer from it in private.

Jock itch is a common infection of the groin area in young men that often occurs in association with athlete’s foot. While the term “jock itch” is the popular expression that describes any rash in the groin area, it usually indicates a superficial fungous (ringworm) infection caused by the same organisms – miniature plants called fungi – that can give you athlete’s foot.

Jock itch occurs more frequently in summertime. It commonly affects plump people and people who are physically active. The tiny fungi that cause jock itch often live harmlessly on the skin, but when exposed to the right conditions – hot, humid, and damp places such as locker rooms, shower stalls, and swimming pools – they begin to thrive, multiply, and become harmful.

The groin area is more susceptible to skin irritation and infection than other parts of the body for several reasons. Groins are wet, warm, and dark. The skin is thin and delicate, and subject to friction, particularly if you do a lot of strenuous activity or if you have some extra folds of fat to chafe against your clothing. In addition, jockey shorts, tight pants, jock straps, and wet bathing suits not only make you sweat more, but they prevent evaporation – making the groin area ideally suited for the growth and proliferation of these infectious organisms.

Jock itch usually begins as a small, reddish, scaly rash in the groin area that gradually enlarges to form a patch with a sharply defined border. If left untreated, the rash may spread to involve the upper inner thighs, the scrotum, the buttocks, and the pubic and anal areas. The skin becomes raw and soggy due to moisture and friction. Itching is the most common symptom, but there also may be some burning and pain.

How can you prevent jock itch? And if you have it already, how can you treat it? Here are some general measures to prevent jock itch:

If you already have jock itch, over-the-counter ringworm preparations – the same as is used for athlete’s foot – can be used twice daily. The chances are that you also have athlete’s foot, so treat this condition as well.

    TREATING JOCK ITCH

In the acute stage of jock itch, when there's redness, burning, and pain, do not apply any creams or powders to the affected areas. he only treatment that will alleviate this phase is to soak the areas in a tub of warm water. This will soothe the burning and itching and help dry up wet, weeping areas.

After the baths, apply one of the following twice daily:
Lamisil Cream
Tinactin Cream

When the rash is nearly healed, dust an antifungal powder – Tinactin Powder – in the groin areas twice daily to prevent a recurrence of the jock itch.

Remember also to put on your socks before your boxer shorts. No jockey shorts!

Also, it's important to treat any athlete's foot you may have. No athlete's foot, no jock itch . . .

 

CANDIDIASIS

andidiasis – sometimes called moniliasis – is a common infection of the skin, mucous membranes, and nails (and, occasionally, internal organs) caused by a yeast-like fungus called Candida (or Monilia).

The body acts as a host to many different types of microorganisms including bacteria and fungi. Candida is a normal inhabitant of the human digestive tract where it flourishes without causing any disease most of the time. While some microorganisms are useful to the body, others, as a result of a lowered resistance, can multiply rapidly, proliferate and set up housekeeping – very often on the skin.

These Candidal organisms can involve almost any skin surface on the body and it is the most common cause of diaper rash in infants and young children where the warm and moist conditions under the diaper make it an ideal environment for the proliferation of these organisms. In adults it is often found in skin folds such as under the breasts, in the armpits, in the groin areas, in skin folds, around the nails, on the glans penis, and in the anal area. It is characterized by enlarging, scaly, reddish patches surrounding which are bright-red pimples and pus bumps.

Candidiasis often occurs during pregnancy, in diabetes, in various endocrine disorders, in obese individuals, in those who perspire freely, and in those who are immunodeficient as occurs in AIDS and other conditions. Other predisposing factors for increasing the risk of candidiasis of the skin and mucous membranes include oral antibiotics and oral contraceptives; warm, humid climate; occlusion as with plastic and rubber panties (in babies) and nylon pantyhose; other underlying skin conditions, such as psoriasis; chemotherapy and corticosteroids; and others.

The condition called “thrush” is a form of oral candidiasis that is found in the mucous membranes of the mouth and is very common in infants and young children.

Candidal infections are highly contagious and can be passed from direct contact, often sexual, or by contact from pets, clothing, showers, swimming pools, combs and the like.

Once your physician has made the diagnosis by microscopic or culture examination (as is done for other fungal infections), topical (and occasionally systemic) treatment is simple and usually curative.

To prevent recurrences of candidiasis, keep the skin dry and preferably cool. Expose the affected areas to air whenever possible. Wear loose-fitting “breathe-able” natural materials; wash hands thoroughly very often; and keep clothing scrupulously.

If you are taking an antibiotic, ask your physician to eliminate it for a few days it if it will not interfere with your general health.

And make sure you do not have diabetes. Only your physician can know that.

 

TINEA VERSICOLOR

inea versicolor is a common, friendly, minor fungous – actually a yeast-like – infection of the upper layers of the skin. Friendly means that it is relatively harmless; minor means that it is only mildly contagious (through direct contact and clothing) and, for the most part, is easy to cure. While it lasts, however, it can be itchy and, when widespread, may be embarrassing cosmetically.

To the eye, tinea versicolor appears as fine, round, scaly patches that usually are tan or fawn-colored. These patches are most common over the chest, back, shoulders and upper arms, but they can also appear on the neck, face and other areas of the body. Acting as a sunscreen, they block out the sun’s rays. In white people, this results in depigmented areas of the skin that are lighter than the surrounding, tanned skin in summer and darker than the surrounding, untanned skin in winter. In black people, these depigmented patches can be various colors: tan, brown, gray, yellow, or even pink.

Like most fungous infections, tinea versicolor thrives in hot, humid environments. During the summer months, people often complain about itching and scaling; in winter, many of the symptoms disappear. Some people are more predisposed to this condition than others, and adolescents and young adults seem to be most susceptible. In tropical climes, where there is uninterrupted heat and humidity, people often have these patches all year round. In Liberia and Samoa, for example, almost half the adult population may be affected.

The name tinea versicolor means “superficial fungous infection characterized by a change of color.” To establish a diagnosis of this condition, a dermatologist will scrape some of the scales of one of the patches and search for the responsible fungus. Under the microscope, the fungus looks like a dish of spaghetti and meatballs – small spherical spores and rod-like filaments. (Dermatologists refer to it as the “spaghetti-and-meatball” fungus.)

Although it’s the most common fungous infection in the world, tinea versicolor is easy to treat and leaves no scars. Since the condition has a tendency to recur, however, particularly in hot, humid weather, you may have to continue treatment over a long period of time. If left untreated, the condition may persist indefinitely.

Treatment usually consists of washing the affected areas with a non-prescription-type shampoo containing selenium sulfide (Selsun Blue) or ketoconazole (Nizoral), and applying a specific antifungal cream or lotion. Once you have begun treatment, it is important to wear freshly laundered or dry-cleaned clothing to prevent reinfection.

Some newer oral medications are being used by many dermatologists to treat tinea versicolor. Only a few tablets or capsules are required to destroy the infection, so if you have a stubborn and recurrent case of this “friendly fungus,” see your dermatologist.

Even after you have destroyed the fungus, the patches may require repeated sun exposure – and Tincture of Time – to change back to their normal color. This may take months, so be patient!

    TREATING TINEA VERSICOLOR

Wash the affected areas thoroughly for 5 minutes daily for a period of two weeks. Repeat these washings monthly for at least a year. Use any of the following "washes":
ZNP Bar
DHS Zinc Shampoo
Selsun Blue

For more information on the various fungous infections, log on to:
www.aad.org
1-888-462-DERM x22
or
www.familydoctor.org/handouts/316.html

RECAP (in appropriate sections)



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