Tinea skin infections

Tinea is a condition caused by a fungi that infect the skin. Tinea infections are most common on the feet, particularly between the toes, and around the upper thigh and groin.

Common types of tinea infection include:

  • Tinea pedis – this is tinea of the foot or between the toes and is also known as athlete’s foot.
  • Tinea unguium – this is tinea that involves one or more toenails or fingernails.
  • Tinea cruris – this is tinea of the groin or upper thighs and is also known as jock itch.
  • Tinea corporis – when tinea is present on other parts of the body or skin and this is often known as ringworm.

Causes

Tinea can be easily contracted through skin-to-skin contact with an infected person or animal, or through indirect contact with an object or surface that an infected person or animal has touched. Bathroom floors, bathmats, towels, showers and communal bathing, swimming and changing room areas are common sources of infection.

On contact with your skin, the dermatophyte fungi spread to the surface layers of dead cells – they generally do not invade living skin cells. Symptoms result from the body’s allergic and inflammatory response to the infection, and they usually appear within four to 10 days.

Symptoms

Tinea symptoms can differ depending on the location on the body and may include:

  • redness and/or itching
  • burning or stinging
  • a rash that may form blisters or pustules
  • raw, inflamed or scaly skin
  • in more severe cases, weeping or oozing areas of skin.

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Athlete’s foot (tinea pedis)

Tinea between the toes is a common condition affecting the toe web. In its most common form, it occurs as red or white areas of scaling or cracking between the toes (most commonly between the small and fourth toes). The affected area usually itches and burns and the skin cracks may be painful.

Less common is ‘moccasin-type’ tinea pedis, which involves the sole of the foot and usually appears as dry, scaly patches or cracks in the skin. These may extend up onto the side of the foot in a moccasin-style pattern.

Jock itch (tinea cruris)

Tinea affecting the genitals, groin or upper thigh usually appears as a red rash with raised borders that may be scaly. It is often accompanied by itching and burning or tenderness. Chafing (irritation of the skin by friction, for example, from close-fitting underwear) may aggravate the problem.

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Ringworm (tinea corporis)

Tinea of the body may occur on the trunk, arms or legs, and usually starts as flat, scaly spots before developing a raised red border that advances outwards in a circle. The border may be scaly and may blister, while the centre of the area often becomes more normal in appearance with fine scaling. Ringworm is often itchy.

Scalp ringworm (tinea capitis) 

Tinea of the scalp may appear as a small, raised pimple that spreads leaving fine, scaly patches of skin. Infected hairs can become brittle and break off causing small areas of temporary hair loss. This condition is most often seen in pre-adolescent children.

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Nail infection (tinea unguium)

Tinea of the nail bed (beneath the nail) usually affects the toenail and can cause the nail itself to become discoloured and thickened. The nail may become brittle and crumble or lift away.

Treatment

See your doctor if the infection becomes severe, long-lasting or if non-prescription treatments from the pharmacy have not worked, or if the skin is swollen, blistered, crusted or smells unpleasant. If your nails are involved you may need a prescription course of antifungal tablets rather than a pharmacy product. You should also see your doctor or pharmacist if the infection involves the scalp or beard.

Not all skin and nail changes that look like tinea are in fact tinea, so it is important to have them checked if they do not clear up quickly. While not too common, it is possible for melanoma skin cancers beneath the nail to grow unchecked, and other skin conditions can be mistaken for tinea.

Your doctor can determine the exact cause of an infection painlessly by taking a small scraping of skin or nail from the affected area and sending it to a laboratory for analysis. It may take up to four weeks for your doctor to get the results, but he or she may then be able to prescribe a more suitable treatment. If this fails, your doctor can refer you to a dermatologist, a doctor who specialises in skin problems.

People with diabetes or long term conditions that require immune-suppressing drugs (e.g. after kidney transplant) are more at risk from tinea and other infections. These people should always seek advice from their doctor for unusual looking skin changes. Older people and those with diabetes, swollen legs or suppressed immunity can also find the broken skin, caused by tinea, can become infected by other bacteria as well, causing inflammation and a more serious problem called cellulitis.

Self care

  • Use an antifungal cream, lotion, gel or spray from the pharmacy or as prescribed by your doctor. Some antifungal products stop fungi growing and another type kills the fungus; others are combined with a corticosteroid drug to reduce itching.
  • Keep your skin as clean and dry and possible. Shower or bathe daily, dry thoroughly between your toes and skin folds, and use a hair dryer if necessary.
  • Wear socks and loose clothing made from fibres that draw moisture away from the skin, such as wool, cotton or the newer synthetic fibres.
  • Wear breathable fabric (e.g. leather) not synthetic material shoes. Change them each day and allow them to dry out.
  • Wash the shower and bath using a bleach-based product every couple of days.
  • Wash socks, towels, bathmats and underwear in very hot water (over 60ºC) and dry them well.
  • Regularly wash floors (with very hot water and soap) where you walk in bare feet.
  • Do not share towels, clothing or shoes.

Medicines for tinea can be bought from a pharmacy or be prescribed by your doctor. It is important to follow the instructions on the pack carefully. Some products need a single application only; others need regular application until one or two weeks after the infection has cleared, to prevent recurrence. If the infection has not gone away by the time you have finished the course of treatment, or it is getting worse, visit your doctor.

Prevention

Once your tinea has cleared up, you should try to avoid a recurrence by:

  • wearing open-toed shoes or going barefoot as often as possible
  • alternating the shoes you wear each day so they can dry out – air them in the sun if possible
  • drying your skin carefully after you shower or swim
  • wearing jandals or plastic sandals in public bathing or changing areas to reduce the risk of picking up or passing on a fungal infection
  • not sharing towels
  • wearing loose fitting clothes and underwear that ‘breathes’.

Learn more

Tinea  DermNet NZ, 2013
Ringworm and tinea infection - a patient's guide  Family Doctor NZ, 2015

Credits: Original material provided by everybody.co.nz. Updated by Health Navigator April 2014.. Reviewed By: Adam May