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Skin Fungal Infection

Living in a hot humid climate of Singapore, fungal infection of the skin is common. The fungus thrives and favors body areas that are moist and warm such as the armpit, breast folds, groin, buttocks, feet, toes or even nails.
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Table of Contents

What is Fungal Infection?

Living in a hot humid climate of Singapore, fungal infection of the skin is common. The fungus thrives and favors body areas that are moist and warm such as the armpit, breast folds, groin, buttocks, feet, toes or even nails.

In people with lower immune system such as diabetes, fungal infection can recur frequently. One can even manifest with a dramatic widespread fungal rash.

What causes skin fungal infection?

Superficial skin fungal infections are commonly caused 2 main groups of fungi: The dermatophytes (such as Trichophyton, Epidermophyton and Microsporum spp), and Yeast (such as candida spp). Dermatophytes tends cause fungal infection affecting the skin surface, hair and nails. Yeast, on the other hand, causes fungal infection affecting the skin, nail and mucous membrane.

What causes Eczema?

  • Genetics
    Atopic eczema tends to run in the families. The alteration of the gene maintaining a good skin barrier is believed to be the key factor in development of eczema.
  • Impaired skin barrier
    It is believed that people with eczema has skin barrier impairment, predisposing them to triggers in the environment, eventually leading to an inflammatory, allergic, and itchy skin response. Environmental triggers include chemicals such as wash/detergents/soaps, and exposure to infection, allergens, bacteria and etc.
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What are the symptoms and presentations of Fungal Infection?

  • Round-shaped ringworm
    Skin fungal infection can appear as red, scaly, round-shaped patches that gives an appearance of rings. This can sometimes be spotted over the body, groin, or even the scalp. Depending on the areas affected, they are medically termed tinea corporis, tinea cruris and tinea capitis respectively.
  • White Spot
    White scaly spots may appear over the sweaty areas of the body such as the face, neck, upper chest, back or limbs. This is a type of superficial skin fungal infection known as pityriasis versicolor.
  • Athlete Foot
    Also known as tinea pedis, it typically presents with scaly, itchy, blistering and peeling red rashes over the feet and web spaces. There can be tell-tale signs of abnormal nail changes.
  • Yeast Infection
    Yeast fungal infection tends to present with a red, macerated, sticky patch that can be found over skin folds of the breast lines, armpits, and groins. It can also occur over the genital region and is one of the common cause of vaginal discharge in women.

What is the difference between a skin fungal infection and a skin bacterial infection?

Commonly, the symptoms for skin fungal and bacterial infection may overlap or both infection can co-exist concurrently.

A simple guide of distinguishing both skin fungal infection and bacterial infection is as below.

SymptomsSkin fungal infectionSkin Bacterial Infection
MarginGenerally well defined red patchLess defined, slightly more indurated
Other featuresScaly +
May have scattering pustules
Center of the rash maybe fainter in color
May present with blisters
Uniformed in color
May have deep seated pus, with oozing sinus
May present with blisters
Systemic symptomsIntense itchLess intense itch, pain and fever

Who is at risk of developing fungal infection in Singapore?

Everyone has a risk to develop a skin fungal infection. As the climate in Singapore is relatively hot and humid, skin fungal infection is a common infective skin condition seen locally.

Although healthy people can develop skin fungal infections, patients who are immunocompromised, diabetes, background retroviral disease, cancer patients may have higher risk to develop skin fungal infection.

How is Fungal Infection diagnosed?

Skin fungal infection are usually diagnosed visually during clinical examination, supported by patient’s clinical history. Occasionally when the diagnosis is inconclusive, your doctor may advise you for fungal scrape, fungal culture or skin biopsy to confirm the diagnosis.

How can I treat Fungal infection?

In mild fungal infection cases, it is treated with anti-fungal cream. Oral anti-fungal medication may be required in more severe recalcitrant cases or infection that affects a large surface of the skin. Speak to your doctor on individual treatment options.


Why does fungus grow on the skin?

The skin environment can be a suitable place for fungus to thrive due to the below reasons:

  • Keratin protein on the skin surface allows the fungus to grow
  • Warm and moist environment are conducive climate for fungus to live
  • Poor skin barrier, breakage of skin surface encourages fungus to invade the deeper later of the skin causing infection and inflammation
What do I expect when I see my doctor?
Your doctor will take a relevant rash history and review your rash. Sometimes, your doctor may offer scrapping of the affected skin surfaces or nail testing. These tests are to aid the diagnosis by reviewing the affected skin or nail under microscope for any signs of fungus.
Why do I have to treat my skin fungal infection? What will happen if I leave my skin fungal infection untreated?
Although majority of skin fungal infections are not life threatening, leaving the condition untreated allows the fungus to spread to other parts of the body area.

In more severe cases, patients may develop secondary bacterial infection or systemic fungal infection. One may present with more alarming symptoms such as worsening skin itchiness, skin pain, systemic symptoms such as fever, unwell.

If the fungus infection affects your hair region such as the scalp, one may notice balding over the region. You are encouraged to seek medical advice as skin fungal infection are treatable.
How do I avoid recurrence of Fungal infection?
  • Keep your toes, feet, groin, armpit, body dry and clean.
  • Powder your body and feet to keep them dry
  • Avoid excessive sweating
  • Avoid walking bare-footed in areas with wet floor
  • Avoid sharing towels, napkins, hair brushes, combs that may have been infected with fungus
  • Wear cotton socks rather than nylon socks as cotton socks can absorb sweat
  • Change your socks daily
  • Consider open-toe sandals
  • Alternate your shoes
  • Avoid wearing damp shoes
Is Fungal Infection infectious?
Yes, Skin fungal infection can be passed on via contact to another person. You are advised to see your physician to get treatment for skin fungal infection as they are treatable condition with favorable outcome.
Why does my Fungal skin infection not go away?
If your fungal skin infection does not go away, you are advised to seek further advice with your physician. Sometimes, your physician may have to review the diagnosis, the progression of your rash, understand the response of the medication or treatment that you have received.

Depending on individual condition, your doctor may run some blood tests, fungal scrape tests or offer skin biopsy test to understand your skin condition further. Your medication may be changed accordingly as well.
Can boosting my immune system help to treat fungus infection?
Yes, living a healthy lifestyle and maintaining a good immune system reduces occurrence of skin fungal infection. Smoking cessation, healthy nutritious balance diet, adequate rest, regular exercise, avoid stress are important steps for ensuring our immune system is always at its tiptop condition.

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