Tinea

A common and benign condition, tinea is a fungal infection of the skin, hair, or nails. Of note, the infection is contagious and may be spread either from person-to-person or to multiple sites on a single individual. However, the fungus can also be found in various places such as soil, damp floors/showers, sheets, brushes, hats, gym mats, and on pets – all of which may be potential sources for infection.  The appearance of tinea, as well as the symptoms, may be different on different parts of the body.

TINEA CAPITIS – SCALP

Primarily seen in kids, the scalp may show flakes of skin resembling dandruff. There may also be pus bumps or patches of hair loss or broken hairs. In some people, the fungus causes more inflammation with redness, crusting and weeping on the scalp, and there may be enlarged lymph nodes in the neck (“swollen glands”). When hair loss occurs, it is usually temporary, as long as treatment is adequate and timely. 

TINEA CORPORIS – BODY

Better known as “ringworm,” the skin often appears like a red, scaly ring with clearing in the center. Sometimes, rings will be partial/broken, multiple/numerous, or even “snake-like” and irregularly shaped.

TINEA CRURIS – GROIN

Better known as “jock itch,” the skin is typically red, itchy, and limited to areas of skin folds. It commonly starts as a small  patch that slowly enlarges with time. The patch may be in the shape of a round ring, 1 to 2 inches wide, and it may or may not have associated flaking. 

TINEA PEDIS – FEET

Better known as “athlete’s foot,” the skin is usually moist and flaky between the toes, with diffuse dry scaliness over the sole. Less commonly, there may be red, scaly rings on the tops of the toes and feet, or even associated blisters. It is common for patients to have associated toenail involvement. 

ONYCHOMYCOSIS – NAILS

Primarily seen in the toes of older adults, nails are typically thickened with a yellowish discoloration. Additionally, there is often buildup of loose skin and fungus underneath the nail plate, especially at the outer edges or borders.

Treatment

There are a variety of over-the-counter and prescription medications, with treatment varying based on infection type and severity. Typically, the most effective topical will be over-the-counter butenafine cream (Lotrimin Ultra), which should be applied twice daily for 2 weeks or as otherwise directed.  Of note, tinea of the hair and nails will almost always require oral medication and should be discussed with your provider.  

Additionally, there are several ways to reduce tinea spreading and repeat infections. Avoid sharing combs, hair brushes, hats, pillowcases and towels. Keep combs and hair brushes clean. Towel dry well after baths or showers. Pay special attention to body folds and feet, including the skin between toes. Wear sandals or flip flops in locker rooms, public showers and around the pool. Change your socks at least once daily.