Summary
Superficial fungal infestations may affect the skin and nails.Fungal infections may occur all over the body. Although fungal infection of the scalp, hair and skin is sometimes called ringworm, it is caused by fungi, not worms. Fungal infection of the mouth ? oral thrush ? is usually caused by Candida albicans. Some people are more susceptible to fungal infections than others. Some people may be carriers of fungi, but are symptom free. If left untreated, fungal infections may cause discomfort and pain. Fungi may be present on the skin without causing an infection.

Symptoms
Ringworm of the skin - Scaly, red, crusted or swollen blister-like bumps with pus (abscesses) that look like worms around the edges - Itchy rash that spreads rapidly - Rash resembling a ring, with a clear centre (some cases) - Patches of rash with a border that is not clearly distinguishable (some cases) - Exacerbation of the rash after exposure to the sun Ringworm of the scalp and beard - One or more round or oval patches of baldness on the scalp, beard or moustache - Flakes resembling dandruff on the hair Irritation of the scalp, beard or moustache - Crusted, broken or matted hair - Hair loss (temporary or permanent) - Black dots on the scalp where hair has broken off at the roots (less common) - Swollen lymph nodes in the neck (occasional) Ringworm of the groin - A rash in the groin, in skin folds, and on inner thighs or buttocks (usually not on the penis or scrotum) - A well-defined border around the rash, with scaly or blister-like bumps - A red-brown centre inside the rash - Simultaneous occurrence of athlete?s foot (some cases) Ringworm of the hand - A rash on the palm or back of the hand - Rash on palm: may be dry and scaly, resembling the symptoms of athlete?s foot - Rash on back of hand: may be scaly, with blister-like bumps around the edges - Fingernail infection (some cases) - Simultaneous occurrence of athlete?s foot (some cases) Tinea versicolor - Rash with spots on the upper arms, chest and back Some people with ringworm have an allergic reaction (called id reaction) on a different part of the body. In ringworm of the scalp, the id reaction usually occurs on the face. Nail infections Symptoms may include the following: - A distinct white or yellow spot on the nail that gradually spreads over the entire nail - Discoloured, damaged, splitting, brittle, thickened and rough nails - Cracking of nails - Build-up of debris (nail fragments and pieces of skin) under the nail - Red, itchy or swollen surrounding skin - Athlete?s foot occurring simultaneously If the skin under the nail is infected (distal subungual onychomycosis), the following symptoms may appear: - Yellow streaks in the nail bed and on the under side of the nail (nail plate) - Build-up of debris (nail fragments and pieces of skin) under the nail - Discolouration of the entire nail and separation of the nail from the nail bed (onycholysis) ? severe infections - Brittle and broken nails If the nail surface is infected (white superficial onychomycosis), there may be: - White spots or white streaks on the nail surface - A soft and powdery nail surface - Damage to the nail, crumbling and brown or grey discolouration If the fungal infection is in the nail (Candida onychomycosis), the symptoms vary. This infection usually occurs in the fingernails. The following symptoms may appear: - Opaque, greenish or brownish nails - Oddly shaped nails - Thick nails - Infection of the nail fold skin - Infection of all nails - Pain (the only type of fungal nail infection that may be painful) If the base of the nail is infected (proximal subungual onychomycosis), the following symptoms may appear: - Whitish appearance of the nail base - Opaque nails - Infection on top of the feet Oral thrush - Curd-like white patches inside the mouth, on the tongue, palate and around the lips - Red, inflamed areas underneath the white surface, with slight bleeding when attempting to scrape off the white patches - Cracked, red, moist areas of skin at the corners of the mouth - Fussiness, irritability, and poor feeding in infants if the infection is painful (rare)

Prevention
Nail infections - Keep the nails clean and dry. Dry the feet well after a bath or shower, especially between the toes. - Change socks at least daily, or more often if your feet perspire excessively. - Do not over-trim nails, or pick at and poke around the toenails; prevent minor injury which might provide an entry point for fungi. - Do not wear tight or ill-fitting shoes. - Try not to wear the same pair of shoes for two days in a row. Give a pair of shoes time to dry out. - Do not share shoes with someone else. - Do not walk barefoot in public or shared showers or locker rooms. Wear shower sandals or shower shoes. - Treat other infections such as athlete?s foot. Oral thrush - Follow a healthy diet. - Use antibiotics only as prescribed by a doctor. - Visit the dentist if you have an irritation caused by dentures. - Pregnant women should be checked for vaginal thrush to prevent oral thrush infection of their newborn babies.