Fungal Infections
Fungal infections can affect virtually any part of your skin.
Get early treatment of your fungal infections to reduce symptoms and spread.
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Table of Contents
What are fungal infections?
Fungal infections are one of the most common conditions afflicting the skin, often caused by overgrowth of fungi associated with a change in the skin microenvironment. They are capable of infecting cutaneous structures such as the skin, nails and hair. Fungal infections have evolved along with geography and socioeconomic conditions.
How do fungal infections spread?
There are over 40 species of fungi that are recognised but only about 10 are responsible for most human infections. Tinea rubrum is the most common fungal infection and is endemic in Southeast Asia, Australian outback and western Africa.
Fungal infections can be transmitted from these sources:
- Person-to-person spread
- Animals e.g. dogs, cats
- Soil (least common)
There are some risk factors that increases the likelihood of fungal infections:
- Atopic eczema
- Topical steroid cream usage
- Immunosuppression: those with a weakened immune system tend to have more difficult to treat infections.
How are fungal infections diagnosed?
Depending of your condition, your doctor may carry out some physical and laboratory tests to establish the diagnosis and guide treatment.
- Direct Microscopy – most common test with relatively fast results.
- Wood Lamp – may be useful to exclude other skin conditions.
- Fungal Culture – slow and expensive test, may be necessary if considering long term anti-fungal therapy.
- Skin or nail biopsy – may be helpful when diagnosis is difficult to establish.
What are the types of fungal infections?
Fungal Toenail Infection (Onychomycosis)

An unsightly toenail can cause social embarrassment. It is more than just a cosmetic concern; it is an infection that can spread to other toes, distant parts of the body and to the people. Fungal toenail infections are common, especially with advancing age, diabetes and nail injury. The nail may have a yellow discolouration, crumbly edges, and may even separate from the nailbed.
The various treatment options such as topical and oral antifungals have a modest benefit in patients. However, if you are not keen on consuming medication or an unsuitable candidate for medication, laser treatment is an alternative to consider. Laser of a suitable wavelength is used to reach and heat the affected area, the high temperature will result in fungal cell damage and death. As Laser treatment does not require any ingestion of oral medications, it eliminates the risk of potential allergies, drug interactions and drug related side effects.
Pityriasis Versicolour

A common superficial fungal infection of the skin, that is common in warm and humid environments like Singapore. Numerous skin patches that may take on different hues from pink to brown or almost white. Mildly itchy, it can be cosmetically displeasing and most commonly involves the trunk, back and abdominal areas. A normal skin flora known as Malassezia furfur causes the skin manifestation of pityriasis versicolour.
The treatment involves application of topical antifungals for mild cases, and oral antifungal therapy for more severe cases. It’s a condition with a high recurrence rate, and some patients may benefit from therapy on an intermittent basis to prevent recurrence.
Fungal Acne

Fungal acne describes the infection of the pilosebaceous unit by the Malessezia furfur yeast species. These yeast, which are normally present on human skin, can feed on the sebum and cause skin conditions such as Malassezia folliculitis or Pityrosporum folliculitis.
Treatment:
- Topical therapy in the form of shampoos (containing selenium sulphide or pyrithione zine) may be helpful.
- Topical anti-fungal creams
- Oral anti-fungal therapy for more severe and extensive cases.
Tinea pedis (Athlete's foot)

Tinea pedis, commonly known as athlete’s foot, results from fungal infections on the skin of the feet. The infection is more common in individuals who walk barefoot in common areas like gym and swimming complex shower facilities. Those with a history of diabetes or who wear tight fitted footwear are at increased risk. The rash is usually itchy, can form small vesicles and may give off an offensive odour. Left untreated, tinea pedis can lead to more serious skin infections such as cellulitis.
Treatment:
- Improve hygiene to prevent re-infection.
- Topical anti-fungal creams e.g. miconazole, clotrimazole
- Oral Anti-fungal medication for those who do not respond to topical therapy or have severe infection.
Tinea corporis (Ringworm)

Tinea corporis (ringworm infection) can affect the body, arms, legs or neck region. It can occur at all ages, and may be transmitted from other parts of the body (e.g. tinea pedis), from another person or contact with animals or contaminated soil. Apart from mild itch, there are often no symptoms with the rash lasting over weeks to years.
Treatment:
- Topical anti-fungal creams
- Oral anti-fungal agents for lesions that are extensive or fail to respond to topical preparations.
Tinea Cruris (jock itch)

Tinea cruris or Jock itch is a common infection affecting the groin and thighs. It may extend to buttocks and genitalia in some cases. Being more common in males, it is usually associated with tinea pedis (athelete’s foot) and fungal toenail infections. Risk factors include warm, humid environments, tight clothing and obesity. Often there are no symptoms, and patients often seek help when it itches or enlarges.
Treatment:
- Use anti-fungal powder for prevention
- Simultaneous treatment of tinea pedis and fungal toenail infections.
- Topical anti-fungal creams
- Oral Anti-fungal medication for those who do not respond to topical therapy or have severe infection.
Frequently asked questions about fungal infections
Symptoms may vary depending on the type of infection but often include itching, redness, scaling, cracking, and in some cases, blistering or oozing lesions. The affected area may also appear inflamed or have a raised border.
Diagnosis typically involves a visual examination of the affected area by a healthcare provider. In some cases, they may also take a skin scraping or culture to identify the specific type of fungus causing the infection.
Treatment usually involves antifungal medications, which can be applied topically (creams, lotions, or powders) or taken orally (pills). Over-the-counter options are available for milder infections, but severe or persistent cases may require prescription-strength medications.
The duration of treatment varies depending on the type and severity of the infection. In many cases, symptoms improve within a few days of starting treatment, but it’s important to continue treatment for the full duration prescribed by a healthcare provider to prevent recurrence.
Yes, there are several measures you can take to reduce the risk of fungal infections, including keeping the skin clean and dry, wearing breathable clothing, avoiding sharing personal items such as towels and clothing, and using antifungal powders or creams in high-risk areas like locker rooms or communal showers.
Yes, many types of skin fungal infections are contagious and can spread through direct contact with infected skin or contaminated surfaces. It’s important to practice good hygiene and take precautions to prevent spreading the infection to others.
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References:
- Zhan P, Liu W. The changing face of dermatophytic infections worldwide. Mycopathologia. 2017 Feb;182(1):77-86.
- Hainer BL. Dermatophyte infections. American family physician. 2003 Jan 1;67(1):101-9.
- Malgotra V, Singh H. Malassezia (Pityrosporum) folliculitis masquerading as recalcitrant acne. Cureus. 2021 Feb;13(2).
ABOUT DR MOSES NG

MBBS (London) with distinction
Dip Practical Dermatology (Cardiff) with distinction
Member of American Acne & Rosacea Society
Fellow of American Society for Laser Medicine & Surgery
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Dr. Moses Ng is a distinguished professional in the field of aesthetic medicine, renowned for his expertise in advanced cosmetic procedures. With over 15 years of experience, extensive training and a keen eye for detail, Dr. Ng specializes in a wide range of treatments, including injectables, laser therapies, and acne scar management.
Dr. Moses Ng’s commitment to excellence and patient-centric approach have earned him a reputation as a trusted clinician in aesthetic medicine. His continuous pursuit of the latest advancements in the field ensures that his patients receive the highest standard of care and the most effective treatments available.