Scaly, itchy skin on the soles of the feet is usually the first sign of tinea. White, soggy skin between the toes and discolouration of the toe nails can also point to tinea. It generally begins on one foot then spreads to the other, and is transmitted from person to person. It does survive in water and is readily picked up at swimming pools, shared showering facilities and gymnasiums. Wearing thongs in communal showers will not prevent tinea. Once it occurs it proliferates in warm, sweaty conditions.
Wearing open leather sandals or shoes allows sweat to evaporate and should be encouraged in those whose feet tend to sweat. On the other hand, runners, gym shoes and vinyl footwear encourage tinea. Cotton socks are preferable to wool or nylon ones as they also absorb perspiration. Nylon pantyhose can also promote tinea. After showering, the skin between the toes should be dried thoroughly (hair dryers work better than towels). Antiperspirants can be used on the feet if there are no open cracks or sores. Driclor and Hidrasol are particularly effective.
Itchy, red skin in the groin spreading to the thighs is a common manifestation of tinea, especially in men. Many red, scaly, oval-shaped rashes on the body are called tinea, but are often due to eczema. Unless a correct diagnosis is made by a doctor, incorrect treatment may worsen the condition. Like tinea of the feet, tinea of the groin can be transmitted from person to person and can also be picked up at swimming pools, gymnasiums and the like.
Tinea groin can be prevented by wearing loose, cotton underwear and loose trousers or loose, cotton shorts. Tight-fitting jeans cause sweat retention and so promote tinea. Likewise, lycra bike shorts and gym tights are particularly likely to produce tinea. Tinea of the groin can also occur in women who wear nylon pantyhose. Changing to either stockings or pantyhose is helpful if this is the case.
Tinea scalp produces patchy hair loss and hair breakage, especially in children. It is transmitted from cats and dogs when children cuddle their pets.
Tinea scalp can be prevented by treating pets for itchy skin ‘ rashes.
This is a common problem, especially in tropical climates. It can produce a white, scaly rash on the chest, back and neck, which worsens when the weather becomes warmer. Traditionally, Selsun shampoo was used to treat this tinea infection but recurrences were common. A newer drug, called Ketoconazde (Nizoral), which is taken orally, is far more effective.
For mild cases of tinea, a cream such as Canestan, Daktarin or Lotremin can be used. These newer anti-fungal creams are more effective than the old-fashioned preparations such as Tinaderm. In more severe cases, oral medication is necessary. The main one currently available is Griseofulvin, which is safe and moderately effective.
Unfortunately, tinea of the toe nails is extremely difficult to treat, responding poorly to topical anti-fungal creams and to Griseofulvin. A drug called terbinafine will soon be available and looks extremely promising for the treatment of tinea in the toe nails.