Skin Infections

Different types of Skin Infections

A skin infection occurs when parasites, fungi, or germs such as bacteria penetrate the skin and spread. When this happens, it can cause pain, swelling, other types of discomfort, and skin color changes. A skin infection may be mild or serious.

Skin infections are different from rashes. A rash is an area of swollen or irritated skin. While rashes can be symptoms of some skin infections, a person with a rash does not necessarily have an infection.

There are four types of skin infection:

  • bacterial
  • viral
  • fungal
  • parasitic

Bacterial Skin Infections (Cellulitis)

This common bacterial skin infection occurs when bacteria infect the deep layers of skin and nearby tissues.Cellulitis can lead to serious complications, and receiving treatment early is important.

Before causing complications, cellulitis appears as swollen skin that is a different color from a person’s usual skin tone. The area is sometimes warm and tender to the touch.

Cellulitis can develop anywhere on the body. In children, it commonly affects the face, and in adults, it often appears on the lower legs.

Early treatment is key to a successful outcome without complications. If a person does not receive treatment, cellulitis can lead to blood infections and damage the immune system.

The most typical treatment is oral antibiotics. Some people require this medication intravenously. A person should also rest, elevate the affected area, and cover it to aid healing.

Bacterial Skin Infections (Impetigo)

Impetigo is usually due to a bacteria called Staphylococcus aureus. These germs pass from person to person by skin-to-skin contact or, less often, by bedding, clothing and towels. Impetigo can spread rapidly through families and school classes. However, it can also spontaneously appear with no link to where it came from. The bacteria that cause impetigo can invade normal skin, but more often take advantage of skin that is already damaged by cuts or grazes, insect bites, head lice, scabies, cold sores, or eczema. People with diabetes or low immunity are more susceptible to getting it.

Impetigo can make the skin red, sore and itchy. There may be swollen glands. It is unusual to have a fever or feel very unwell.

Impetigo can appear -anywhere, but is most common on exposed areas of skin such as the face (around the nose and mouth) and on the hands. It starts as a rash of small pus-filled blisters. These tend to break easily to leave round oozing patches covered with yellow or brownish crusts.

Yes. Usually it clears in a few days with treatment and 2 to 3 weeks without treatment.

The first step is to remove the crusts gently and regularly -antibacterial liquid soap/skin wash and water is as good for this as anything else. Apply an antibiotic cream, or ointment, onto the patches and the skin around them, two or three times a day, for 7-10 days until they clear up.

Bacterial Skin Infections (Pseudofolliculitis)

Pseudofolliculitis, also known as ‘shaving bumps’, or ‘razor bumps’, is inflammation of hair follicles and surrounding skin, caused by hairs trapped beneath the skin surface. It appears similar to folliculitis, which is inflammation of hair follicles due to infection, but the inflammation in pseudofolliculitis is not primarily due to infection. Pseudofolliculitis is typically seen on the face and neck of men who shave, when it may be called pseudofolliculitis barbae.

Hair removal, particularly shaving, leads to pseudofolliculitis. Usually the hair has been cut too short resulting in the hair shaft retracting back into the hair follicle (ingrown hair). As the hair grows it can then break into the wall of the hair follicle, enter the surrounding skin and result in inflammation. This process is more likely to occur in curly hair. In addition, skin folds or scarred skin may allow in-growth of straight hairs.

Yes, if shaving, waxing or tweezing is stopped, though it may take 4-6 weeks for inflammation to settle and for the hairs to reach a length where ingrowth will not recur. If the practice of hair removal continues, the problem is likely to persist, although some measures can be taken to help.

The only certain cure is to stop shaving, waxing or tweezing. Adjusting your shaving technique may sometimes help. There is no single technique that works for everyone because for some people the problem is due to hairs curling back into the skin whilst for others the cause is that hairs are cut so short that they retract. You should experiment to find the best method for yourself. Wet shaving usually gives a closer shave than using an electric razor, but the choice is once again an individual one. Those who wet shave should avoid methods that give such a close shave that the hair retracts inside the follicle. The following is recommended:

1.Shave in the direction of hair growth

2.Avoid stretching the skin tight

3.Use single blades

4.Shave every second day rather than daily, if possible

5.Aim for a stubble length of 1 mm, though the beard area will not look clean shaven

6.Avoid plucking hairs

Viral Skin Infections - Herpes Simplex (Cold Sore)

Herpes simplex is an infection of the skin with the herpes simplex virus. There are two types of herpes virus, called herpes simplex type 1 and herpes simplex type 2. Herpes infection is caught from another person through contact with mouth, eye or genital secretions or through direct contact with an active lesion. Herpes simplex type 1 usually infects the mouth or eye and herpes simplex type 2 usually infects the genital area. Reactivation can occur after a few weeks or even years, when the virus travels to the skin supplied by the nerve and appears as a blister or rash on the skin. The commonest areas to be affected by herpes simplex are the lips (as cold sores),and the genital area (as genital herpes).Genital herpes infection is usually a sexually transmitted disease.

The very first infection is often unnoticed as it may only produce a short-lived redness of the skin. Sometimes, however, a first infection can make a person feel very unwell with a temperature, swollen lymph glands and soreness and blisters in the mouth, on the lips or elsewhere on the skin.The virus may lie dormant in the nerve endings for sometime but when it becomes active again, the first symptom is a burning or stinging pain at the affected site, followed by pink bumps and small blisters. The blisters quickly dry and crust over, and the areas usually heal within a few days. Repeated attacks usually occur at a similar site.If herpes simplex virus infects the eye, it causes pain, discharge and sensitivity to light, and can cause scarring.

Symptoms clear in7-10 days, with or without treatment, though the virus will remain in a dormant state in the body. In a majority of patients, recurrent symptoms are mild and infrequent, or do not happen at all. For a minority, troublesome recurrences can usually be prevented by using oral anti-viral drugs or adopting lifestyle changes.

Many mild cold sores need no specific treatment; but the general rule in treating herpes simplex is that all treatments work best if they start as soon as possible.The anti-viral treatments (aciclovir, famciclovir or valaciclovir) can be taken as tablets, which have few side effects.

If you have recurrent attacks of herpes simplex, you may be able to avoid things that seem to trigger an attack, or make certain lifestyle alterations:

•Avoid getting stressed or run down.

•Avoid anything else that you have noticed seems to bring on an attack.

•Keep healthy and get enough sleep.

•Avoid sunlight on the affected area if you find it triggers outbreaks.

•Avoid sun beds

Viral Skin Infections - Chickenpox

There are two types of treatments for chickenpox: Those that ease its symptoms and those that target the infection. While most people can benefit from treatments to ease symptoms, not all people who get infected need treatment for the virus itself.

There are two types of treatments for chickenpox: Those that ease its symptoms and those that target the infection. While most people can benefit from treatments to ease symptoms, not all people who get infected need treatment for the virus itself.

Managing symptoms — Simple treatments can usually ease fever and itchiness caused by chickenpox.

  • Fever — To manage fever, you can take acetaminophen (sample brand name: Tylenol). (Note that children should not be given aspirin, as it can cause a dangerous condition called Reye syndrome). Children should be given acetaminophen according to their weight, rather than their age.
  • Itching — To manage itching, you can take antihistamine medications, such diphenhydramine (sample brand name: Benadryl), which can make you sleepy, or loratadine (sample brand name: Claritin), which does not usually cause sleepiness. Skin treatments, like calamine lotion and oatmeal baths, may also help with itching, although there is scare scientific evidence that these remedies work.

Scratching the skin can cause a skin infection because bacteria hide beneath the fingernails. Scratching may also increase the chances of developing a scar. Fingernails should be clipped to reduce these risks.

Targeting the infection — A medication called acyclovir (sample brand name: Zovirax) or a medication similar to acyclovir (such as valacyclovir; sample brand name: Valtrex) can help shorten or combat the varicella infection if it is started within 24 hours of the rash developing. This medication is not necessary for everyone who develops chickenpox.

Acyclovir can be taken in pill form or as an injection. It is generally well tolerated but can cause stomach upset or headache.

Potential complications of chickenpox include:

  • Skin infections
  • Pneumonia, an infection of the
  • Encephalitis, inflammation of the brain

Children with a viral illness should be given acetaminophen for fever to avoid the complication of Reye syndrome, a rare condition that can cause severe brain and liver damage.

Coming down with chickenpox during pregnancy can lead to complications, such as pneumonia in the mother, or in rare cases, birth defects in the baby. Chickenpox is also very dangerous for newborn babies, so pregnant women who are not immune should contact their healthcare provider right away if they develop any signs of chickenpox or if they are exposed to someone with chickenpox or shingles.

Pregnant women who are exposed to the virus cannot receive the varicella vaccine, but they may need to take varicella immune globulin (brand name: VariZIG), an injection that can help to protect against infection. Pregnant women who get chickenpox need to be closely monitored for signs of infection and/or complications.

Viral Skin Infections - Shingles (Zona)

Shingles is a painful blistering rash caused by the same virus that causes chickenpox, known as the varicella (chickenpox) zoster (shingles) virus.

After a person has had chickenpox, the virus remains dormant in some of the nerves linked to either the spinal cord or nerves of the head and neck region. If the virus becomes active again, it multiplies and moves along the nerve fibers to the area of skin supplied by those nerves; shingles then appears in this area. You can only get infected with shingles if you have had chicken pox. About 1 in 5 people who have had chickenpox will have an attack of shingles later in life. Most attacks of shingles occur for no obvious reason, but an attack is more likely if:

  • You are elderly. Likelihood increases with age.
  • You are experiencing physical or emotional stress.
  • You have an illness that weakens the immune system, such as leukemia, lymphoma (e.g. Hodgkin’s disease) or HIV infection.
  • You are taking treatments that suppress the immune system, including radiotherapy for cancer, chemotherapy, steroid drugs, and drugs taken to prevent organ rejection.

Shingles itself is not caught from someone who has shingles. It develops when the dormant herpes zoster virus becomes active, for example when a person’s immune defence are weaker than normal. However, a person with shingles can pass on chickenpox to someone who has never had chickenpox. A person with shinglesis infectious from the point of blister development up until the blisters crust over (approximately 7 days).

Pain is usually the first and most predominant symptom of shingles. However, it is important to note that not all people with shingles will experience pain; for example, many young people will not experience any pain, but rather just an itching or mild burning sensation of the affected area. For those who do experience pain, this pain is usually localized and can range from mild to severe; a constant dull, tingling, aching or burning pain/sensation may be experienced. The rash usually appears a day or two after these symptoms, and a fever and/or a headache may develop.

The first sign is the appearance of groups of red spots on a pink-red background, which quickly turn into small fluid-filled blisters. Some of the blisters burst, others fill up with blood or pus. The area then slowly dries out, and crusts and scabs form. The scabs will drop off over the next 2-3 weeks. The rash usually covers a well-defined area of skin on one side of the body only, without crossing the midline to the other side.Its position and shape will depend on which nerves are involved. Shingles can affect any area, but common patterns include a band running round one side of the chest, or down an arm or leg. Sometimes temporary dark scabs follow shingles, particularly after a severe attack. Less commonly shingles can affect the face, around one of the eyes and can cause complications affecting the eyes.A chickenpox-like rash occasionally comes up at the same time as shingles. This may indicate a more serious and widespread attack of shingles or that there is an underlying reason for the shingles.

Shingles usually resolves on its own within a few weeks. Oral antiviral treatment can make the rash of shingles clear sooner and can reduce its unpleasant effects. These effects depend largely on which nerve is involved:

  • Shingles of the area served by the nerve that carries sensation from the front of the eye can lead to inflammation and ulceration of the eye structures, and later to scarring, glaucoma and/or blindness. Blisters coming up on the side of the nose will alert your doctor to this risk, and you should also get urgent advice from an eye specialist (ophthalmologist).

•Muscles supplied by the nerves taking part in the shingles occasionally become weak, for example, temporary facial paralysis of the affected side. The pain of shingles may persist long after the rash has cleared (this is called post herpetic neuralgia), particularly in the elderly. Usually this goes away within 6 months, but a few people can experience pain for a year or more.

  • To shorten the attack.Antiviral drugs, such as acyclovir tablets and/or cream, are safe and can do this, but only if they are given within the first few days of an attack. Therefore it is very important to get an early diagnosis.
  • To make it less painful. Rest and taking pain-killers may help, i.e. non-steroidal, anti-inflammatories, applying a cool compress.
  • To deal with complications. A bacterial infection complicating shingles may require an antibiotic cream or tablets. Eye involvement will need a specialist ophthalmic review, and eye drops may be prescribed.
  • To prevent post herpetic neuralgia.Taking antiviral drugs during an attack of shingles may reduce the risk of getting post herpetic neuralgia, and can shorten its duration if it does occur.
  • To treat the pain of post herpetic neuralgia.Using an anaesthetics ointment (lidocaine 5%) before applying a topical analgesic cream (capsaicin cream) may help. The lidocaine can be bought over the counter, but the capsaicin needs to be prescribed by your doctor.

Viral Skin Infections - Molluscum Contagiosum

Molluscum contagiosum is a common and generally harmless condition that causes spots on skin. It is most common in children and young adults.

Molluscum contagiosum is caused by a pox virus. It can spread to others if the spots are in direct contact with someone else or they share the same item such as a towel. The spots usually appear a few weeks later. They are more common and extensive in people who have eczema. Sometimes people whose immune system is suppressed for any reason, such as by HIV infection or through taking immunosuppressive treatments may develop large numbers of molluscum spots, but most people with molluscum contagiosum are generally in good health.

Sometimes they can be itchy but most of the time they are asymptomatic. If they are scratched or traumatised they can occasionally become infected and feel sore. They can bleed slightly if scratched.

The molluscum contagiosum spots have the following characteristics:

  • Are small (from 2 to 6 mm across); however, they can grow larger than this, up to 10 to 20 mm
  • Are raised, and hemispherical (like a tiny dome), with a shiny surface •Usually they are skin colored, though they can be red or pink
  • Their most striking feature is a central dimple

•Sometimes areas of dry redness, like eczema, appear around the The most common areas where these spots appear are on the face, chest, armpit, upper legs and genital area.

Yes. This condition usually clears by itself within 6 to 18 months. However, during this time there may be development of new ones whilst the old spots are clearing. Sometimes it may take a few years for the body to clear all the spots.

  • There are a range of topical therapies used which includes, salicyclic acid and potassium hydroxide.
  • The spots can be frozen with liquid nitrogen (cryotherapy) at intervals until they are clear.
  • The spots can be scraped off with a sharp instrument (curettage) after local anaesthetics injectionby the general practitioner or dermatologist.
  • A hospital eye specialist can deal with spots on the eyelids.
  • A cream containing a chemical that affects the immune system (imiquimod) has been used for molluscum contagiosum
  • Squeezing the spots is not recommended anymore as it can result in scarringand also risk spreading the spots to others part of the body

You should make every effort not to pass the infection on to others, particularly those in your family. Stick to your own towel, flannel, clothing and bedding. However children with molluscum contagiosum need not be kept off school, nor should they be barred from swimming, etc.

Viral Skin Infections - Plantar Wart

Warts are localized thickenings of the skin, and the term ‘plantar warts’ is used for those that occur on the soles of the feet (the ‘plantar’ surface). They are also known as verrucas.

Warts are caused by infection in the outer layer of the skin (epidermis) with a virus called the ‘human papilloma virus’. There are many different strains of this virus, and plantar warts are usually due to just a few of these strains. Infection makes the skin over-grow and thicken, leading to a benign (non-cancerous) skin growth (the wart). Plantar warts are caught by contact with infected skin scales – for example from the floors of public locker rooms, shower cubicles and the areas around swimming pools. The virus is not highly contagious, and it is unclear why some people develop plantar warts while others do not. The virus enters the skin through tiny breaks in the skin surface. Moistness and maceration of the skin on the feet probably makes infection with the virus easier.

In most cases plantar warts cause no symptoms. Some plantar warts can be uncomfortable, particularly if they are present on a weight-bearing area. ‘Mosaic’ warts (see below) are usually painless.

Plantar warts can occur anywhere on the soles and toes, and often affect the weight-bearing areas. They vary in size from just a few millimeters to more than one centimeter. They may have a rough surface that protrudes from the skin surface

There is no guaranteed cure, but some treatments can help to clear warts. The best chance of cure is in young people who have not had their warts for very long. If you have an illness that affects your immunity or are taking immunosuppressant medication, treatment can be less successful. Most verrucas will clear with time and can be left untreated if not causing problems.When deciding whether to treat plantar warts or not, the following should be taken into account: •Warts usually resolve by themselves without leaving a blemish or scar.

  • Successful treatment of a viral wart does not prevent further warts. •Some warts can be very stubborn. Treatment does not always work and may be time-consuming.
  • Treating plantar warts can be painful, especially when liquid nitrogen is used, and can occasionally cause a blister which, on the sole, can be very uncomfortable.

Treatment options include:

  • Salicylic acid paints and gels:
  • Cryotherapy
  • Other approved topical treatments for plantar warts include formaldehyde gel, gultaraldehyde and silver nitrate caustic pencils.
  • Other preparations include topical dithranol, podophyllotoxin, 5-fluorouracil trichloroacetic acid and bleomycin injections.
  • Contact immunotherapy with a chemical paint such as diphenycyprone causes an allergic skin reaction that may boost the body’s immune reaction against the wart virus.
  • Surgical removal of warts is an option if topical treatments do not work. Options include tissue destructive laser therapy or curettage and cautery after a local anaesthetics injection into the skin. These procedures are painful and can lead to uncomfortable scarring. The wart may come back in the scar after surgery.
  • Photodynamic therapy and other lasers(Pulsed Dye Laser and Nd-YAG) have also been used but are not widely available for treatment of warts.

Wear comfortable shoes and do not share your shoes or socks with anyone else. Special pads to relieve pressure on plantar warts can be bought at a chemist.

  • Keep your feet clean and dry. Change your shoes and socks daily. •Do not go barefoot in public places. Plantar warts should be covered with waterproof plasters or rubber ‘verruca socks’ if you go swimming. •When treating the wart, dispose of any skin filings hygienically and do not use the emery board or hard skin removal tools elsewhere as this could spread the infection.
  • Apply topical treatment regularly to get the maximum chance of cure.
  • To avoid spreading viral warts to other parts of the skin (autoinoculation) do not pick or scratch plantar warts.
  • Do not use same pumice stone, nail file and or nail clippers for your warts and your healthy skin and nails.

Fungal skin infections - (Athlete's foot)

These types of skin infections are caused by a fungus and are most likely to develop in damp areas of the body, such as the feet or armpit. Some fungal infections aren’t contagious, and these infections are typically non-life-threatening.

Skin changes, redness, and itching are common symptoms of many fungal infections.

The symptoms of a fungal infection will depend on the type, but common symptoms include the following:

  • skin changes, including red and possibly cracking or peeling skin
  • itching

Fungal infections are common in humans and are usually not very serious if they are treated quickly and correctly. Anyone with a weakened immune system may be more likely to contract a fungal infection, as well as anyone who is taking antibiotics. Cancer treatment and diabetes may also make a person more prone to fungal infections.

Athlete’s foot

Tinea pedis or athlete’s foot is a common fungal infection that affects the foot.

Athlete’s foot is commonly associated with sports and athletes because the fungus grows perfectly in warm, moist environments, such as socks and shoes, sports equipment, and locker rooms.

In reality, anyone may be affected by athlete’s foot. It is most common in warmer climates and summer months, where it can quickly multiply.

Athlete’s foot is a common infection where the fungus grows in warm and moist environments.

The symptoms of athlete’s foot may vary slightly from person to person. Classic symptoms include:

  • redness or blisters on the affected area
  • the infected skin may be soft, or layers may start to break down
  • peeling or cracking skin
  • the skin may scale and peel away

Itching, stinging, or burning sensations in the infected area.

Not all itchy feet are the result athlete’s foot. Doctors usually diagnose the infection by scraping scaling skin off of a person and inspecting it under a microscope for evidence of any fungus.

There are a few different fungi that can cause athlete’s foot. The infection may behave differently depending on the specific fungus that is infecting the skin.

Athlete’s foot is often treated with topical anti-fungal ointments, which are available to purchase over-the-counter or online. Severe infections can require additional oral medications as well. The feet will also need to be cared for and kept dry to help kill the fungus.

Prevention methods include allowing the feet plenty of air to breathe and keeping them clean and dry. It is a good idea to wear sandals in public showers or locker rooms.

Fungal skin infections - (Yeast Infection)

Vaginal yeast infections are a common form of Candida overgrowth in women, usually caused by Candida albicans.

An overgrowth of Candida disrupts the normal balance of the bacteria and yeast in the vagina. This imbalance of bacteria may be due to antibiotics, stress, and hormone imbalances, or poor eating habits, among other things.

Candida infections can also commonly cause fungal toenail infections and diaper rash.

A yeast infection may commonly cause fungal toenail infections.

Symptoms of a yeast infection include:

  • itching and swelling around the vagina
  • burning sensations or pain during urination or intercourse
  • redness and soreness on and surrounding the vagina
  • unusual vaginal discharge, such as gray clumps that resemble cottage cheese or a very watery discharge

A rash may develop over time in some cases. Yeast infections should be treated quickly, as the symptoms may become severe if left untreated.

The classic symptoms of a yeast infection make them easy to diagnose. Doctors may ask about the person’s medical history, such as any previous yeast infections or sexually transmitted infections (STIs). They may also ask whether the person was recently taking antibiotics.

Doctors will then examine the vaginal walls and cervix for signs of infection, taking cells from the vagina if necessary for proper diagnosis.

Treatment of yeast infections depends on their severity. Standard treatments include creams, tablets, or suppositories, which are available via prescription, or over-the-counter or online. Complicated infections may require complex treatments.

Avoiding yeast infections begins with a balanced diet and proper hygiene. Wearing loose-fitting clothing made from natural fibers may also help prevent infection. Washing underwear in very hot water and changing feminine products often can also help prevent fungal growth.

Fungal skin infections - (Jock Itch)

Tinea cruris, commonly known as jock itch, is another common fungal skin infection.

These fungi love warm and damp environments and thrive in moist areas of the body, such as the groin, buttocks, and inner thighs. Jock itch may be more common in summer or in warm, humid areas of the world.

Jock itch is mildly contagious and is often spread through direct contact with an infected person or an object that is carrying the fungus.

Thrush can affect the genital area in men as well as women.

Jock itch appears on the body as an itchy, red rash that often has a circular shape to it. Symptoms include:

  • redness in the groin, buttocks, or thighs
  • chafing, irritation, itching, or burning in the infected area
  • a red rash with a circular shape and raised edges
  • cracking, flaking, or dry peeling of the skin in the infected area

Jock itch has a very particular look and can usually be identified based on its appearance. If doctors are uncertain, they may take a skin sample to inspect and confirm their diagnosis.

Treating jock itch usually involves topical antifungal ointments and proper hygiene. Many cases of jock itch are improved by over-the-counter medications, though some require prescription medications. Cleaning the affected area and keeping it dry can also help kill the fungus.

Jock itch can be prevented by wearing loose-fitting natural fibers, such as cotton underwear which is available to buy online. Avoiding contact with others who have the infection is also important. Avoiding shared items, such as towels and sporting equipment may also help.

Fungal skin infections - (Ringworm)

Tinea corporis or ringworm is a skin infection caused by a fungus that lives on dead tissues, such as the skin, hair, and nails. Ringworm is the fungus that causes both jock itch and athlete’s foot. When it appears anywhere else on the body, the infection is just called ringworm.

Ringworm is a skin infection that causes jock itch and athlete’s foot.

Ringworm is usually easy to notice because of its shape. A red patch that may itch or be scaly will often turn into a raised, ring-shaped patch of skin over time. It may even spread out into several rings.

The outside of this ring is red and may appear raised or bumpy, while the inside of the ring will remain clear or become scaly.

Ringworm is highly contagious, and it can be transmitted by skin-to-skin contact, or from contact with pets, such as dogs. The fungus may also survive on objects, such as towels, clothes, and brushes.

The ringworm fungus also infects soil and mud, so people who play or work in infected dirt may catch ringworm as well.

Other skin conditions may look like ringworm, so doctors will usually want to take a skin sample to inspect for the fungus.

After confirming a diagnosis, doctors will recommend a treatment, depending on how severe the symptoms are.

Creams and medicated ointments are often sufficient to treat many cases of ringworm, and may be purchased over-the-counter or online. Ringworm of the scalp or severe ringworm may require a prescription.

Basic hygiene can help treat and prevent ringworm as well. Keeping the skin clean and dry can help avoid infection.

Safety in public includes wearing sandals into public showers or locker rooms and avoiding shared items and towels.

Treatments for ringworm are available for purchase online.

Fungal skin infections - (Pityriasis Versicolor)

Pityriasis means a type of fine skin scaling, and versicolormeans changing colour. It is a common and harmless rash due to the overgrowth of yeasts that live on everyone’s skin. These yeasts, called Malassezia, are not related to yeast in food or to those that cause thrush. It is also sometimes called tinea versicolor.

Large numbers of tiny harmless organisms, known as ‘the resident flora’, liveon the surface of everyone’s skin. Some of them are yeasts. At times, these yeasts can overgrow and trigger the rash known as pityriasis versicolor. This happens most often in warm moist climates. Most people with this condition are in good health.The condition is most common in people in their early 20s. People who get it may also have dandruff which is caused by a similar yeast overgrowth on the scalp. We do not understand why some people tend to get it and others do not.

The rash can be mildly itchy but usually causes no trouble apart from its appearance. It often goes unnoticed if only a few patches are present.

Yes, the rash clears with treatment although the pale areas will take several months to return to their normal colour. Importantly, this does not mean treatment has failed. The rash often recurs as the yeasts that cause it to live on normal skin and cannot be eradicated completely. Pityriasis versicolor does not leave scars.

Treatments applied to the skin:Most patients are treated with topical antifungal agentsthat are applied to the skin. Treatments thatr educe the amount of skin yeasts include terbinafine cream, clotrimazole cream and miconazole cream. Ketoconazole and selenium sulphide shampoo scan be used as body washes but should not be left on the skin.

Medicines taken by mouth:These include itraconazole and fluconazole, which can be prescribed by your doctor. They are effectivebut can have side effects so are usually prescribed forwidespread rashes, or when topical treatment has failed.

Recurrences:The rash of pityriasis versicolor often comes back. Occasional use of ananti-dandruff shampoo as a bodywash may reduce the chance of this happening.

Parasitic skin infections - (Scabies)

Scabies is a common and very itchy skin condition caused by a tiny mite called Sarcoptes Scabiei. It can affect people of any age but is most common in the young and the elderly.

Itching is the main symptom of scabies, usually starting about a month after the mites are picked up. The itching can affect the whole body apart from the head and neck, although the elderly and infants may develop a rash on their headand neck. The itch often gets worse at night. It is common for several people in the same family, and their friends, to become itchy at roughly the same time.

Yes, with the right treatment, it clears up quickly and completely; but if it is nottreated, scabies lasts for months or even years. However, even after the mites have been killed by treatment the itching usually carries on for a few weeks before settling.

The treatment of scabies involves:

  1. Using medication to get rid of your own scabies.
  2. Making sure that you, family members, friends and any sexual contact sare all treated at the same time whether they are itchy or not. Several preparations are effective in the treatment of scabies. Of these, permethrin cream and malathion liquid are the ones most commonly used.
  • The mites may be anywhere on the skin, so the treatment must be applied to all areas of skin below the neck in adults, all areas of skin in children including the scalp, and not just to the itchy parts.
  • The treatment should be left on for at least 12 hours before beingwashed off.
  • When you wash your hands or any part of your body, you should re- apply the treatment to the washed areas again.
  • Two treatments, one week apart, are necessary to kill mites that have hatched out from eggs after the first application.
  • One normal high temperature wash of bedding and clothes should eradicate mites. Items that can’t be washed or dry cleaned can be sealed in a plastic bag for at least 1 week, or put in a freezer.
  • Taking a bath before treatment is not necessary.

Fungal skin infections - (Head Lice)

The head louse is a tiny, grayish-white insect. Female head lice typically live for about one month and lay 7 to 10 eggs (called nits) per day. The eggs are attached to the base of a hair, near the scalp. The eggs hatch after about eight days.

After the eggs hatch, the egg cases become easier to see. Since the eggs are firmly attached to the hair, they move away from the scalp as the hair grows. Head lice do not jump or fly, and they cannot spread from person to person by attaching to pets.

Direct contact with the hair of a person with lice (hair to hair contact) is thought to be the most common method of spreading head lice. The degree to which contact with objects used by people with head lice, such as clothing, bedding, combs, or brushes, contributes to the spread of head lice is unclear.

Most people with head lice do not have any symptoms. Some people feel itching or skin irritation of the scalp, neck, and ears. This is caused by a reaction to lice saliva, which the lice inject into the skin during feeding.

Head lice are diagnosed by examination of the scalp and hair. Special “nit combs” can be used to assist with the diagnosis.

  • Before using the fine-toothed comb, use a regular brush or comb to remove tangles. This can be done while the hair is wet or dry. If the hair is wet, apply hair conditioner to make the hair easier to comb.
  • Place the fine-toothed comb at the top of the head, touching the scalp. Pull the comb through the hair from roots to ends. After each stroke, carefully examine the comb for lice or eggs.
  • Comb the entire head at least twice.

There are several options for getting rid of head lice, including creams and liquids, combing, and oral medicine (pills). It is important to follow directions carefully to be sure that the treatment works.

If you are sure that your child (over age two years) has head lice, you can use a nonprescription lice treatment. Examine family members and close contacts at the same time and treat them if needed. If your child is under age two years, contact the child’s doctor or nurse for treatment advice.

  • Permethrin (Nix)
  • Pyrethrin (A-200, Pronto, Rid, Triple X, R&D)

Wet-combing– is a way to remove lice from the hair with careful and repeated combing. It is a good option for treating very young children or if you want to avoid using insecticides. However, wet-combing is time consuming and must be repeated multiple times over a period of a few weeks.

Wet the hair and add a lubricant, such as hair conditioner or cream rinse, vinegar, or olive oil. See above for a description of how to wet-comb .The combing session should take 15 to 30 minutes, depending how long and thick the hair is. Comb every three to four days for two weeks AFTER you find any large, adult lice.

Oral medicines – A medicine taken by mouth called ivermectin might be prescribed for people whose lice are resistant to topical insecticide treatment.

Adults and children who live with a person diagnosed with lice should be examined for lice and treated if needed. Anyone who sleeps in the same bed should be treated for lice, even if no lice or eggs are found.

School policies differ about who at a school, if anyone, needs to be informed when a child has lice. A confidential call or visit with the school nurse is a good place to start. Most experts believe that children with head lice do not need to be removed from school.

Clothing, bedding, and towels used within 48 hours before treatment should be washed in hot water and dried in an electric dryer on the hot setting. Dry cleaning is also effective. You can use a vacuum to clean furniture, carpet, and car seats. Items that cannot be washed or vacuumed can be sealed inside a plastic bag for two weeks. Items that the person used more than two days before treatment are not likely to be infested because head lice cannot survive off the body for more than 48 hours. You do not need to have your home sprayed for lice.