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Skin scourge
Your Health - Dr. Gita Mathai
Summer means hot, sweaty days, and, with this year's drought and water shortage, baths are almost a luxury. As the sweat stays on the body in areas unexposed to air, such as the folds of the groin, armpits and under the breasts, the warm moist environment can cause fungus to grow and flourish.
Candida (a fungus) thrives in these areas, especially in individuals who are overweight, diabetic, on antibiotics or steroids, have hypothyroidism or deficiencies of iron or zinc. It is aggravated by friction between the clothes and skin, especially if the clothes are tight fitting and synthetic. Infection can produce itching that is uncontrollable and embarrassing. Eventually, the areas can become discoloured and flaky.
Children can develop candida as a diaper rash on the groin and buttocks. It is common when wet underclothes or cloth diapers are not changed frequently. They can also develop it in the mouth, especially if they are bottle-fed or use pacifiers.
Infection with a fungus of the Malassezia family causes Tinea versicolor, which produces light or reddish patches on the skin of the trunk, chest and, sometimes, upper arms This fungus lives symbiotically on almost everyone's skin. When the environment is ideal, or immunity compromised (diabetes, medication, HIV infection), the fungus invades the superficial layers of the skin. It is highly contagious and spreads rapidly if there is close contact and sharing of towels and clothing.
"Ring worm" is another fungus infection common in children and teenagers. The spores can remain inactive in the soil for months on end. Animals can also be affected. The infection can spread from animals to humans. It causes itchy, raised, red, scaly patches. When it affects the head, the hair falls off in circular patches leaving bald areas.
The areas between the toes of the feet and the fingers of the hands can develop a fungal infection called "Athlete's Foot" in people whose hands and feet are immersed in water for long periods of time. Different types of fungi cause these infections.
The nails of the fingers and toes can be affected by fungus, making them brittle, dark and distorted.
A dermatologist can make a diagnosis of fungal infections by scraping off a small, infected area and examining it under a microscope.
Superficial fungal skin infections heal if the area is kept dry and anti-fungal creams (single ingredient) applied twice or thrice a day. Anti-histamines will relieve the itching. The response is faster, better and permanent if the precipitating factors are removed.
In children, pacifiers should be avoided. Bottles should not be left in the mouth all night. As far as possible, a cup and spoon should be used for feeding. Diapers should be changed regularly or disposable diapers with "Dri" technology should be used. In adults, precipitating factors such as iron and zinc deficiency, diabetes and obesity should be tackled.
Sometimes for a rapid response, a combination cream with steroids and anti-fungal medication is used. The symptoms return once the cream is stopped. This is because fungal infections thrive in the presence of consumed or applied steroids. Anti-fungal tablets may need to be taken for 1-12 months to cure infections of the nail and hair.
Dr Gita Mathai is a paediatrician with a family practice at Vellore and author of Staying Healthy in Modern India. Questions on health issues may be emailed to her atyourhealthgm@yahoo.co.in
