Common Fungal Skin Infections in Children and Adolescents

• Skin fungi thrive in damp areas, such as the diaper area in children.
• Fungal skin infections can occur anywhere but is generally rare in children.
• Common risk factors include animal contact, poor hygiene and being overweight.

• This is a fungal infection of the scalp and hair.
• It can be contagious, especially among children.
• It occurs most commonly in children between the ages of 2 and 10 years.
• Contact with animals, especially cats, is a common risk factor for tinea capitis.
• Symptoms include localised areas of hair loss, and itchy, red scaly rashes on the scalp. Sometimes, there may be rashes elsewhere on the body.
• It can also present as a painful, oozy swellings on the scalp, called kerion, which may be associated with lymph node swelling in the neck.
  
• If not treated early and adequately, the hair loss can become permanent.

What is tinea corporis/pedis/cruris/faciei?
Tinea can affect other areas of the body e.g. trunk (corporis), feet (pedis), groin (cruris) and face (faciei).

This is more common in adolescents and adults compared to children.

Symptoms include itchy, red, circular rashes with raised edges with clearing in the central areas of the rash.

How is tinea infection diagnosed?
Tinea infection can resemble other skin conditions and will usually require a visit to the physician for diagnosis.

The doctor may use a special light, called a Wood’s lamp, to look for the bright fluorescence of tinea capitis.

The doctor may also order a skin scraping or pulled hair for fungal microscopy and to grow the fungus (fungal culture) to confirm the diagnosis.

How is tinea infection treated in children?
Specific treatment regime and length of treatment will be determined by the doctor based on:

• Child’s age, overall health, drug allergies and medical history
• Extent of the infection
• Location of the infection
  
  • Tinea capitis should be treated early and more aggressively
  • The presence of a kerion should be treated with oral antifungals for at least 2 to 3 months and sometimes oral steroids is prescribed to help reduce the swelling.
• Child or parent’s expectations and preference

Treatments include:

• Antifungal shampoos
• Antifungal creams
• Oral antifungal medications e.g. griseofulvin, itraconazol
  

It is important to follow your doctor’s orders and complete the treatment prescribed, as recurrence is high if not adequately treated.

If infection is acquired from a pet, it should be brought to a veterinarian for treatment.

What is tinea versicolor?
This is a common fungal infection of the skin, caused by a yeast (Pityrosporum/Malassezia). It most commonly affects adolescents and young adults.

Increased sweating in hot, humid weather and poor hygiene can predispose to tinea versicolor.

What are the symptoms of tinea versicolor?
Whitish, pinkish, or light brown patches that may be scaly.

Most commonly affects the trunk but may also spread to the face and upper arms. In some adolescents, the yeast can infect hair follicles, resulting in pityrosporum folliculitis, characterised by many small red bumps over the back, chest and upper limbs.

The rash may or may not be itchy.

How is tinea versicolor diagnosed?
Diagnosis of tinea versicolor is by clinical history and examination of the rash. The physician may also order a skin scraping for fungal microscopy to help confirm the diagnosis.

How is tinea versicolor treated?
Depending on the extent, duration of the rash and how affected the patient is, the following may be prescribed in combination:

• Antifungal shampoos
• Antifungal creams
• Oral antifungal medications

It is important to follow your doctor’s orders and complete the treatment prescribed, as recurrence is high if not adequately treated.

Lifestyle modifications advice:

• Good personal hygiene
• Avoid excessive heat and perspiration
• Dry perspiration after physical exercises
• Wear loose clothing

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