Fungal infections and eczema are skin conditions that can appear very similar with signs and symptoms like dry, itchy, inflamed skin. However, they are two separate conditions with different causes and treatments. Please continue reading to learn more.

What are fungal infections?

Fungal infections are skin infections caused by fungi. Common fungal infections include ringworm (athlete’s foot, jock itch) and candidiasis. 

Ringworm, also called tinea, is a highly contagious fungal infection that can occur on the scalp (tinea capitis); the body including the upper chest, arms, and legs (tinea corporis); the hands and feet (tinea manus and tinea pedis); the fingernails and toenails (tinea unguium); and the groin (tinea cruris). It is called ringworm because this fungus causes a circular, red, itchy, scaly rash.

Cutaneous candidiasis is a fairly common skin infection caused by candida fungi. It can occur on any part of the body but is common in warm, moist areas with skin creases such as the groin and armpits. Candida yeast infections are not contagious, although people with weakened immune systems can sometimes catch the infection through skin to skin contact.

What is eczema?

Eczema, also called atopic dermatitis, is an inflammatory skin condition that causes a dry, itchy rash. It can occur on the face, elbows, knees, hands, and feet. Eczema is not contagious. It is a chronic skin condition that comes and goes, i.e., it can get better or worse at times.

A specific type of eczema called nummular dermatitis causes a red rash and coin-shaped or oval patches on the skin. Nummular eczema and ringworm can appear very similar and be confused with each other because both cause a circular red rash and itchy skin.

Causes and Risks

Eczema Causes and Risks

The exact cause of eczema is unknown but it is believed to be a combination of genetic and environmental factors. Substances that irritate the skin can trigger eczema flares. 

Risk factors for eczema include a personal or family history of eczema, hay fever, or asthma.

Causes and Risk Factors for Fungal Skin Infections

Unlike nummular eczema and other types of eczema, the cause of fungal skin infections is well known, i.e., fungi like tinea or candida. These infections spread through skin-to-skin contact and public showers and locker rooms. 

Risk factors for ringworm include poor hygiene, prolonged exposure to sweaty or damp clothes, sharing towels or razors with others, and living in warm, humid climates. Athletes who have frequent contact with others in locker rooms and public showers at are risk of ringworm. 

Other risk factors for candida yeast infections include recent antibiotic use, pregnant women, people with diabetes, and people with weakened immune systems.

Fungal Infection vs Eczema Symptoms

Common nummular eczema or discoid eczema symptoms include:

• Intensely itchy skin
• Dry skin
• Scaly skin
• Raised rash
• Coin-shaped scaly patches

Common symptoms of ringworm include:

• Ring-shaped rash
• Red skin
• Scaly skin
• Itchy skin
• Cracked skin

Common symptoms of candida include:

• Intense itching
• Skin irritation
• Swollen skin
• A growing rash in skin folds, such as under the breasts and in the genitals and buttocks
• Skin lesions that may look like pimples

Prevention

You can prevent fungal infections by keeping your skin clean, washing your hands after contact with other people, not sharing towels or razors with others, and wearing shoes or slippers in public showers, locker rooms, and swimming pools.

Eczema flares can be prevented by moisturizing often, using mild skincare products, and having a humidifier in your room.

Fungal Infection and Eczema Treatment Options

Candida and Ringworm Treatment

It is possible to treat ringworm and candida with over-the-counter antifungal creams like terbinafine (Lamisil AT), clotrimazole (Lotrimin AF), miconazole (Cruex), and ketoconazole (Xolegel). You typically need to use these antifungal medications for 2-4 weeks. If the infection does not go away or gets worse, you should seek professional medical care from a healthcare provider who can make an accurate diagnosis and prescribe the right treatment, including stronger antifungal medications, such as griseofulvin (Grifulvin), itraconazole (Sporanox), and fluconazole (Diflucan), if needed.

Eczema Treatment

Treating eczema involves avoiding triggers, using mild soap, and keeping the skin well moisturized. Repeated scratching can lead to secondary skin infections, so you should avoid scratching. Here are some home remedies that might help:

• Wet wrap therapy can rehydrate and calm eczematous skin. This involves wrapping the affected area with fabric soaked in water. If you have foot or hand eczema, you can wear gloves or socks soaked in water, followed by a dry layer.
• Colloidal oatmeal baths can also help to relieve the dry, itchy, and irritated skin associated with this chronic condition.
• Tea tree oil, which has anti-inflammatory and anti-itch properties, may also be helpful.

If home remedies do not work, you can try other treatment options for eczema flare ups such as an OTC medication like hydrocortisone (Cortaid) which is a steroid cream. 

Prescription eczema treatment for severe symptoms may include stronger topical steroids, calcineurin inhibitors such as tacrolimus (Protopic) and pimecrolimus (Elidel), and antibiotics for secondary infections. 

Warning: It is important to get an accurate diagnosis from your primary care doctor and make sure your skin condition is treated appropriately. For example, topical corticosteroids can treat eczema but can make ringworm worse.

References:

1. https://www.cdc.gov/fungal/diseases/ringworm/definition.html
2. https://medlineplus.gov/ency/article/000880.htm#
3. https://medlineplus.gov/eczema.html
4. https://www.cdc.gov/fungal/diseases/ringworm/treatment.html
5. https://nationaleczema.org/eczema/treatment/wet-wrap-therapy/