DR FLO: Is there a cure for fungal skin infection?

Dr Flo, I have recurring fungal skin infection that ‘clears’ after I apply antifungal creams, but comes back after I stop. How can I treat it once and for all? Maina

Dear Maina,

Recurring fungal infections could be due to misdiagnosis, not completing treatment, or a weak immune system. It could also be due to a genetic condition where the skin does not recognise the fungus as foreign matter and therefore the body does not try to get rid of it.

Many times, the fungi that cause infection live naturally on or in our bodies and only cause a problem when they multiply too much. Fungi can be passed on to other people. It may be found on clothing, towels, lanyards, floors, etc.

Fungi like warm and wet environments, which is why fungal infections between the toes, or in the groin are common.

Fungi shed spores, which collect in clothes or shoes, waiting for the right conditions to grow again. If there are spores present, infection will recur after treatment when the spores start growing.

You need to visit a dermatologist for a proper diagnosis. Also check for any conditions that might be lowering your immunity like diabetes or HIV.

Take medication for the prescribed duration, even if the skin rash has disappeared. You can also take tablets or use a cream or anti-fungal shampoo occasionally after treatment to prevent re-growth. Dust antifungal powder in your shoes every day.

Clothes should be washed and sun-dried in an airy place, and if possible, ironed inside-out. Clean shoes regularly and get rid of old shoes.

Any family members or other contacts that have the skin infection should also be treated. Avoid sharing clothes, shoes, towels and other personal items, and avoid wearing tight-fitting clothes, and wear cotton clothes and leather shoes.

***

Dr Flo, I was diagnosed with scalp psoriasis 10 years ago. I have tried all prescribed remedies including tar-based shampoos and soaps, elocom, salycilic acid ointments and others, but nothing has helped. What’s the best treatment available? Jane

Dear Jane,

Psoriasis is a condition where the immune system makes the skin cells grow faster than the old ones can be shed off. This causes cells to pile up leading to raised scaly patches. It can affect any part of the body, including the scalp, and cause itching, a burning sensation and hair loss.

Psoriasis should be managed by a dermatologist. The first line of treatment is topical medications like coal tar, medicated shampoos, topical steroids, salicylic acid, and antibacterial and antifungal medications for secondary infection.

Other medications include vitamin A derivative e.g. tazarotene, soriatane, vita-min D derivatives e.g. calcipotriene and anthralin cream. Phototherapy using a UVB comb, or excimer laser, or even direct sunlight may also work. Stronger medications include oral or injectable steroids, methotrexate, cyclosporine and biologic agents.

The skin overgrowth is triggered by your immune system, so the disease cannot be completely cured. Medication helps with the symptoms or to soften the scales, or to suppress the immune system and reduce the overgrowth of skin cells. Avoid scratching your scalp, shampoo gently, use a scale softener (salicylic acid) and remove the scales gently.

***

Dr Flo, there are times when there is pus on my penis. What causes this? Lenny

Dear Lenny,

Pus indicates an ongoing infection. You may also have pain or irritation when passing urine, urethral itchiness or abdominal pain. It may be due to gonorrhoea, chlamydia, trichomonas, or other bacterial infections.

If not treated, the symptoms may reduce with time, though the infection is still present. The danger with this is that the infection can spread to the testicles and the rest of the reproductive tract and lead to infertility; or spread to the rest of the body, causing serious illness. Any time you have unprotected intercourse, you can spread the infection to your partner.

You need to see a doctor who will examine you and take urine and discharge samples for analysis and culture.

You also need a chlamydia test and a HIV test. You will be given antibiotics to treat the infection, depending on the results. Abstain from sex until you have completed treatment, been re-tested and found to be cured.

Any partners you have had in the past three to six months also need to be treated, for their own health’s sake, and to prevent re-infecting you.

Send your medical questions to [email protected] for absolutely free expert advice