What types of fungal diseases are there and how are they treated?

Fungal diseases are unpleasant. Even more uncomfortable to talk about. They affect different parts of the body, but can be treated if you know how to do it. We answer the most important questions.

How do you infect yourself with a fungus and how do you prevent it?

Basically, getting infected does not automatically mean that you will get sick. The yeast fungus Candida albicans, for example, is already present in about 70 percent of the population, mainly in the intestine – and usually without noticing it. If it enters the vaginal area from there or through an infection in the partner and infects the vaginal area, however, women feel the vaginal fungus very clearly with itching, burning and discharge.

Proper intimate hygiene is important for prophylaxis: Do not wipe from back to front in the toilet and it is best to clean the vaginal region with water only. “It is a misconception that a fungal infection can be prevented by using acid products or taking lactic acid bacteria. It can even be counterproductive, because the fungi love acid,” says Professor Hans-Jürgen Tietz from the Institute for Fungal Diseases and Internal Medicine in Berlin.

What other fungus are there?

Very “popular” are also the pathogens of foot and nail fungus – they are the same. You can get it mainly in public showers, swimming pools or hotel rooms with carpeting, but also in the family. It often starts with an infection of the skin, which then spreads to the nail – that is why athlete’s foot should always be treated early.

One way to reduce the risk:

• Dry toe gaps thoroughly after bathing and do not walk barefoot.
• Since the spores can also be passed on in the family, infected persons should pay attention to hygiene and should not share towels or nail scissors with others.
• Wash socks at at least 60 degrees.
• And above all: treat yourself.

For these fungus, man is the main host. But we can also infect animals. In Germany about 20 percent of cats are infected with Microsporum canis, in southern countries 90 percent of stray animals. “You can’t tell from the animals. Therefore, the best prophylaxis is to not touch stray animals,” said Tietz.

Why did it have to be me?

Quite unfair: Many people never have problems with fungal diseases. “This has genetic causes,” explains Dr Tietz. “This is because the prerequisite is that the pathogens adhere to the skin or mucous membrane. And you may or may not have the necessary receptors for this.”

There are also other factors: people who do a lot of sport and put a lot of strain on their feet and nails have a higher risk of nail fungus because the pathogens only penetrate into injured tissue.

And trends also play a role: “Sports and plastic shoes in which moisture accumulates are also the reason why more and more children have nail fungus,” says expert Tietz. “The circumstances are more fungus-friendly than ever.”

Vaginal mycosis can be caused by stress

According to Professor Tietz, vaginal fungal infections are also becoming more frequent. One reason for this is stress: “It increases the possibility of the pathogen to attach itself.” Even if antibiotics destroy the natural vaginal flora, Candida pathogens can get out in force. The pill and smoking are also suspected. It is also clear that oestrogen in particular affects the receptors that enable the pathogens to attach themselves and promote their growth. During pregnancy and in the days before menstruation, diseases are therefore more frequent. Some women even suffer from it in every cycle.

“However, healthy germs also dock at the receptors to which the fungi attach themselves,” explains physician Tietz. “Women with chronic vaginal mycosis therefore usually have many healthy lactic acid bacteria. They hardly ever have urinary tract infections, are only rarely ill and also develop a fairly strong defence against cancer. So they don’t have a poor immune system.”

Is there any chance that the infection will go away on its own?

No, you shouldn’t hope for a spontaneous healing. On the contrary: It is important to become active early. Skin fungi can spread to the entire body, vaginal fungi usually develop chronically without comprehensive therapy.

Only in one respect can women rely on time working for them: Since the receptors to which Candida docks are dependent on oestrogen, the annoying suffering reliably disappears with the hormonal change in the menopause.

Can I treat myself?

“80 percent of patients with foot, nail or vaginal mycosis do not go to the doctor but to the pharmacy,” says Tietz. “And that’s fine, because over-the-counter products work well and are almost always successful.” Provided, of course, that the diagnosis is correct, i.e. that it is actually a fungus – and that the treatment is successful. In the case of nail fungus, this means until the nail has grown back completely healthy, which can take up to a year.

Expert Tietz recommends that the damaged nail material should always first be removed with 40 percent urea ointment and then treated consistently and long-term with a water-soluble anti-fungal varnish or a fungicidal spray every day. “If you don’t know exactly which one it is, you should always take medication with a broad spectrum of activity,” says Hans-Jürgen Tietz. “Favorites are Bifonazole and Ciclopirox.”

So when do I go to the doctor?

In any case, if the self-treatment does not work, and generally in case of serious infections. If the fungus has already damaged more than three nails or one nail more than two thirds of the way, local treatment is no longer sufficient. In this case, additional tablets prescribed by a physician are needed. Even in the case of recurring vaginal infections, a doctor should be consulted to find the source of the pathogens.

The most common cause is a fungal infection in the woman’s bowel, but the partner must also be examined and treated. “Often, the colonisation in the mouth of the partner is the cause of the infection,” said Tietz. “You may not see it – only in the case of an immune deficiency – but as long as the fungus in the mouth is not eliminated by professional tooth cleaning and lozenges, it is of no use to do anything against the pathogens in the intestines. Otherwise they will always come back from above. The mouth of both partners should be as fungus-free as possible.”

Ultimately, every woman can be helped by searching for clues and treatment, says Tietz: “Every fungal disease can be cured, no matter how persistent it is.”

Little mycology

There are numerous pathogens that can infect us. The following fungal diseases are particularly common:

• Foot fungus: is one of the most common infectious diseases, affecting about 30 percent of the population. It manifests itself through itching and scaling of the skin, especially between the toes, but can also affect hands or groin areas.
• Nail fungus: Is caused by the same pathogen as athlete’s foot. Approximately one in six people is affected, over the age of 65 one in two. Affected nails become thick, brittle and discoloured.
• Vaginal mycosis: Pathogen is the yeast fungus Candida albicans. Three out of four women fall ill at least once in their lives, about one million suffer from chronic infections – that is at least four times a year at intervals of eight weeks, often even more frequently. Typical symptoms are itching, burning and discharge.
• Skin fungi from animals: Many bring the infection with them on holiday trips, 90 percent of stray cats in southern countries are fungal. You can also get infected from domestic pets like a cat or guinea pig. Typical is a circular red rash that spreads quickly.