Pale white patches on the skin are a common sight across all sections of society during the summer months. Fungal infections spare no one. And have the highest rate of incidence in the country. The reason for its prevalence is simple and obvious fungi sustains itself very easily in hot and humid tropical climes. And a city like Mumbai, where the atmosphere is loaded with moisture, is an ideal breeding ground for such infections.

Fungal infection is thus generally found on those parts of the body where one sweats a lot and from where sweat can't easily be wiped away. But that is not to say that everyone who sweats get the infection. The fungus is an acquired skin condition. "But from where?" is what patients want to know.

Most people panic because they associate fungal infections with poor personal hygiene habits. To an extent it is true. But it is not always the case. A perfectly hygienic, unsuspecting person can acquire the fungus from a simple hand shake. Sharing combs, clothes, bed sheets, towels, handkerchiefs, wigs or socks as well as wearing tight fitting clothes all contribute to the manifestation of a skin infection. Swimming pools are places we love to go to, but they are exactly the places from where one can get infected by the fungus. An immediate shower after a swim and a thorough bath at home is therefore, a must. Wearing closed shoes over a long period of time, particularly if they are slightly damp due to the rains, can also lead to the infection. Which is why most executives who have to be formally dressed are more prone to fungal infections. Besides the corporate cadre, obese people are prone to catching the infection. Due to their excess weight the body tends to trap sweat in the various rolls of fat, creating an ideal climate for the fungus to breed. Thus, the main source of the fungus is anthrophilic, that is from human contact. The other two sources are zoophilic (from animals) and geophilic (from mud). Fungal infections can be either superficial or deep. Superficial infection is just skin deep while deep infection involves the internal organs too. The infection manifests itself mainly in three forms:

1) Ring worm fungal infection: Medium-sized pale patches appear chiefly on the groin, neck and inner toe (also called Athletes Foot). This type of infection appears on the waist region among women. This is largely due to the fact that most Indian women tie their saris rather tightly around the waist trapping sweat for a long period of time. This infection is often accompanied by severe itching and can lead to the formation of pus.

2) Tinea versicolor: This kind is commonly seen among youngsters who sweat a lot. It appears as small dots mainly on the neck, trunk region and at times even the face. Infection of this type is the least harmful.

3) Candidiasis: This type of fungal infection is seen among those people whose bodies tend to remain moist for a long time. Bais and washerwomen whose work involves water are vulnerable to it. The infection is seen in finger spaces and nail folds. Infants are also prone to it as over-protective parents keep them tightly-bundled up, even on hot and humid days.

People who are HIV positive also tend to acquire this kind of an infection. They get infected usually in the mouth and more often than not the mucus membrane is involved. A curdy membrane is then formed on the tongue, inner cheek and gums. Manifestations of fungal infections are thus, severe in immuno-compromised people while immuno-competent people (HIV negative) can be completely cured of fungul infections if, of course, a doctor is consulted in time. Intermittent therapy has now considerably reduced the period of treatment. But many people choose to solve the problem by buying across the counter solutions. The infection is only aggravated by this kind of self-prescription. If the skin is thick these ointments may provide relief but otherwise it just adds insult to injury.

The best bet therefore is to seek medical advice as soon as possible. The treatment consists of both ointments and pills to be taken orally. Besides treatment, the best bet to remain fungus free is to keep the skin well ventilated. And above all, the attitude of people towards skin diseases needs to change radically. Only then will patients report to doctors at the onset of an infection, rather than wait till it has festered into a condition that requires long-term, intensive treatment.

Dr Satish Wadhwa is a professor and the Head of Dept of Dermatology and Venereology, T N Medical College, B Y L Nair Hospital. He is also the consultant dermatologist at Breach Candy Hospital and Research Centre.
-- As told to Anagha Sawant

A damp squib

Bathe twice a day during the summer months

Copyright © 1997 Indian Express Newspapers (Bombay) Ltd.