Why does a fungal infection occur even after taking complete treatment?

A fungal infection may recur even after treatment is completed. The reasons are inadequate fungal infection treatment, low hygiene, moist body surfaces, or environment, skin lesion is caused by other diseases and not a fungal infection. Some people have a peculiar immune system in which their immune system is unable to detect the fungus as a foreign object, hence will not eliminate it. Immunocompromised patients are also at risk of developing a recurrent fungal infection. Their immune systems are weak due to certain reasons such as on corticosteroid treatment, on immunosuppressive medications, suffering from cancer, or Acquired Immunodeficiency Syndrome (AIDS). However, most patients will recover from fungal infection after completing their treatment.

Fungal infection can affect your hair, nails, and skin. Dermatophyte is the main cause of fungal infection. Dermatophytes are a type of fungi with filaments and metabolize keratin which presents in our skin, hair, and nails. There are a few types of dermatophyte infections. They are Tinea corporis, Tinea pedis, Tinea cruris, Tinea capitis, and Tinea unguium. Other types of fungi are Candida albicans, Aspergillus, Candida neoformans, Histoplasma, and many more.

Tinea pedis or athlete’s foot is the most common fungal infection caused by a dermatophyte. Tinea pedis usually take place between your toes and it is frequently accompanied by Tinea unguium, Tinea cruris, and tinea manuum. Tinea pedis often affect young men after the age of puberty. The common causative organisms for this condition are Trichophyton rubrum, Trichophyton interdigitale, and Epidermophyton floccosum. Patients usually got the infections via direct contact with the organisms. Walking barefoot on contaminated surfaces is a risk factor for this condition. The clinical features are:

  • Red and itchy scales or erosions
  • Fissures between toes
  • Vesicular lesions
  • Bullous lesions

This condition is diagnosed by skin scrapings and test with a potassium hydroxide solution to detect the presence of the causative organism. Gram staining is important if a secondary bacterial infection is suspected. The goals of treatment are:

  • Relieve and reduce symptoms
  • Reduce the risk of secondary bacterial infection
  • Limit the spread of infection to other parts or other people

Topical antifungal is the treatment of choice. However, some patients may need oral antifungal. The example of topical antifungals are azoles, allylamines, butenafine, ciclopirox, tolnaftate, and amorolfine. Examples of oral antifungals are terbinafine, itraconazole, and fluconazole.

Tinea corporis is the skin infection other than the feet, face, groin, or hand. The causative organisms are T. rubrum, Trichophyton tonsurans, Microsporum canis, T. interdigitale, Microsporum gypseum, Trichophyton violaceum, and Microsporum audouinii. The clinical features are:

  • Itchiness
  • Redness
  • Round or oval scaling patches or plaque

Econazine cream is one of the topical antifungals commonly used for patients with fungal infections. This medication is only meant for external use. Econazine is applied to the affected area a few times a day until the infection is cleared. The advice on dosage and duration of treatment will be given by the pharmacist. This medication does not require a physician’s prescription, however, you will need to fill in your details in the prescription book at the pharmacy. Econazine cream should not be used in viral skin infection.

The possible side effects are only local irritation and a burning sensation over the skin. Those who are allergic to econazole nitrate or triamcinolone acetonide should not use econazine cream. Syphilis skin infection and tuberculosis skin infection patients should not use this medication as treatment. Econazine is not suitable for treating both conditions. Please avoid any long term use and avoid getting it into your eyes. If your skin condition does not improve with this medication as advised by a doctor or pharmacist, please get advice from a dermatologist.