Skin infections comprise a variety of conditions, such as warts, molluscum, herpes zoster, tinea (ringworm), fungal acne (pitysporum folliculitis), and tinea versicolor. These skin conditions can result from bacterial, viral, fungal, or parasitic infections, varying from mild to severe. If left untreated, these infections affect the skin’s barrier and may lead to discomfort, pain, and sometimes severe complications.
Viral warts, a common skin ailment, are caused by various strains of the human papillomavirus (HPV). These growths can range from small, flat-topped bumps to more prototypical warts with a distinctive cauliflower-like appearance.
Warts are usually skin-coloured and appear primarily on the hands, feet, and genital areas. There are several types, including common, plantar, flat, mosaic, filiform, and genital warts, each with unique features and locations on the body.
Diagnosis is generally straightforward, relying on the wart's unique appearance. However, in ambiguous cases, a biopsy may be conducted for confirmation. Transmission of HPV leading to warts occurs through either direct contact with an infected individual or indirectly via contact with surfaces contaminated with the virus. A key factor for transmission is the presence of abrasions or cuts on the skin, allowing the virus to enter and infect the individual.
At Lumine Dermatology & Laser Clinic, we are committed to providing a holistic approach to managing viral warts. Our treatment strategies are tailored to each patient's specific condition and may include one or a combination of the following options:
Molluscum contagiosum is a common viral infection dermatologists encounter, particularly in children. Caused by the poxvirus, it leads to distinctive, pearl-like, small, raised lesions that are skin-coloured to pink, often with a central indentation or pit.
Certain groups, such as children with atopic eczema and adults who frequently shave areas like the beard, scalp, and genital regions, are more prone to contracting this infection.
In Singapore's humid environment, molluscum contagiosum spreads primarily through direct skin contact or via contaminated objects, known as fomites.
Diagnosing molluscum contagiosum is predominantly clinical, based on a detailed examination of the skin and, when necessary, dermatoscopic analysis. A key diagnostic technique involves pricking and expressing the lesions to extract a seed-like material, confirming molluscum contagiosum's presence.
Treatment for molluscum contagiosum includes:
Herpes Zoster, or shingles, is caused by VZV. This infection triggers a distinct rash across a body segment. It starts as red papules that evolve into blisters and pustules, eventually scabbing over. This can lead to scarring and significant dyspigmentation alongside a painful, burning sensation.
Herpes Simplex, caused by either HSV-1 or HSV-2, is characterised by clusters of small, painful blisters on a red base, commonly on the lips or genitals. It spreads through direct contact with the infected secretions.
Impetigo is a highly contagious skin infection caused by Staphylococcus aureus and Streptococcus pyogenes. It commonly affects children, presenting as red sores or crusted blisters, especially around the nose and mouth. These are often covered with a honey, yellowish-brown crust, causing alarm due to their rapid progression. While the lesions may itch or cause light discomfort, they typically aren't painful.
Our comprehensive management approach also involves identifying bacterial colonisation and stressing the importance of good personal hygiene and wound coverage to prevent further spread and minimise recurrence risk.
MRSA, or Methicillin-Resistant Staphylococcus Aureus, can arise from various sources, such as direct contact with infected wounds, contaminated surfaces, or sharing personal items like towels or razors. The bacteria find a foothold in cuts and abrasions, breaching the skin’s barrier to cause infection. Symptoms of MRSA include red, swollen, and painful bumps that can turn into deep abscesses without proper treatment.
Risk factors for community-acquired MRSA include having a household member or pet with MRSA, a compromised skin barrier due to frequent skin injuries or conditions like eczema, living in or frequenting crowded places, participation in contact sports, and using or touching items and surfaces contaminated with MRSA (gym equipment, towels, razors).
MRSA is resistant to standard antibiotics, making it a more formidable foe due to its propensity for recurrences and the potential for aggressive progression. Effective treatment often combines surgical drainage of abscesses, oral antibiotics guided by wound cultures, decolonisation measures, and heightened hygiene practices at home.
Ringworm, also known as tinea, is a common fungal infection. It is recognised by its distinct, circular rash with clearer skin in the centre, often resembling a ring. This itchy rash can appear on various parts of the body, including the scalp (tinea capitis), feet (tinea pedis or athelete's foot), groin area (tinea cruris or jock itch) or nails (onychomycosis), with symptoms that may vary based on the infection site.
Ringworm causes include direct contact with an infected individual or animal or indirect contact with contaminated objects or surfaces, like towels, clothing, or floors. Its preference for warm, moist environments makes ringworm a prevalent infection in tropical climates.
The diagnosis of ringworm often involves a clinical examination by a dermatologist, and confirmation might require a fungal culture or a microscopic examination of a skin scraping. A Wood's lamp examination is another diagnostic tool that utilises ultraviolet light to identify certain types of fungi on the skin.
The treatment for ringworm typically involves antifungal medications, available as topical applications for mild infections or oral drugs for more severe cases. Maintaining the cleanliness and dryness of the affected area is crucial in preventing the spread of the fungus, highlighting the importance of personal hygiene in managing and preventing ringworm.
Tinea versicolor, also known as pityriasis versicolor, is a prevalent fungal skin infection we frequently encounter in our dermatology practice, particularly given Singapore’s warm and humid climate. This condition is characterised by small, discoloured patches of skin that can appear lighter or darker than the surrounding skin. It typically affects the chest, back, shoulders, and upper arms. Lightly scratching the skin often reveals fine, bran-like scaling. This rash is usually more visually disturbing than symptomatic.
The risk factors for developing tinea versicolor include living in a tropical climate, excessive sweating, oily skin, and a weakened immune system. The yeast responsible for tinea versicolor, Malassezia, is a natural inhabitant of the skin's surface, leading to the condition when overgrown.
Diagnosing tinea versicolor in Singapore involves a visual examination and may be confirmed through skin scraping under a microscope or a Wood's lamp examination, which highlights the yeast.
Treatment options include topical antifungal creams, lotions, shampoos, and oral antifungal medications for more persistent cases. Prevention strategies, crucial in Singapore's climate, involve keeping the skin dry, avoiding excessive perspiration, and using medicated cleansers.
Pitysporum folliculitis, also known as fungal acne, is caused by an overgrowth of yeast in the hair follicles, leading to a slightly itchy, acne-like eruption. This yeast belongs to the Malassezia family and naturally exists on the skin but can flourish excessively in Singapore's hot and humid climate. It typically appears as small, red clusters of bumps on the chest and back.
The tendency for yeast overgrowth in Pitysporum folliculitis stems from factors such as excessive sweating or recent antibiotic use, all of which disrupt the skin’s natural flora.
For more advanced/recurrent cases, treatment often involves topical or oral antifungals. Modifying one’s skincare routine and lifestyle practices and avoiding products that aggravate yeast growth is also advised. Wear “breathable” clothing and shower post-exercise to better manage this condition.
How can I tell if my rash is a fungal infection or eczema?
Fungal infections often present with a rounded, active edge or border, which may have some scaling or pustules. It commonly occurs in the moist areas of the body, such as the armpits, groin or between the toes. On the other hand, eczema can be round in configuration but seldom presents with an active edge or border with central clearing, like in fungal infections. Eczema commonly affects the elbow creases, behind the knees or the face and neck and is often associated with a history of generally dry and sensitive skin.
A thorough examination by a dermatologist is crucial to accurately diagnosing your condition. To determine the exact cause of your rash, we might perform specific tests, such as skin scraping for fungal infections or a patch test for eczema.
How do I prevent skin infections in a tropical climate?
A few precautions can be taken, such as showering at least once daily with a gentle, non-irritating shower gel. This is especially important after activities that induce sweating.
Wearing “breathable”, loose-fitting clothing made of natural fibres like cotton also reduces the risk of trapped moisture that predisposes to bacterial and fungal overgrowth.
After exercise, avoid staying in damp clothing for prolonged periods, as this creates an ideal environment for microbial growth. This is especially important for swimwear and workout attire.
What should I do if over-the-counter treatments for fungal skin infections don't work?
It would be prudent to consult a dermatologist in this case. At Lumine Dermatology & Laser Clinic, we can ascertain the diagnosis and exclude other skin conditions that could mimic fungal infection. We can perform a skin scraping for fungal tests. Based on the diagnosis, prescription-strength antifungal medications may be recommended. These can include topical antifungals with higher potency than over-the-counter options or oral antifungal medications for more widespread or resistant infections.
How are skin infections transmitted?
Skin infections can be transmitted through direct or indirect contact. Direct contact includes skin-to-skin contact, such as when hugging and shaking hands. Indirect contact includes sharing razors and towels or touching surfaces an infected person has previously touched.
