Beach mycosis

During the hot season, at the sea or in the pool, it is not uncommon to come into contact with the microorganisms responsible for skin mycoses, able to resist long enough on mats, deck chairs, sunbeds, platforms, walkways, floors, tub edge, terry towels, slippers and shelves of bathrooms and changing rooms, even when, at first glance, the level of hygiene seems good and absolutely reassuring.

To favor the spread and engraftment of dermatophyte fungi and pathogenic yeasts / molds (in particular candida) are above all the hot and humid environment typical of the Mediterranean summer and the countless occasions of contact with a large number of people, both direct (skin to skin) and indirect (i.e. mediated by commonly used objects or surfaces). And it does not matter that they are perfect strangers or dear friends: anyone can unknowingly carry a fungus on the epidermis and transfer it to others.

To aggravate the situation contributes, then, the fact that in summer you are less protected by clothes, due to high temperatures, and footwear, normally open (sandals and slippers) or even left near the umbrella while you reach friends at the beach bar or ping pong table. As if that were not enough, in every self-respecting summer, inevitably, you sweat even when stationary and the presence of moisture on the skin reduces its defenses and creates the ideal microenvironment for the proliferation of fungi.

Despite all these negative elements, reducing the risk of contracting a summer mycosis is possible and not too complicated: just adopt some practical precautions, which will remain useful even in the following months if you regularly attend gyms, indoor pools or spas during the rest of the year. Let’s see how.

Skin mycoses

The cutaneous mycoses that can be contracted during the summer season, as a rule, are not painful, nor even less risky for health, but undoubtedly can create a fair number of discomforts, not only of an aesthetic type.

Appearance of light spots on tanned skin orreddened and / or slightly flaky zone, sometimes associated with burning or itching, are the main manifestations that can occur in most cases and that can persist for several weeks, if you do not intervene immediately with a targeted antifungal treatment.

The skin discomfort that is felt, often, induces to touch or rub the area affected by mycosis, further damaging the skin, amplifying the symptoms and favoring the spread of pathogenic microorganisms in other parts of the body, as well as exposing to the risk of bacterial infection.

Avoiding scratching lesions is therefore the first recommendation, but not everyone succeeds and this makes it even more obvious to others that something is wrong and that it is better to be alert.

But even when the spots are small or not very evident, knowing that you have a skin mycosis can generate serious embarrassment and psychological discomfort. Also for this reason, preventing mycoses is much better than having to treat them after contracting them.

In this regard, however, it should be emphasized that not all mycoses are contagious and those typical of the summer season, namely pityriasis versicolor and candidiasis of skin folds, are even less so than others. To trigger them is, in fact, above all the weakening of the skin’s immune defenses due to the sun, the chlorine of the pool, too much time spent soaking and sweat, which allows pathogenic microorganisms, always present in minimal quantities on the epidermis, to take over the healthy skin microflora and to act undisturbed.

Other risk factors that especially facilitate the onset of skin candidiasis are therapies with antibiotics or other drugs that weaken the body and the fact of following an unregulated diet, poor in vitamins and essential micronutrients and rich in sugars, with a consequent rise in blood sugar.

To be looked at with suspicion are instead the reddened, inflamed patches, with a powdery appearance in the central area and surrounded by a halo of raised scabs, typical of mycoses caused by ringworm. These fungi, which can be transmitted by animals or intercepted by lying on the grass of a lawn, are, in fact, very aggressive and contagious and require special caution when they have to be treated, so as not to transmit them to other people, starting from family members.

Myths about skin mycoses

Contagiousness is not the only cliché circulating about summer mycoses. Another misconception is, for example, that, once taken, from pityriasis versicolor or skin candidiasis you can no longer get ridof and that, from year to year or in moments of particular fatigue or physical weakness, skin spots will recur.

Healing, on the other hand, is possible, as long as you check the skin from time to time (when bathing or showering or at least 1-2 times a week) and be timely in going to the family doctor or dermatologist in case of suspicious signs, for precise diagnosis and identify the appropriate treatment, which, needless to say, It must be started immediately and followed consistently, as per the prescription received.

Contacting the doctor immediately and counteracting mycosis in the bud is essential, not only to avoid having to endure avoidable discomfort, but also to prevent the extension of the infection on the surface and in depth and the possible complications even severe, if the fungus involved is an aggressive microorganism capable of infecting, for example, even the oral mucosa or the respiratory tract.

Although this last eventuality is quite remote, if you have average good immune defenses, running even a minimal risk is completely unreasonable, considering that the visit to the family doctor can be done at any time and free of charge and that the drugs suitable to counteract mycoses exist and are safe and effective.

If you want to know more about the prevention of mycoses read this article.

How to recognize pathogenic fungi

The most common forms of cutaneous mycosis, in summer especially among adolescents and young adults and among athletes throughout the year, are:

• pityriasis versicolor, caused by Malassezia furfur
• Tinea pedis, responsible for the so-called “athlete’s foot”
• tinea cruris, often due to the propagation in the groin area or other skin folds of an untreated or poorly managed tinea pedis
• the colonization of the inguinal folds, skin and axillary cavity by Candida albicans, a yeast that proliferates well especially on the skin of overweight or obese people, suffering from a disease that reduces the immune system or diabetes.

To understand which mycosis it is necessary to observe the appearance and distribution of lesions on the epidermis.

How to prevent skin mycoses

If it is true that some of the factors that favor the development of mycoses can not be eliminated (difficult, for example, not to sweat if you are on a sunny beach), it is equally true that many others can be easily kept under control.

The first is hygiene, which does not go on holiday in summer, but rather must be treated with particular attention if you want to avoid both mycoses and other health problems caused by pathogenic microorganisms present in the environment. Therefore, it is a good rule to always take a shower after each swim in the pool or in the sea, first with simple water, when you are still on the beach and / or you plan other dives shortly, then with a mild and good quality detergent, at the end of the day.

On the other hand, it is not even the case to exaggerate with washing, because excessive cleaning and / or with too aggressive detergents destroys the protective skin barrier and alters the physiological pH of the skin (pH 5.5-6.0), weakening it. The degree of acidity of the epidermis is in fact essential to maintain the balance of the protective microbial flora and counteract the development of mycoses and other skin disorders (for example, dermatitis).

After showering or bathing, the skin should be dried gently, but completely, in every possible fold, because eliminating excess moisture helps prevent the development of mycosis. Always apply a moisturizing and emollient cream is, instead, useful to replenish the protective skin barrier more quickly and make the epidermis less prone to colonization of various types.

A further recommendation against mycoses is to be careful not to walk barefoot in places frequented by many people, ie swimming pools, showers, toilets, but also hotel rooms, corridors, beach bars, walkways between cabins, even if they look clean and harmless and, above all, if everyone does it.

If you do not have your slippers at hand, using those of a friend or relative is not a great idea because mycoses do not care about friendship or the degree of kinship. The same goes for towels, terry towels, T-shirts, tank tops and various accessories: to protect yourself, it is better to always use your own and not lend them to others, at the cost of seeming unavailable.

Another warning: when you relax on deck chairs, sunbeds or beach chairs, under the umbrella or at the bar, you must always first interpose your towel.

All linen and towels used on the beach or in the pool, at the end of the day, must be washed at high temperature and with disinfectant detergents to eliminate any possible fungus. This precaution is all the more necessary if you already have a skin mycosis, to be sure to kill all the pathogenic microorganisms present and minimize the risk of further infecting yourself or transmitting the mycosis to other people.

An additional tip is not to give in to the temptation to get massages or other aesthetic treatments on the beach: beyond the experience and goodwill of those who offer them, the risk of transmission of mycosis and other diseases, through contaminated hands, is very high.

The most suitable therapy on a case-by-case basis

If, despite appropriate precautions or precisely because you have not taken them, mycosis manifests itself, it is not the case to panic. In fact, numerous effective and safe antifungal products are available in pharmacies, to be applied directly on the skin affected by the spots.

The main and most widely used antifungals are based on azole derivatives and are available in different formulations depending on the area to be treated. For example:

• Against tinea cruris, candidiasis of skin folds and tinea pedis with moist/macerated lesions, a powdered antifungal should be preferred to help absorb excess moisture
• In case of tinea corporis or tinea pedis characterized by dryness and flaking, creams are indicated, which can be distributed precisely on the area to be treated and moisturize the skin, also reducing any itching
• If the areas of the body affected by mycosis are extensive or difficult to reach, as in the case of pityriasis versicolor spread to the shoulders, back and abdomen, the spray is more suitable, ideal even if you have to treat areas with hair (for example, the scalp).

Only in a few cases, particularly serious, the family doctor or dermatologist may decide to prescribe an antifungal drug to be taken orally, rather than for topical use.

Whatever the therapy identified (always preferably with the help of the doctor, to have a certain diagnosis, even if many topical antifungals can be purchased without a prescription), you must remember to apply antifungal preparations every day, in sufficient quantity and for the time indicated by the doctor or on the package, if you want to see the lesions disappear permanently.

On average, for the complete treatment it will take 2-4 weeks for skin mycoses, but also a few months in case of a tinea pedis that has also infected the nails. Throughout this period and for at least one additional week, areas treated with antifungals should not be exposed to intense sunlight, but protected with clothing or anti-sun protection products with a high protection factor (SPF ≥ 50) and of good quality.