What Is Paronychia?
Paronychia
Paronychia (pronounced: par-uh-nik-ee-uh) is an infection of the skin around a fingernail or toenail. The
infected area can become swollen, red, and painful. Sometimes a pus-filled blister may form.
Most of the time, paronychia is no big deal and can be treated at home. In rare cases, the infection can
spread to the rest of the finger or toe. When that happens, it can lead to bigger problems that may need
a doctor's help.
You're not likely to get paronychia in a toe (unless you have an ingrown toenail). But fingernail
paronychia is one of the most common hand infections there is.
What Causes Paronychia?
Paronychia usually happens when the skin around a person's nail is irritated or injured. When the skin
around the nail is damaged, germs can get in and cause an infection. These germs can be bacteria
(causing bacterial paronychia) or fungi (causing fungal paronychia).
Common paronychia causes include:
biting or pulling off a hangnail
clipping a nail too short
cutting or pushing back the skin around the sides and bottom of the nail (the cuticle)
Some people get paronychia infections after a manicure or using chemicals like nail glue. Certain health
conditions (like diabetes) also can make paronychia more likely. And if your hands are in water a lot (if
you wash dishes at a restaurant, for example), that ups the chances of getting paronychia.
What Are the Signs of Paronychia?
Chances are, if you have paronychia, it will be easy to recognize. There will be an area of skin around a
nail that is painful and tender when you touch it. The area probably will be red and swollen and feel
warm. You may see a pus-filled blister.
If the paronychia has been there a long time, the nail may turn a different color. It might not be its usual
shape or might look as if it's coming away from the nail bed.
What Should You Do?
If paronychia is mild and hasn't started to spread beyond the fingernail, you can probably treat it at
home. Soak the infected nail in warm water for 20 minutes a few times a day. The infection will probably
heal on its own in a few days.
If paronychia doesn't get better after a week or so, call your doctor. You'll want to call a doctor right
away if you have an abscess (a pus-filled area in the skin or under the nail) or if it looks like the
infection has spread beyond the area of the nail.
If paronychia becomes severe and you don't see a doctor, infection can spread through the finger or toe
What Do Doctors Do?
Usually, a doctor or nurse practitioner will be able to diagnose paronychia just by examining the infected
area. In some cases, a doctor may take a pus sample to be examined in a laboratory to determine what
type of germ is causing the infection.
If you have diabetes, let your doctor know if you notice any signs of paronychia, even if it seems mild.
Don't try to puncture or cut into an abscess yourself. Doing that can lead to a more serious infection or
other complications. The doctor may need to drain the abscess and possibly prescribe antibiotic
medications to treat the infection. Once an abscess is treated, the finger or toe almost always heals very
quickly.
If someone has fungal paronychia, a doctor may prescribe antifungal creams, lotions, or other medicines.
Can Paronychia Be Prevented?
Here are some things that can lessen your chances of developing paronychia:
Don't bite your nails or pick at the cuticle area around them.
Don't cut nails too short. Trim your fingernails and toenails with clippers or manicure scissors,
and smooth the sharp corners with an emery board or nail file. The best time to do this is after a
bath or shower, when your nails are softer.
Don't push your cuticles back, trim them, or use cuticle remover. Damaging your cuticles gives
bacteria a way to get into your skin and cause an infection.
If you'll be washing a lot of dishes or if your hands might be coming into contact with chemicals,
wear rubber gloves.
If you have diabetes, make sure it is under control.
Practice good hygiene: keep your hands and feet clean and dry.
If you get manicures or pedicures at a nail salon, consider bringing along your own clippers, nail
files, and other tools.
As much as possible, try to avoid injuring your nails and the skin around them. Nails grow slowly. Any
damage to them can last a long time.
Reviewed by: Elana Pearl Ben Joseph, MD
Date reviewed: March 2012
Note: All information on TeensHealth® is for educational purposes only. For specific medical advice,
diagnoses, and treatment, consult your doctor.
© 1995- 2013 The Nemours Foundation. All rights reserved.
Jock Itch
Game over! It was a hard-fought match, and Pete's team just won in the final seconds. Now, as he basks
in the afterglow of sweet victory, he thinks about all the great things he's going to get for his sweaty
efforts — admiring glances, bragging rights, a medal, a trophy, maybe even a mention in the local paper.
But he's feeling a little itchy and uncomfortable in an area due south. And it's starting to burn. Yes, it's
something else Pete got for his athletic efforts — jock itch.
What Is Jock Itch?
Jock itch is a pretty common fungal infection of the groin and upper thighs. It's part of a group of fungal
skin infections called tinea tinea. The medical name for jock itch is tinea cruris (pronounced: tih-nee-uh
krur-us).
Jock itch, like other tinea infections, is caused by several types of mold-like fungi called dermatophytes
(pronounced: dur-mah-tuh-fites). All of us have microscopic fungi and bacteria living on our bodies, and
dermatophytes are among them. Dermatophytes live on the dead tissues of your skin, hair, and nails and
thrive in warm, moist areas like the insides of the thighs. So, when the groin area gets sweaty and isn't
dried properly, it provides a perfect environment for the fungi to multiply and thrive.
Who Gets Jock Itch?
You don't have to be a jock to get that itch down south. Jock itch is so named because mostly athletes
get it. But it can affect anyone who tends to sweat a lot. It most often affects guys, but girls can get it,
too.
Some things can make jock itch more likely to develop. These include lots of sweating while playing
sports, hot and humid weather, friction from wearing tight clothes for extended periods (like bathing
suits), and sharing clothes with others.
People who have certain health conditions, such as obesity, diabetes mellitus, or other diseases that
cause problems with the immune system, are also more likely to develop it.
What Are the Signs and Symptoms?
Jock itch is usually less severe than other tinea infections. If it's not treated, though, it can last for weeks
or months. Symptoms of jock itch include:
a circular, red, raised rash with elevated edges
itching, chafing, or burning in the groin, thigh, or anal area
skin redness in the groin, thigh, or anal area
flaking, peeling, or cracking skin
How Do I Get Rid of It?
Jock itch usually responds to self-care: Over-the-counter antifungal creams, powders, and sprays will
probably clear it up. Sometimes, though, a person may need to see a doctor for a prescription antifungal
cream.
When it comes to healing a fungal infection, it's essential to keep the affected area clean and dry. Follow
these steps when treating jock itch:
Wash, then dry the area using a clean towel. Use a separate, clean towel on the rest of your
body — don't use the same towel you used on your groin.
Apply the antifungal cream, powder, or spray as directed on the label.
Change your clothes, especially your underwear, every day.
Treat other fungal infections, such as athlete's foot.
It's important to continue this treatment for the amount of time recommended in the instructions on the
product label. Continue following the steps above even if symptoms disappear sooner to prevent the
infection from coming back.
If these steps don't work, or if symptoms last longer than 2 weeks, talk to your doctor, who might need
to prescribe a stronger antifungal cream, spray, or pill.
Can I Prevent Jock Itch?
Good hygiene is the most important thing you can do to help prevent jock itch:
Shower or take a bath daily, as well as after playing sports.
Keep the area as dry as possible by always using a clean towel after showering or swimming.
Avoid sharing towels.
Wash athletic supporters as often as possible.
If you have a fungal infection somewhere else on your body, like athlete's foot or ringworm, be sure to
treat it to help prevent the fungus from spreading to your groin. The best way to prevent the spread is to
not touch or scratch your groin area after touching your feet.
Also, use a separate towel on your feet after showering — or if that's not possible, dry your groin before
your feet so the towel doesn't spread the infection. If you have athlete's foot, put your socks on before
your underwear — this covers your feet so the germs don't get on your underwear.
Jock itch is pretty common. The good news is it can be avoided through proper care and attention — and
it's easily treated if you do get it.
Reviewed by: Patrice Hyde, MD
Date reviewed: October 2011
Note: All information on TeensHealth® is for educational purposes only. For specific medical advice,
diagnoses, and treatment, consult your doctor.
Ringworm
Although their names — ringworm, jock itch, and athlete's foot — may sound funny, if you're a teen with
one of these skin infections, you're probably not laughing. If you've ever had one, you know that all of
these can produce some pretty unpleasant symptoms.
The good news is that tinea, the name for this category of common skin infections, is generally easy to
treat.
The Basics on Tinea Infections
Tinea (pronounced: TIH-nee-uh) is the medical name for a group of related skin infections, including
athlete's foot, jock itch, and ringworm. They're caused by several types of mold-like fungi called
dermatophytes (pronounced: der-MAH-tuh-fites) that live on the dead tissues of the skin, hair, and
nails.
What Is Ringworm?
Ringworm, which isn't a worm at all, can affect not only the skin, but also the nails and scalp.
Ringworm of the skin starts as a red, scaly patch or bump. Ringworm tends to be very itchy and
uncomfortable. Over time, it may begin to look like a ring or a series of rings with raised, bumpy, scaly
borders (the center is often clear). This ring pattern gave ringworm its name, but not every person who's
infected develops the rings.
When ringworm affects the feet it's known as athlete's foot, and the rash, which is usually between a
person's toes, appears patchy. In fact, the rashes a person gets with athlete's foot and jock itch may not
look like rings at all — they may be red, scaly patches.
Ringworm of the scalp may start as a small sore that resembles a pimple before becoming patchy, flaky,
or scaly. It may cause some hair to fall out or break into stubbles. It can also cause the place where the
infection is to become swollen, tender, and red.
Ringworm of the nails may affect one or more nails on a person's hands or feet. The nails may become
thick, white or yellowish, and brittle. Ringworm of the nails is not too common before puberty, though.
Can I Prevent Ringworm?
The most common sources of the fungi that cause tinea infections are other people. Ringworm is
contagious and is easily spread from one person to another, so avoid touching an infected area on
another person. It's also possible to become infected from contact with animals, like cats and dogs.
It can be difficult to avoid ringworm because the dermatophyte fungi are very common. To protect
yourself against infection, it can help to wear flip-flops on your feet in the locker room shower or at the
pool, and to wash sports clothing regularly. Because fungi are on your skin, it's important to shower after
contact sports and to wash your hands often, especially after touching pets.
If you discover a red, patchy, itchy area that you think may be ringworm, call your doctor.
How Is Ringworm Treated?
Fortunately, ringworm is fairly easy to diagnose and treat. Doctors usually can diagnose ringworm based
on how it looks, but sometimes will scrape off a small sample of the flaky infected skin to test for fungus.
If you do have ringworm, your doctor will recommend an antifungal medication. A topical ointment or
cream usually takes care of skin infections, but ringworm of the scalp or nails requires oral antifungal
medication. Your doctor will decide which treatment is best for you.
Reviewed by: Patrice Hyde, MD
Date reviewed: February 2013
Note: All information on TeensHealth® is for educational purposes only. For specific medical advice,
diagnoses, and treatment, consult your doctor.
© 1995- 2013 The Nemours Foundation. All rights reserved.
Athlete's Foot
Although the words ringworm, jock itch, and athlete's foot may sound funny, if you have one of these
skin infections, you're probably not laughing.
The good news is that tinea, the name for this category of common skin infections, is usually easy to
treat. Read on to learn some fast facts about foot fungus.
The Basics on Tinea Infections
Tinea (pronounced: tin-ee-uh) is the medical name for a group of related fungal skin infections that
affect the skin, nails, or scalp, including athlete's foot, jock itch, and ringworm (despite its name,
ringworm is not a worm).
These infections are caused by several types of mold-like fungi called dermatophytes (pronounced:
der-mah-tuh-fites) that live on the dead tissues of your skin, hair, and nails.
What Is Athlete's Foot?
The medical name for athlete's foot is tinea pedis. Usually, athlete's foot affects the soles of the feet and
the areas between the toes, and it may also spread to the toenails. Athlete's foot can also spread to the
palms of your hands, groin, or underarms if you touch your feet and then touch another area of your
body.
Athlete's foot doesn't just aggravate athletes; anyone whose feet tend to be damp or sweaty can get this
infection. The fungi that cause athlete's foot thrive in warm, moist environments.
The signs and symptoms of athlete's foot include itching, burning, redness, and stinging on the soles of
the feet. The skin may flake, peel, blister, or crack.
How Can I Prevent It?
Athlete's foot is contagious. It's often spread in damp areas, such as public showers or pool areas. To
avoid getting athlete's foot, dry your feet — and the spaces between your toes — thoroughly after
showering or swimming. Use a clean towel. (Avoid sharing towels because doing so can spread the
infection.) If you use public showers, like those in the locker room, wearing waterproof shoes or flip-flops
is a good way to protect your feet.
To keep your feet as dry as possible, try not to wear the same shoes or sneakers all the time, and don't
wear socks that make your feet sweat or trap moisture. Cotton or wool socks are a good bet. You can
also find socks made of special "moisture wicking" fabrics in many sports stores — these are designed to
keep feet dry.
If possible, choose sneakers that are well ventilated — some sneakers contain small ventilation holes that
help to keep your feet dry.
How Is Athlete's Foot Treated?
A doctor can often diagnose athlete's foot simply by examining the affected area. Your doctor may also
take a small scraping of the skin on your foot. This sample is then examined under a microscope or sent
to a laboratory for culture to see if the fungi that cause athlete's foot are present.
If you have athlete's foot, over-the-counter antifungal creams and sprays may solve the problem. Most
mild cases of athlete's foot usually clear up within 2 weeks, but it is common for athlete's foot to recur
(come back), so some people use medicated powders and sprays to prevent this from happening.
If an athlete's foot infection is more serious, it can take longer than a couple of weeks to get better. In
these cases, it's a good idea to see your doctor, who may prescribe a stronger antifungal cream, spray,
or pill.
Reviewed by: Patrice Hyde, MD
Date reviewed: October 2011
Note: All information on TeensHealth® is for educational purposes only. For specific medical advice,
diagnoses, and treatment, consult your doctor.
© 1995- 2013 The Nemours Foundation. All rights reserved.
Vaginal Yeast Infections
When Juanita was diagnosed with strep throat, her doctor prescribed an antibiotic to treat the infection.
Juanita started to feel better soon after she took the medication — the pain in her throat subsided and
her temperature returned to normal. But then she noticed an unusual discharge in her underwear. To
make things worse, her vaginal area felt very itchy.
Juanita told her mom what was going on, and her mom took her back to the doctor's office. There,
Juanita found out she had a yeast infection. Although she'd had been nervous about seeing a doctor for
such a personal reason, she was relieved to find out that diagnosing and treating a yeast infection is
simple and painless.
What Is a Yeast Infection?
A yeast infection, also known as candidiasis (pronounced: can-dih-DIE-uh-sis), is the name for a
common infection caused by a yeast called candida albicans (a type of fungus).
Yeast infections usually occur in warm, moist parts of the body, such as the mouth and moist areas of
skin. When they cause an infection in the vagina, it is known as vulvovaginal candidiasis.
Candida can overgrow for many reasons. Stress, pregnancy, and illnesses that affect the immune system
may allow yeast to multiply, as can certain medicines. These include some birth control pills and steroids.
Or if you're taking antibiotics, such as for strep throat, the antibiotics can kill "good" bacteria that also
live in the body and normally keep the growth of candida in the vagina in check. Yeast also can flourish if
a girl's blood sugar is high. Girls who have diabetes that isn't controlled are at a higher risk for yeast
infections.
Many girls find that yeast infections tend to show up right before they get their periods because of the
hormonal changes that come with the menstrual cycle. Clothing (especially underwear) that is too tight
or made of materials like nylon that trap heat and moisture might make yeast infections more likely
because yeast can thrive in this type of environment. Using scented sanitary products can irritate the
vagina, and douching can upset the healthy balance of bacteria in the vagina. Both can make yeast
infections more likely.
Yeast infections can happen to any girl, and they're not considered sexually transmitted infections —
although they may be able to be spread from one sexual partner to the other. This is rare, though, and
the partner of someone who has a yeast infection does not automatically have to be treated unless
symptoms appear.
A doctor won't be able to tell how you got a yeast infection, but will be able to tell you if you really have
one and, if so, how to treat it.
What Are the Symptoms?
Common signs and symptoms of yeast infections may include:
itching and irritation in the vagina
redness, swelling, or itching of the vulva (the folds of skin outside the vagina)
a thick, white discharge that can look like cottage cheese and is usually odorless, although it
might smell like bread or yeast
pain or burning when urinating or during sex
If you have any of these symptoms, see your doctor or gynecologist. It's easy to confuse the symptoms
of a yeast infection with those of some STDs and other vaginal infections. Your doctor can give you the
right diagnosis so that you can be treated appropriately.
Do Guys Get Yeast Infections?
Guys don't get vaginal yeast infections, but they can get an infection of the head of the penis that is
caused by the same candida that causes infections in girls. Guys who have diabetes or are on antibiotics
for a long time are more prone to this infection. A guy with a yeast infection may not have any
symptoms or the tip of the penis may become red and sore or itchy. Some guys might have a slight
discharge or pain with urination as well.
Guys who are not circumcised need to take extra care to clean properly beneath their foreskins. The
warm, moist folds of the foreskin are the perfect environment for yeast to thrive. Keeping the area clean
and dry may help prevent an infection, but if symptoms do show up, a trip to the doctor will treat the
infection.
How Can I Prevent Yeast Infections?
What you wear — or don't wear — can help you avoid a yeast infection. Yeast grows best in a warm,
moist environment: think wet bathing suits, tight jeans, and stretchy exercise gear. Nylon underwear,
pantyhose, and other synthetic materials that trap moisture also make yeast infections more likely.
Some girls may react to certain dyes or perfumes in soaps, bath gels or lotions, sanitary products, and
laundry detergents. When the reaction causes irritation, that can set the stage for a yeast infection. Your
best bet is to steer clear of perfumed products and to use mild and fragrance-free products when
possible.
To help keep your vaginal area dry, try switching to all-cotton underwear and make sure you carefully
dry off after you shower. If you can, wear cotton underwear to bed or don't wear any, and always wash
and thoroughly dry your underwear before wearing them. Don't lounge around in a wet bathing suit and
avoid jeans or pantyhose that are too tight.
Don't take leftover antibiotics or someone else's antibiotics if you think you have an infection. Only take
antibiotics when and how they're prescribed for you. And if you have diabetes, make sure you keep your
blood sugar levels under control.
Do I Need to See a Doctor?
Treating a yeast infection is simple. But it's still important to visit your doctor for the right diagnosis,
since other infections can cause similar symptoms but require different treatments. Your doctor might
take a urine sample — to rule out a urinary tract infection — and swab some discharge from your vagina
to examine under a microscope.
If you do have a yeast infection, your doctor will probably prescribe a pill to swallow or a cream, tablet,
or suppository to put in the vagina. When you get home, follow all the directions on the package
carefully. Creams, tablets, and suppositories for the vagina often come with an applicator to help you
place the medicine inside your vagina, where it can begin to work. If you're using a vaginal treatment,
you should abstain from sex until the infection has been treated — these medications can weaken
condoms and diaphragms.
All of these types of medication can clear up your symptoms in a couple of days and cure the infection
within a week. It's important that you take the medicine for the whole time that your doctor prescribes.
If you stop taking it too soon, the infection could come back. If you're not feeling better within a few
days of finishing treatment, call your doctor.
Some of the medications used to treat yeast infections are available without a prescription in your local
drugstore, but you shouldn't just buy one if you think you have a yeast infection. It's important to see a
doctor for your diagnosis, because if you actually have another type of infection, it could get worse if not
properly treated. Also, over-the-counter medicine should not be used by anyone younger than 12 or girls
who might be pregnant without talking to a doctor first.
Yeast infections can be annoying, especially if they happen regularly. To help avoid them, follow your
doctor's advice, wear cotton underwear, and try to wear loose-fitting clothes. Your body will thank you.
Reviewed by: Larissa Hirsch, MD
Date reviewed: January 2012
Note: All information on TeensHealth® is for educational purposes only. For specific medical advice,
diagnoses, and treatment, consult your doctor.
© 1995- 2013 The Nemours Foundation. All rights reserved.
Swimmer's Ear (External Otitis)
The pool party had been awesome. Ryan and his friends had eaten pizza, listened to music, and, of
course, spent lots of time in the water. But the aftermath of the party wasn't as great. Two nights later,
Ryan woke with a sharp pain in his ear — it really hurt! He remembered having ear infections when he
was a little kid, but this didn't feel the same somehow. His outer ear felt so sore to the touch that he
couldn't even stand to rest his head on his pillow. He wondered if it had something to do with the water
that had been stuck in his ear after swimming.
Ryan was right — he had an infection of the ear canal commonly known as swimmer's ear. Keep reading
for tips and tricks on keeping swimmer's ear at bay.
What Is External Otitis?
The medical terms for swimmer's ear are external otitis or otitis externa. Swimmer's ear is an
infection of the ear canal (the tubular opening that carries sounds from the outside of the body to the
eardrum) that can be caused by many different types of bacteria or fungi. It usually develops in ears that
are exposed to moisture.
People who get external otitis often have been diving or swimming for long periods of time. This can
bring infectious bacteria directly into the ear canal. External otitis occurs most often during the summer
months — when more people are participating in water activities.
People who don't swim can also develop external otitis by scratching their ear canals when they try to
clean their ears. This is especially true if they use cotton-tipped applicators or dangerously sharp small
objects, like hair clips or bobby pins. Sometimes, in a person with a middle ear infection (otitis media),
pus collected in the middle ear can drain into the ear canal through a hole in the eardrum and cause
otitis externa to develop.
What Are the Signs and Symptoms of External Otitis?
The primary symptom of external otitis is severe ear pain that gets worse when the pinna, or outside
part of the ear, is pulled or pressed on. Sometimes there is itching in the ear canal before the pain
begins. The outer ear may become reddened or swollen, and lymph nodes around the ear may become
enlarged and tender. There also may be a greenish-yellow discharge of pus from the ear opening. It can
be hard to hear in the affected ear if pus or swelling of the canal begins to block passage of sound into
the ear. A slight fever may accompany external otitis.
There is no set time that it takes external otitis to develop, but the ear pain often follows an episode of
swimming or water immersion and develops gradually over several days.
Can I Prevent External Otitis?
You may be able to prevent external otitis by using acid alcohol drops after you've finished swimming for
the day. (You shouldn't use these drops if you have ear tubes or a hole in your eardrum.) It's also a good
idea to dry your ears thoroughly with a clean towel after swimming, bathing, or showering.
Keep all objects out of your ear canals — including cotton-tipped applicators — unless your doctor has
told you it's OK to use them.
How Long Does It Last?
If it's treated with prescription ear drops, external otitis is usually cured within 7 to 10 days. The pain
should lessen within a few days of treatment.
External otitis is not contagious, so you don't have to limit your contact with friends as long as you're
feeling well enough to socialize.
Should I Call My Doctor?
You should call your doctor if you have any of the following:
pain in an ear with or without fever
persistent itching of the ear or in the ear canal
loss of hearing or decreased hearing in one or both ears
discharge from an ear, especially if it's thick, discolored, bloody, or bad-smelling
These are all signs that you may have external otitis.
How Is External Otitis Treated?
If you think you have external otitis, you should see your doctor. This is the fastest way to relieve the
ear pain and to prevent the spread of infection.
Your doctor's treatment for external otitis will depend on how severe the pain and the infection are. For
most all outer ear infections, your doctor may prescribe ear drops containing antibiotics or maybe mixed
with corticosteroids. These will help fight the infection and reduce swelling of the ear canal. For full
treatment, ear drops are usually given several times a day for 7 to 10 days.
If the opening into your ear is narrowed by swelling, your doctor may clean your ear and insert a wick
into your ear canal to help carry ear drops into the ear more effectively. If you have a severe infection,
he or she may give you antibiotics to take by mouth as well. Your doctor may take a culture of the
discharge from your ear to help identify what type of germ is causing the infection.
What Can I Do to Make Myself Feel Better?
Place a warm cotton cloth or heating pad against your ear to help relieve the pain. You may also take
acetaminophen or ibuprofen.
At home, follow your doctor's directions for using ear drops and take all oral antibiotics as prescribed
(don't stop taking these even if you feel better; it's important to take the full course of any antibiotics
your doctor prescribes). To avoid contaminating the infected ear, your doctor will probably tell you to
keep your head out of water for several days or weeks — even while showering or shampooing! This can
be tough, but your doctor can give you suggestions on how to do this, such as using a shower cap or
cotton earplugs coated with petroleum jelly (removed after the shower is finished).
If your ear pain is not relieved by over-the-counter pain medications, your doctor may order a stronger
prescription pain reliever. You'll use this only for a short time — until the ear drops and antibiotics begin
to work.
Reviewed by: Steven P. Cook, MD
Date reviewed: August 2012
Note: All information on TeensHealth® is for educational purposes only. For specific medical advice,
diagnoses, and treatment, consult your doctor.
© 1995- 2013 The Nemours Foundation. All rights reserved.
Dandruff
When Kevin went for his school physical, he told the doctor that his biggest worry about going back to
school was the dress code. This year the uniforms were dark blue, and Kevin hated wearing dark colors.
He told his doctor that he got embarrassed because dandruff always showed up on his shoulders. When
the doctor said that dandruff was treatable, Kevin was relieved.
What Is Dandruff?
The flaking accompanying dandruff is caused by something called seborrheic dermatitisseborrheic
dermatitis (sometimes just called seborrhea). Dandruff flakes may be white or light yellow and will
usually rub off a person's head easily.
Someone who has dandruff may notice his or her scalp feels crusty, red, and raw in the areas where
seborrhea is getting worse. If this happens, seborrhea can cause the scalp to itch pretty badly. In very
rare cases, seborrhea may cause hair loss if it isn't treated. But any lost hair should start to grow back
once seborrhea is treated.
For some people, seborrheic dermatitis just causes a relatively mild case of dandruff — a bit of flaking
and itching in the scalp. Other people with seborrheic dermatitis have crusty, red, irritated skin that may
spread to different areas of the body. Common locations to find seborrhea include inside the ear, the
armpits, and even the belly button.
Seborrheic dermatitis and dandruff aren't contagious. So you can't catch dandruff from (or give it
to) another person.
Who Gets Dandruff?
If you're worried about dandruff, you're not alone. Dandruff can start in early adolescence as someone
goes through puberty, and lots of teens and adults live with it.
People who get eczema may notice that their dandruff gets worse when they have an eczema flare-up.
Dandruff also often gets worse during the winter and in cold weather.
Treating Dandruff
Most of the time dandruff can be treated and controlled with over-the-counter dandruff shampoo. More
severe dandruff may need prescription shampoo, steroid creams, or antifungal creams to help improve
the skin irritation.
Home Treatment
If you have seborrhea only on your scalp, you should be able to treat it just with dandruff shampoo. Four
types of dandruff shampoo are available over the counter, and they work equally well:
1. Selenium sulfide 1% shampoo (e.g., Selsun Blue)
2. Sulfur shampoo (e.g., Scalpicin, X-Seb)
3. Tar-based shampoo (e.g., T-Gel)
4. Zinc pyrithione shampoo (e.g., Head & Shoulders)
If you have dandruff, you may need to use a dandruff shampoo every day at first. Once your dandruff
has improved, it is OK to use your dandruff shampoo less often. Using dandruff shampoo once a week
may be enough to keep dandruff flakes off your shoulders.
If one type of dandruff shampoo irritates or bothers your scalp, try a different one. You might need to
experiment with a couple to figure out which one works best for you.
Most dandruff shampoos have little or no smell. But you can still smell like you by using your regular
shampoo after rinsing the dandruff shampoo out. You also can use your usual conditioner after your
dandruff shampoo.
Medical Treatment
If you have seborrhea in areas other than your scalp, or if shampoos alone are not controlling your
dandruff, talk to your doctor about other treatments.
Your doctor will examine you and get your medical history in order to work out the best treatment for
you. If your doctor decides you need medication, he or she may recommend:
prescription-strength dandruff shampoos
antifungal shampoos, creams, and lotions
steroid creams, lotions, and ointments
Some people notice that, after treatment, areas of skin that had severe seborrhea may be lighter than
the surrounding skin. This is more common in people with darker skin. Over time, this color difference
will fade and the skin's color will return to normal.
Living With Dandruff
Most people are able to control dandruff with shampoos. Some need to use these shampoos as often as
twice a week; others can go a month between uses. Other people may need special prescription
shampoo to keep dandruff away. It all depends on the person.
Dandruff can't be cured, but it can be kept under control. And, once it's under control, most people can't
tell that someone has it. In fact, the only way someone might know you have dandruff is by looking at
the shampoos in your shower.
Reviewed by: Jeremy Michel, MD
Date reviewed: March 2011
Note: All information on TeensHealth® is for educational purposes only. For specific medical advice,
diagnoses, and treatment, consult your doctor.
© 1995- 2013 The Nemours Foundation. All rights reserved.
Blastomycosis
Blastomycosis is an infection caused by breathing in the Blastomyces dermatitidis fungus.
The fungus is found in wood and soil.
Causes
You can get blastomyocosis by contact with moist soil, most commonly where there is
rotting wood and leaves. The fungus enters the body through the lungs, where the infection
starts. The fungus then spreads to other parts of the body. The disease may affect the skin,
bones and joints, and other areas.
Blastomycosis is rare. It is found in the central and southeastern United States, and in
Canada, India, Israel, Saudi Arabia, and Africa.
The key risk factor for the disease is contact with infected soil. It most often affects people
with weakened immune systems, such as those with HIV or who have had an organ
transplant. Men are more likely to be affected than women.
Symptoms
You may not have any symptoms if the infection remains in the lungs. The following
symptoms can develop if the infection spreads to other parts of the body:
Lung infection may not cause any symptoms. Symptoms may be seen if the infection
spreads. Symptoms may include:
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Bone and joint pain
Chest pain
Cough (may produce brown or bloody mucus)
Fatigue
Fever and night sweats
General discomfort, uneasiness, or ill feeling (malaise)
Muscle pain
Unintentional weight loss
Most people develop skin symptoms when infection spreads. You may get papules,
pustules, or nodules on exposed body areas.
The pustules:
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May look like warts or ulcers
Are usually painless
Vary in color from gray to violet
May appear in the nose and mouth
Bleed easily and form ulcers
Over time, these skin lesions can lead to scarring and loss of skin color (pigment).
Exams and Tests
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Chest CT scan
Chest x-ray
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Skin biopsy
Sputum culture and examination
Tissue biopsy
Urine culture
Treatment
You may not need to take medicine for a mild blastomycosis infection that stays in the
lungs. Your doctor recommend the following ant-fungal medicines when the disease is
severe or spreads outside of the lungs.
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Fluconazole
Itraconazole
Ketoconazole
Amphotericin B may be used for severe infections.
Follow-up regularly with your doctor to make sure the infection doesn't return.
Outlook (Prognosis)
People with minor skin sores (lesions) and relatively mild lung infections usually recover
completely. The infection can lead to death if not treated.
Possible Complications
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Large sores with pus (abscesses)
Return of the infection (relapse or disease recurrence)
Side effects from drugs such as amphotericin B
When to Contact a Medical Professional
Call your health care provider if you have symptoms of blastomycosis.
Prevention
Avoiding travel to areas where the infection is known to occur may help prevent exposure
to the fungus, but this may not always be possible.
Alternative Names
North American blastomycosis; Gilchrist's disease
References
Kauffman CA. Blastomycosis. In: Goldman L, Schafer AI, eds. Cecil Medicine. 24th ed.
Philadelphia, Pa: Saunders Elsevier; 2011:chap 342.
Update Date: 8/15/2012
Updated by: David Zieve, MD, MHA, Medical Director, A.D.A.M. Health Solutions, Ebix,
Inc. Jatin M. Vyas, MD, PhD, Assistant Professor in Medicine, Harvard Medical School;
Assistant in Medicine, Division of Infectious Disease, Department of Medicine,
Massachusetts General Hospital.
Aspergillosis
Aspergillosis is an infection or allergic response due to the Aspergillus fungus.
Causes
Aspergillosis is caused by a fungus (Aspergillus), which is commonly found growing on
dead leaves, stored grain, compost piles, or in other decaying vegetation. It can also be
found on marijuana leaves.
Although most people are often exposed to aspergillus, infections caused by the fungus
rarely occur in people who have a normal immune system. The rare infections caused by
aspergillus include pneumonia and fungus ball (aspergilloma).
There are several forms of aspergillosis:
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Pulmonary aspergillosis - allergic bronchopulmonary type is an allergic reaction to the
fungus that usually develops in people who already have lung problems (such as asthma or
cystic fibrosis).
Aspergilloma is a growth (fungus ball) that develops in an area of past lung disease or lung
scarring (such as tuberculosis or lung abscess).
Pulmonary aspergillosis - invasive type is a serious infection with pneumonia that can
spread to other parts of the body. This infection almost always occurs in people with a
weakened immune system due to cancer, AIDS, leukemia, an organ transplant,
chemotherapy, or other conditions or medications that lower the number of normal white
blood cells or weaken the immune system.
Symptoms
Symptoms depend on the type of infection.
Symptoms of allergic bronchopulmonary aspergillosis may include:
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Cough
Coughing up blood or brownish mucus plugs
Fever
General ill feeling (malaise)
Wheezing
Weight loss
Other symptoms depend on the part of the body affected, and may include:
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Blood in the urine
Bone pain
Chest pain
Chills
Decreased urine output
Headaches
Increased phlegm production, which may be bloody
Shortness of breath
Skin sores (lesions)
Vision problems
Exams and Tests
Tests to diagnose Aspergillus infection include:
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Aspergillus antibody test
Chest x-ray
Complete blood count
CT scan
Galactomannan (a molecule from the fungus that is sometimes found in the blood)
Immunoglobulin E (IgE) blood level
Lung function tests
Sputum stain and culture for Aspergillus
Tissue biopsy
Treatment
A fungus ball is usually not treated (with antifungal medicines) unless there is bleeding into
the lung tissue. In that case, surgery is needed.
Invasive aspergillosis is treated with several weeks of an antifungal drug called
voriconazole. It can be given by mouth or directly into a vein (IV). Amphotericin B,
echinocandins, or itraconazole can also be used.
Endocarditis caused by Aspergillus is treated by surgically removing the infected heart
valves. Long-term antifungal therapy is also needed.
Antifungal drugs alone do not help people with allergic aspergillosis. Allergic aspergillosis
is treated with drugs that suppress the immune system (immunosuppressive drugs) -- most
often prednisone taken by mouth.
Outlook (Prognosis)
With treatment, people with allergic aspergillosis usually get better over time. It is common
for the disease to come back (relapse) and need repeat treatment.
If invasive aspergillosis does not get better with drug treatment, it eventually leads to death.
What happens to a person with invasive aspergillosis also depends on their disease and
immune system function.
Possible Complications
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Amphotericin B can cause kidney damage and unpleasant side effects such as fever and
chills
Bronchiectasis (permanent scarring and enlargement of the small sacs in the lungs)
Invasive lung disease can cause massive bleeding from the lung
Mucus plugs in the airways
Permanent airway blockage
Respiratory failure
When to Contact a Medical Professional
Call your health care provider if you develop symptoms of aspergillosis or if you have a
weakened immune system and develop a fever.
Prevention
Be careful when using medications that suppress the immune system. Preventing AIDS also
prevents certain diseases, including aspergillosis, that are associated with a damaged or
weakened immune system.