What are the other Names for this Condition? (Also known as/Synonyms)

• Facial Ringworm
• Ringworm of the Face
• Tinea Faciale

What is Tinea Faciei? (Definition/Background Information)

• Tinea Faciei, or Facial Ringworm, is an uncommon fungal infection that affects any part of the face, excluding the beard, moustache, and scalp area. The group of fungus causing the infection are called dermatophytes (specifically belonging to the genus Trichophyton or Microsporum)
• The infection causes itching sensation, with the appearance of small, round, and elevated red rashes (ring-like), with scaly textured surface. Tinea Faciei is a highly-contagious fungal infection that may affect individuals of any age category
• The condition is treated using antifungal medications and by maintaining a proper hygiene. With adequate treatment, the prognosis of Tinea Faciei is generally excellent

Who gets Tinea Faciei? (Age and Sex Distribution)

• Tinea Faciei may affect both children and adults, although most of the cases are seen in teens and young adults
• Both males and females are affected, and no gender preference is observed
• Worldwide, there is no racial or ethnic preference observed. A greater number of cases are reported in regions with hot-wet climates such as tropical countries

What are the Risk Factors for Tinea Faciei? (Predisposing Factors)

The risk factors for Tinea Faciei include:

• Neglecting fungal infection at other locations of the body
• Exposure to other infected individuals
• Individuals residing in overcrowded (warm and humid) neighborhoods with poor living conditions
• Sharing items, such as combs, rugs, bed linens, bath towel, brushes, with individuals having the fungal condition
• Playing with infected pets and coming into close contact with infected farm animals
• Having superficial open body wounds
• Those with sweaty body conditions
• Activities or occupations, such as wrestling, with significant human or animal skin-skin contact
• Wearing tightfitting (synthetic) clothes regularly
• If the individual has a weak immune system or diabetes, there is a greater susceptibility to fungal infections
• Those, who were infected with fungal infections in the past, have an elevated risk for recurrences

It is important to note that having a risk factor does not mean that one will get the condition. A risk factor increases one’s chances of getting a condition compared to an individual without the risk factors. Some risk factors are more important than others.

Also, not having a risk factor does not mean that an individual will not get the condition. It is always important to discuss the effect of risk factors with your healthcare provider.

What are the Causes of Tinea Faciei? (Etiology)

Tinea Faciei develops from fungal (ringworm) infection of the face. Mold-like fungi, belonging to any of the genus Trichophyton, Microsporum, or Epidermophyton, transmitted in wet-warm areas causes ringworm infection.

The infection may develop from:

• Direct contact with an infected individual
• An infected pet
• By using shared items
• Infection spread from another body site, such as from the nails or feet, to the face

What are the Signs and Symptoms of Tinea Faciei?

The signs and symptoms of Tinea Faciei may include:

• The fungus typically affects the epidermis (outer skin layer) causing circular ring-like rashes. The skin area within the circles appear normal and healthy
• The enlarging red and inflamed skin rings project out of the surface and develop into fluid-filled lesions
• Burning and itchy sensations may be felt at the site
• Over time, the skin appears flaky and dry with hair loss
• Abscess formation
• The rash may appear on any part of the face such as around the eyes, on the cheek, below the ears, etc.
• Sun exposure may worsen the rash

The incubation period for the symptoms to develop after an infection, may be from anywhere between 7-21 days. Tinea Faciei may have an acute onset with rapid rate of spread, or it may manifest as a chronically developing infection with mild skin rashes.

How is Tinea Faciei Diagnosed?

Tinea Faciei may resemble several skin conditions and can be misdiagnosed. The infection may be diagnosed via the following tests and exams:

• Physical examination and a complete medical history
• Fungal culture
• Potassium hydroxide test (KOH test): A sample of the skin scraping is examined microscopically, to detect the presence of fungus
• Skin biopsy: A skin tissue biopsy is performed and sent to a laboratory for a pathological examination. The pathologist examines the biopsy under a microscope. After putting together clinical findings, special studies on tissues (if needed) and with microscope findings, the pathologist arrives at a definitive diagnosis

A differential diagnosis may be considered to eliminate other skin infections/conditions that present similar signs and symptoms. These may include:

• Actinic keratoses
• Atopic eczema
• Contact allergic dermatitis
• Cutaneous lupus erythematosus
• Perioral dermatitis
• Polymorphous light eruption
• Psoriasis
• Rosacea
• Seborrheic dermatitis

Many clinical conditions may have similar signs and symptoms. Your healthcare provider may perform additional tests to rule out other clinical conditions to arrive at a definitive diagnosis.

What are the possible Complications of Tinea Faciei?

The possible complications due to Tinea Faciei include:

• The infection may spread to other regions, such as the beard, scalp, feet, etc.
• Severe emotional stress due to cosmetic issues
• Permanent scars and patches due to a worsening of the skin condition.
• The lymph nodes may become infected by bacteria leading to conditions, such as lymphadenitis or lymphangitis
• Superimposed bacterial skin infections
• Recurrence of the infection following treatment
• Treatment complications

How is Tinea Faciei Treated?

The treatment measures available for Tinea Faciei include:

• Over-the-counter antifungal medications and dry powder applications
• Oral antifungal medications, as recommended, for more severe cases
• Antibiotics for secondary bacterial infections, if required
• In order to avoid recurrence of the infection, the antifungal treatment measures must be continued for an extended period of time (per advice of the physician); even after the condition has been controlled
• Self-care may be undertaken through:
  • Regular washing and cleaning of the skin surface to prevent spread of the infection to other regions
  • Using clean and disinfected towels, combs, and hairbrushes
  • Disinfecting common shared spaces, such as toilets and shower areas, bathtubs, kitchens, and bedrooms
  • Using the prescribed topical creams and taking the prescribed oral medications regularly

Regular follow up visits with the healthcare provider is important and recommended.

How can Tinea Faciei be Prevented?

Tinea Faciei may be prevented by considering the following measures:

• Keep the body clean and dry regularly
• Practice regular handwashing
• Avoid tightfitting and thick clothing made of synthetic material, where possible, which might induce excess sweating
• Areas frequented by infected individuals must be maintained in proper sanitary and hygienic condition
• Avoid sharing common personal items, such as combs, towels, and bedding
• Avoid contact with infected animals and pets
• Always wash hands or shower following activities such as gardening, outdoor camping, working in fields and farmlands etc.
• Treat any fungal infection immediately, and prevent them from spreading to other regions of the body
• Keep children informed about fungal infections and teach them to recognize certain early signs

What is the Prognosis of Tinea Faciei? (Outcomes/Resolutions)

The prognosis of Tinea Faciei infection is generally excellent with appropriate treatment. The infection may last for several weeks but responds very well to antifungal treatment and good self-care.

Additional and Relevant Useful Information for Tinea Faciei:

The following DoveMed website link is a useful resource for additional information:

https://www.dovemed.com/healthy-living/skin-disorders/