The diagnosis of most fungal skin infections involves obtaining the patient’s medical history, as well as performing a physical examination, examining skin scrapings and fungal cultures. However, a biopsy of the affected skin, nails or hair is occasionally performed as well.

Most forms of fungal skin infections can be cured quickly and easily if they are treated early and properly. However, some infections may be more chronic (ongoing) and difficult to treat. Infections may also come back after treatment.  

Treatment decisions are based on a number of factors including the extent and location of the condition. The patient’s age, overall health and medical history may also influence treatment.

Topical antifungal medications are applied directly to the skin and are usually the first-line therapy for localized fungal skin infections, regardless of their cause (e.g., yeast or other fungi). The azole and allylamine classes of medication are particularly useful. Many effective antifungal creams are available without a prescription and most are applied once or twice a day. It may take several days before a reduction in symptoms is noticed. For minor infections, some physicians prefer topical combinations of corticosteroids and antifungals. Oral antifungals (e.g., griseofulvin, terbinafine) may be required for genital or oral yeast infections or more persistent or chronic infections.

Certain fungal skin infections require specific treatment:

• Tinea capitis. This infection may be particularly resistant. Topical treatments do not work. Therefore, oral antifungals are required.
  
  
• Onychomycosis. This is the most difficult fungal infection to treat. Most topical treatments do not work and oral antifungals may need to be used for several months. It can recur despite treatment with oral medicine because people can have an inherited tendency to get it. A topical antifungal nail lacquer, ciclopirox, may be effective. Even if treatment is successful, it may take up to a year for a new, clear nail to grow and replace the old nail.
  
  
• Piedra (fungal hair infection). Affected hairs are clipped and the area is washed with an antifungal shampoo.

Antibiotics may also be prescribed to treat secondary bacterial infections that develop as the result of scratching or other factors.

Depending on the severity and location of the infection, patients may have to use medication for weeks, months or longer.

Fungi can remain on the skin long after rashes and other symptoms improve. As a result, it is important for patients to continue treatment as recommended by their physician, despite relief of symptoms.