Introduction

It can be frustrating battling against persistent hand infections like tinea manuum. The first step to getting an effective treatment is to understand what tinea manuum is. This infection is often mistaken for eczema or dry skin; therefore, little or even no attention is given to the tinea manuum. 

Tinea manuum is a fungal infection that affects the outer layer (epidermis) of the skin on both hands. Tinea, generally, is another name for ringworm. The names of the different types of ringworm are determined by the location of the infection in your body. Tinea manuum affects the palms, back of your hands, and the skinfolds between your fingers.¹

In this article, you will discover the causes, symptoms and the best treatment options to regain healthy skin. You will also be exposed to the serious complications that can arise if the infection is neglected or not well-treated.

Not just that, knowing how this infection spreads and the best ways to prevent being infected again is as important as treating it. I will be explaining all this and the steps to managing this condition to keep your hands healthy.

Symptoms 

Symptoms commonly associated with tinea manuum are itching and round patches on the back of your hands. On the skin with a lighter tone, the patches could appear red or pink. Brown or grey patches appear on darker skin.

These patches develop into rings that have scaly borders. It is also characterised by thickening of the skin of the palms, dry skin, and deep cracks on the palms. Within the cracks, you may notice white scaling as well. There is pain, swelling, and itching.

On the fingers, red patches with blisters and pimples may be noticed. With time, the infection will spread to the fingernails of the affected hand.

How it spreads 

The Tinea manuum spreads very easily. It can be gotten through:

• Contact with another site of infection, like the feet (tinea pedis) and the groin (tinea cruris)
• Contact with another tinea-infected person
• Direct contact with an animal or soil
• Contact with a contaminated object²

Risk factors for tinea manuum

The tinea manuum thrives in moist and warm environments. The predominant risk factors are:

Living in the tropics

• Staying in areas with hot and humid weather
• Making use of public facilities, like showers and indoor pools
• Staying in close quarters with other people, like in hostels
• Engaging in sports that require contact, like football and wrestling
• Sharing clothing, beddings, objects like hairbrushes, and sports equipment¹

The infection commonly affects people who work with their hands. These people include: 

• Masseurs, barbers, and others whose work demands close contact with people
• Farmers, veterinary doctors, and those who have close contact with animals
• Machine operators, car mechanics and people who work with chemicals¹

Complications of tinea manuum

If the infection is left untreated or inadequate treatment is given, complications can arise. Severe cases of Tinea manuum may result in:

Secondary bacterial infection

The skin, which is already compromised, enables bacteria to enter, therefore leading to conditions such as abscess formation.³ Secondary bacterial infection in skin lesions is a common problem. Staphylococcus aureus and group A beta-hemolytic streptococci are the most prevalent bacteria involved in such infections.⁴

Normal epidermal barrier disruption is one of the factors that predispose one to these infections.⁵ The skin has a protective barrier that shields microorganisms from entering the body. When this mechanism is broken, the body becomes vulnerable to microorganisms. Another cause is itching. When someone continually itches, it causes the skin to produce microtears, and this can be the entry point for bacteria.

This causes the skin to be moist and lighter, thereby predisposing the skin to bacterial infections. Skin bacterial infections can worsen the underlying fungal infection. These bacterial infections cause increased redness, swelling, pus, pain, and may even lead to abscesses formation. 

Chronic or recurrent infections

If you do not complete your antifungal course while treating an infection, it can result in the infection being more persistent.¹

Infections reappear when you come in contact with contaminated objects or untreated body areas.² This causes discomfort and predisposes the skin to more damage. 

Spread to other areas

Fungi can transfer from the hands to other body parts, such as the feet, which causes tinea pedis or nails (onychomycosis).² All affected areas will have to be treated to prevent a recurrence.

Nail involvement

The infection can spread and invade the fingernails, causing them to become thick and discoloured.⁵ This affects the beauty and function of the nails, and the person infected may be hesitant to display nails in public due to poor aesthetics.

Treatment resistance and misuse of antifungals

When steroid creams are used to treat infection without an antifungal, the symptoms can be masked, but the infection worsens^.6 This makes the infection harder to treat, and this would require a more potent and prolonged medication. The patient is also at a high risk of spreading the fungus to others. 

Prevention of complications

Preventing complications of tinea manuum needs an approach that considers both preventive strategies and effective treatment. 

• Washing hands thoroughly with soap and water, especially after exposure to fungal sources, is important as it reduces the risk of infection. These fungi survive in moist environments; therefore, it is important to keep your hands dry after washing or sweating to prevent the growth of the fungus
• When handling animals that you are aware are infected, use gloves and ensure your pets receive adequate veterinary care if they show symptoms of fungal infections²
• Personal hygiene should be practised. Avoid sharing personal belongings, such as towels, gloves or other personal items that can harbour fungi
• Always maintain a clean environment, so sanitise the shared areas

Management of complications

• Seeking medical advice at the first sign of infection is important to manage complications
• When an antifungal medication is prescribed, the patient must show compliance to complete the course of medication as directed by the healthcare professional. It ensures the infection is eliminated and the risk of recurrence reduced as well
• When you know you are infected, monitor for signs of secondary infections, such as increased redness, swelling, or pus, do seek medical attention

FAQs

Can the tinea manuum spread to the face?

Yes, if left untreated, it can spread to other parts of the body, including the face, through direct contact.

How does the tinea manuum look?

If you are dark, you will notice round patches at the back of your hand. On the lighter skin, the patches could appear red or pink. Brown or grey patches appear on darker skin. These patches develop into rings that have scaly borders.

Is tinea manuum contagious?

Yes, it can easily be spread to another person. You can come in contact with the infected individuals by sharing personal belongings, such as towels and brushes. Close contact with infected animals can be the culprit for the spread.

What is the tinea manuum from spreading?

Ensure you receive an appropriate diagnosis and treatment when you begin to notice the symptoms.

Is tinea manuum different from other fungal infections?

Tinea manuum specifically affects the hands, while other infections like tinea pedis affect the legs, and tinea corporis (ringworm) affects the body. 

What are the possible early symptoms of tinea manuum?

You will experience redness, swelling, itching and peeling of the skin around the fingers. In some, small dry blisters may appear.

Are people with weak immune systems at higher risk?

Yes. People who have diabetes, and other illnesses that make their immune system weak (e.g., HIV), or those on long-term steroid therapy are at higher risk of developing severe or recurrent infections.

How can I prevent reinfection after treatment?

To prevent reinfection:

• Keep your hands clean and dry
• Avoid sharing personal items such as gloves and towels
• Treat co-existing fungal infections (e.g., athlete’s foot)
• Sanitise commonly used surfaces, viz., gym equipment and work tools

Can topical steroids help treat tinea manuum?

No. Topical steroids can worsen the infection by suppressing the immune response, allowing the fungus to spread further. This condition, known as tinea incognito, makes the infection harder to treat.

What happens if the tinea manuum is left untreated?

If untreated, it can lead to secondary bacterial infections, chronic inflammation, or spread to other parts of the body. It may also persist for months or years, leading to discomfort and nail damage.

Summary

• Tinea manuum is a fungal infection that affects the outer layer of the hands’ skin. Tinea is another name for ringworm
• Although this infection is often overlooked, it can lead to complications if left untreated. Secondary bacterial infections, swellings and the infection spreading to the nails are among the most common complications
• Having an understanding of the causes, risk factors, and early signs helps one to treat tinea manuum effectively
• There are preventive measures to ensure that the infection does not get worse. Infected individuals should regularly wash and dry their hands, avoid sharing personal items and seek early treatment any time they notice symptoms
• Ensuring a proper diagnosis is done and sticking to medications as prescribed helps prevent complications, too
• With this knowledge, the rate of this fungal infection can be reduced, and so can its complications