Fungal infection of the face: symptoms, precautions and essential advice

A fungal infection of the face is a skin infection caused by the excessive growth of microscopic fungi. It manifests as localised lesions which can take on different appearances depending on the type of infection.

• The best-known form is facial ringworm (tinea faciei), characterised by a red, ring-shaped patch that gradually spreads. It remains relatively rare in Europe, but mainly affects children, often following contact with an infected animal.

• Another form is angular cheilitis, localised at the corners of the mouth. It involves redness, painful cracks and, occasionally, oozing. This condition, often associated with Candida albicans, is exacerbated by salivary maceration.

• More rarely, other fungal conditions such as pityriasis versicolor may appear on the face, particularly in adolescents, presenting as small lighter or brownish patches.

Although these conditions are distinct, they all fall within the category of superficial fungal infections and require a medical diagnosis to confirm their cause and guide treatment.

The onset of a fungal infection of the face results from an imbalance between the fungi present in the environment or on the skin and the body’s defences. Under normal circumstances, these microorganisms coexist with the skin microbiota. When this balance is disrupted, they can proliferate and cause an infection.

Causative agents

The fungi involved belong to several families:

• Dermatophytes (Trichophyton, Microsporum, Epidermophyton): filamentous fungi that feed on keratin and infect the skin, hair and nails. They are responsible for tinea faciei (facial ringworm). Infection can be zoonotic (from an infected animal, often a cat or dog) or transmitted between humans;

• Yeasts, such as Candida albicans: naturally present in the mouth, the digestive tract and on the skin, these become pathogenic when they proliferate excessively. On the face, this mainly manifests as angular cheilitis;

• Lipophilic yeasts, such as Malassezia: these are harmless microorganisms that naturally live on the skin. They may be involved in superficial skin conditions, including pityriasis versicolor, which is usually localised to the trunk but is occasionally observed on the face.

Modes of transmission

• Direct contact: simple skin-to-skin contact with an infected person can be enough to transmit the fungi. In the case of ringworm, infection can also occur via an infected animal, particularly cats and dogs.

• Indirect contact: sharing towels, bed linen, shaving equipment or make-up aids transmission, as fungi can survive for several hours, or even several days, on these surfaces.

Individual factors

Apart from transmission, certain personal factors can compromise the skin on the face and make it more susceptible to fungal infections:

• Weakened immunity: a body weakened by chronic stress, fatigue, certain illnesses or immunosuppressive treatments is more vulnerable to fungal infections.

• Sweating and moisture: heavy sweating, combined with wearing occlusive clothing or masks, creates a warm, moist environment that is conducive to the proliferation of fungi.

• Impaired skin barrier: micro-cuts caused by shaving, scratches or the use of irritating cosmetics make the skin more permeable to infectious agents.

• Inappropriate hygiene: Inadequate cleansing promotes contamination, whilst overly aggressive cleansing with harsh products disrupts the skin’s natural balance.

• Local factors: Saliva maceration at the corners of the mouth or ill-fitting dentures can contribute to angular cheilitis caused by Candida albicans.

Environmental factors

The environment also plays a role by creating conditions conducive to fungal growth:

• Climatic conditions: ambient heat and humidity increase the likelihood of fungal growth.

• Communal areas: swimming pools, steam rooms, changing rooms and gyms are high-risk areas, as heat, humidity and close contact facilitate transmission.

Fungal infections of the face present with characteristic skin symptoms. Although these may vary depending on the causative agent, several symptoms are commonly seen:

• Localised redness in a specific area (cheeks, chin, around the mouth).

• Fine flaking, giving the skin a dry or powdery appearance.

• Itching of varying intensity, sometimes accompanied by a burning sensation.

• Progressive development: the lesions tend to spread or persist without appropriate treatment.

Clinical variations depending on the causative agent

Beyond these common characteristics, certain forms have specific features:

• Facial ringworm (tinea faciei): a round, red patch – sometimes a single one – which gradually enlarges, with a more defined edge and a paler centre. In children, it may be associated with an infection of the scalp, requiring specific treatment.

• Angular cheilitis (candidiasis of the corners of the mouth): painful cracks at the corners of the lips, which may ooze. These are often accompanied by discomfort when opening the mouth, making speaking or chewing uncomfortable.

• Pityriasis versicolor (rare on the face): small pale or brownish patches that are slightly scaly, particularly in adolescents with oily skin.

Distinguishing fungal infections from other common skin conditions

Certain facial skin conditions can be confused with a fungal infection. Recognising the differences helps to guide the diagnosis more effectively:

• Eczema (atopic or contact dermatitis): diffuse red patches, often accompanied by dryness and intense itching. The lesions do not have a distinct ring-shaped border and frequently occur in flare-ups.

• Psoriasis: well-defined, thick plaques covered with scales. The condition often affects the elbows, knees or scalp, but can also affect the face. It is a chronic condition and is not related to an infection.

• Acne: comedones, papules and pustules centred on the hair follicles, generally distributed across the T-zone (forehead, nose, chin). The lesions are not ring-shaped and have a defined border.

• Rosacea: persistent facial redness, associated with skin hypersensitivity and, sometimes, visible small blood vessels (telangiectasia). Flares are triggered by factors such as heat, alcohol or stress.

• Seborrhoeic dermatitis: poorly defined red patches, covered with yellowish, greasy scales, located on the sides of the nose, the eyebrows or the beard. This is linked to an inflammatory reaction in the presence of Malassezia, but is not classified as a fungal infection.

This comparative analysis highlights the importance of seeking medical advice, as only a clinical examination combined with testing a sample can confirm that your complaint is indeed caused by a fungal infection and prevent inappropriate treatment.

Warning signs to look out for

Certain developments should prompt you to consult a healthcare professional promptly:

• Rapid spread of a small lesion into a larger patch.

• Persistence despite basic skincare.

• Bilateral or multifocal involvement: several areas of the face or symmetrical lesions that may suggest a more widespread infection or another skin condition (eczema, rosacea).

• Involvement of other sites: scalp (tinea capitis in children), trunk, skin folds.

• Recurrent fissures at the corners of the mouth: in the case of angular cheilitis, their recurrence may indicate a more general imbalance (digestive, immune) and warrants medical advice.

Chronic and recurrent forms

Recurrences may occur in the event of persistent local factors (maceration, irritating shaving), a compromised immune system or repeated exposure to sources of contamination (untreated carrier animals, contaminated laundry). Medical advice is therefore recommended to confirm the causative agent and tailor the treatment accordingly.

If you suspect a fungal infection of the face, the first step is to consult a healthcare professional to confirm the diagnosis. Medical advice and prescribed treatments depend on the type of fungus involved and the extent of the lesions.

The main medical recommendations are:

• Medical diagnosis: a dermatologist or doctor can confirm that it is indeed a fungal infection and not another condition.

• Topical antifungal treatments: these are generally the first-line treatment, in the form of a cream, gel or lotion to be applied directly to the affected area.

• Oral antifungal treatments: reserved for more severe, widespread or resistant cases, particularly where the scalp or several areas of the body are affected.

• Avoid inappropriate treatments: the use of topical corticosteroids or antifungal products without medical advice may alter the appearance of the lesions, complicate diagnosis and worsen the course of the condition.

• Consideration of contributing factors: for example, treating an infected animal in the case of a zoonotic ringworm, or adjusting a dental prosthesis in the case of angular cheilitis.

These medical recommendations ensure safe and effective management, and help to minimise recurrences by addressing the underlying cause.

There are some simple habits that can help reduce the risk of developing or experiencing a recurrence of a fungal infection on the face.

Firstly, experts recommend adopting a gentle skincare routine: cleansing should be carried out using a suitable, non-irritating product, followed by thorough rinsing. After washing or exercising, it is essential to dry the skin thoroughly, as residual moisture encourages the growth of fungi.

Personal items that come into contact with the face, such as towels, gloves, make-up brushes or sponges, should be for individual use only to minimise the risk of transmission. Similarly, choosing suitable cosmetics helps with prevention: it is best to opt for light, non-occlusive and non-comedogenic products that respect the skin’s natural balance.

Strengthening your natural defences also plays a key role. Adequate sleep, a balanced diet and stress management support both skin and general immunity. Similarly, it is advisable to limit prolonged exposure to hot and humid environments — such as steam rooms, public swimming pools or changing rooms — which provide ideal conditions for fungal growth.

Finally, diet plays a direct role in maintaining the balance of the gut microbiota and skin microbiota. Regular consumption of vegetables, fruit, high-quality protein and fibre helps to maintain this balance, whilst an excess of simple sugars and ultra-processed foods can, in contrast, promote certain imbalances associated with fungal infections.

In children, ringworm linked to pets is the main cause of fungal infections on the face. If an infection is suspected, it is advisable to consult not only a doctor but also a vet in order to treat the infected pet. This approach prevents re-infection and protects siblings or classmates. Maintaining good hygiene with bed linen, towels and soft toys is also essential to limit transmission.

If a lesion suggesting a possible fungal infection is already present, a few simple steps can help minimise complications whilst awaiting medical advice:

• Avoid heavy make-up: do not cover the lesion with occlusive products, as these trap moisture and delay healing.

• Do not scratch or rub: this causes irritation, spreads the fungus and increases the risk of secondary infection.

• Do not share personal items: towels, gloves, razors and make-up accessories must be kept to oneself to limit the spread of infection.

• Monitor the condition: note whether the lesion is getting bigger, changing in appearance or accompanied by lesions elsewhere (scalp, skin folds, trunk).

• Protect those around you: if ringworm is suspected, avoid prolonged close contact and seek medical advice promptly to reduce the risk of transmission.

Angular cheilitis, characterised by cracks at the corners of the mouth, is frequently linked to Candida albicans. Beyond this localised symptom, it may also be a sign of a more general imbalance, particularly in the digestive system. Many cases of candidiasis go unnoticed and can contribute to various digestive disorders. Hence the importance of not ignoring this symptom and discussing it with a healthcare professional to receive appropriate treatment.

Marion has a Doctor of Pharmacy and is a naturopath and coach. After twelve years in the cosmetics industry, she now helps clients achieve greater overall balance and adopt a more mindful lifestyle, with a particular focus on sustainable nutrition. She also created a podcast where she shares insights to promote a lifestyle philosophy that respects both health and the environment.