As global temperatures rise, so does the burden of fungal skin infections. Often dismissed as minor nuisances, cutaneous fungal infections are now becoming more common, more persistent, and in some cases, more resistant to treatment. The link between cutaneous fungal infections and climate change is no longer speculative. With higher humidity, increased sweating, and changing ecosystems, fungi are finding new opportunities to thrive and not just on the feet.

From tinea corporis to tinea faciei, the dermatologic impact of a warming world extends far beyond the locker room. It’s time to rethink how we diagnose, treat, and prevent these infections in a shifting climate landscape.

Climate Change and the Fungal Ecosystem

Fungi are temperature-sensitive organisms. As global average temperatures rise, so do the environmental conditions that support fungal growth especially warm, moist skin folds and occluded areas of the body. Increased humidity, floods, poor ventilation, and overpopulation in urban settings are further amplifying the spread of superficial mycoses (Rashid et al., 2020).

Key environmental drivers include:

  • Heat and humidity, which increase skin moisture
  • Sweating and occlusion from synthetic clothing or PPE
  • Flood-related water exposure and poor hygiene access
  • Migration and travel, introducing new fungal strains to previously unaffected regions

Emerging Patterns in Fungal Skin Infections

1. Beyond Athlete’s Foot: Expanding Tinea Infections

Athlete’s foot (tinea pedis) remains common, but warming climates have given rise to:

  • Tinea corporis (body ringworm)
  • Tinea cruris (jock itch)
  • Tinea faciei (facial ringworm)
  • Tinea capitis (scalp infection), particularly in children
  • Tinea incognito, a misdiagnosed, steroid-masked infection becoming increasingly prevalent

Dermatophyte fungi like Trichophyton rubrum and T. mentagrophytes are spreading more aggressively and even evolving drug-resistant strains in some regions (Verma & Madhu, 2017).

2. Outbreaks of Antifungal-Resistant Tinea

Cases of multidrug-resistant tinea, particularly T. indotineae, have been documented in parts of Asia and now in Europe and North America. These strains resist common treatments like terbinafine, complicating management and increasing relapse rates (Singh et al., 2021).

3. Fungal Infections in Unusual Sites

Climate stress and PPE use have led to more fungal infections on the face, neck, and hands, especially among healthcare workers and athletes. Tinea faciei and onychomycosis are appearing in younger, healthier individuals due to sustained dampness, sweating, and friction.

Risk Groups in a Warmer World

Certain populations are more vulnerable to fungal infections in today’s climate:

  • Outdoor laborers and athletes exposed to prolonged sweating
  • Children, who are prone to scalp infections and skin-to-skin transmission
  • Elderly and immunocompromised individuals, including diabetics and cancer patients
  • Low-income communities, with limited access to hygiene or healthcare
  • PPE users, including masks and gloves worn for extended hours

Prevention in the Age of Climate Change

To combat rising cases, a proactive prevention strategy is key:

  • Keep skin dry and well-ventilated, especially in folds and between toes
  • Choose breathable, natural fabrics over synthetic or tight clothing
  • Change damp clothing quickly after sweating or exercising
  • Avoid unnecessary use of topical steroids, which can worsen undiagnosed fungal infections
  • Disinfect shared surfaces and tools, especially in gyms and salons
  • Educate at-risk populations about early signs and hygienic practices

Public health campaigns may need to address these topics alongside more visible climate-related issues like heatstroke or vector-borne disease.

Diagnosis and Treatment

Early diagnosis is crucial to prevent spread and complications. KOH microscopy, fungal cultures, and dermoscopy can help distinguish tinea from eczema or psoriasis.

Treatment guidelines include:

  • Topical antifungals (e.g., clotrimazole, terbinafine) for mild to moderate cases
  • Oral antifungals (e.g., itraconazole, fluconazole) for widespread, resistant, or hair/nail involvement
  • Avoidance of topical steroids, unless combined with antifungals and under strict supervision

Emerging resistance patterns highlight the need for mycology-guided therapy and rational prescribing practices.

Cutaneous fungal infections and climate change are now clearly linked in dermatologic literature and clinical practice. What was once considered a minor nuisance is evolving into a wider, more persistent public health issue. Rising temperatures, global travel, and environmental stressors have made it easier for fungi to thrive and harder for clinicians to treat.

By understanding these changing patterns and promoting targeted prevention, dermatologists and primary care providers can help mitigate the growing burden of fungal skin disease in a warming world.

References

  1. Rashid, A., et al. (2020). Climate change and fungal diseases of humans. Fungal Biology Reviews, 34(3), 65–72. https://doi.org/10.1016/j.fbr.2020.03.003
  2. Singh, A., Masih, A., Khurana, A., et al. (2021). High terbinafine resistance in Trichophyton interdigitale isolates from India: A multicenter study. Journal of Clinical Microbiology, 59(5), e00938-20. https://doi.org/10.1128/JCM.00938-20
  3. Verma, S., & Madhu, R. (2017). The great Indian epidemic of superficial dermatophytosis: An appraisal. Indian Journal of Dermatology, Venereology and Leprology, 83(5), 525–536. https://doi.org/10.4103/ijdvl.IJDVL_329_17