What is a breast fungus?
A breast fungus is a common term for a fungal infection of the skin overlying the breast. It does not imply an infection of the deeper breast tissue. Fungal skin infections are common and the most affected sites are the feet (athlete’s foot) and groin (itch) although skin anywhere on the body can be affected. The area under the breast (inframammary fold) is particularly prone to fungal infections in women for a number of reasons that makes this region ideal for fungi to thrive.
Most fungal skin infections persist without medical treatment therefore it has to be diagnosed and treated as soon as possible. The infection can spread to eventually affect the top of the breast and even the cleavage. One of the consequences of a long term fungal skin infection is a dark discoloration of the skin which can be unsightly. There are usually no other significant complications of a breast fungus. The symptoms are limited to the skin. Fungal skin infections almost never penetrate into deeper tissue to infect internal organs.
Causes of A Fungus Under the Breast
Fungi thrive on dead matter and the outermost layers are ideal since these skin cells are dead and protein-rich. Certain fungi have a predilection for human skin and are known as dermatophytes. It has special enzymes that can digest the skin protein. In most instances these infections are superficial and never penetrate deeper tissue. Yeasts thrive in cavities lined by living tissue but the immune system usually prevents it from causing an infection. The dark, warm and moist conditions under the breast is ideal for any skin fungus to thrive and even spread with time.
Types of Fungi
- Dermatophytes may be transferred from skin fungal infections elsewhere on the body. It is commonly termed as ringworm due to the red-ring like lesions that these types of fungi cause.
- Yeasts can also cause these infections but usually only do so when the skin is torn and the underlying tissue is exposed (open sores or cuts). Candida species are the main yeasts to infect the areas. This is is then known as inframammary or submammary candidiasis.
Women with larger breasts, who wear tight bras, sweat excessively and live in humid environments are particularly prone to these types of infections. Large breasts usually mean that the fungi can thrive in a warm, dark and moist environment within the inframammary fold. Tight underwire bras especially can lead to chaffing and breaks in the skin. Scratching due to itchy breasts causes micro-tears and further increases the risk of infections. Perspiration provides the moisture that these fungi need for survival.
Women who have fungal infections elsewhere on the body may also be at a greater risk of a breast fungus. The fungi may be transferred by the fingers during scratching from one site, like the feet or groin, to the breasts. Most fungal infections require the skin to be compromised in some way for the infection to set it. Apart from tears in the skin caused by scratching or chaffing, pre-existing diseases like contact dermatitis, atopic dermatitis or psoriasis especially around the inframammary folds can increase the chance of a breast fungus.
Symptoms of a Breast Fungus
The following signs and symptoms are usually present:
- Itching under the breasts in the inframammary fold.
- Peeling, cracking and shedding of the skin.
- Red skin rash.
- Dark discoloration of the skin.
- Thin, clear discharge.
- Unusual musty odor under the breast.
Sometimes the symptoms are not as obvious. Some women may only experience mild itching and a skin-colored ‘dust’ on the bra or upon scratching. The skin symptoms can extend beyond the inframammary folds to affect the breast and even the chest. Many women are concerned about the dark discoloration of the skin that occurs with long-standing infections.
If a breast fungus is not treated as soon as possible, the skin discoloration may be permanent. Bacterial infections can occur secondarily. This can be serious especially if the infection extends to the tissue under the skin (subcutaneous tissue). Bacterial symptoms include swelling, redness, pain, tenderness and a fever. It needs prompt treatment with antibiotics.
Pictures of Breast Fungus
The skin rash seen in a dermatophyte infection often differs from the rash with an yeast infection. The pictures below show the fungal infections due to dermatophytes and yeasts around the armpits to illustrate these differences.
Picture of red ring lesions (‘ringworm’) in deramtophytosis.
Picture of candidiasis (yeast infection)
Treating a Fungal Infection Under the Breast
A breast fungus may appear similar to other skin diseases and it is important that your doctor diagnose a skin fungal infection before commencing treatment. Using an antifungal ointment for a few months usually resolves the infection although oral antifungals may have to be considered in severe cases. A corticosteroid cream may be used if the itching and inflammation is severe but should be a short term measure. The affected area may become dry and start cracking or peeling and a suitable emollient may be necessary.
It is important to identify any predisposing conditions that may be contributing towards a persistent breast fungus. Tight underwear or poorly designed bras are by far the most common cause of chaffing under the breast and should be changed immediately. Treating any pre-existing skin conditions should be the first consideration to prevent a skin fungus from setting in. An antifungal drying powder may be useful for reducing the sweat and moisture under the breast, especially in women with larger busts or those who tend to perspire profusely.
Never share personal items like bras as the infection can be easily spread from one person to another. A prolonged fungal infection under the breast usually causes a dark discoloration of the skin which may not resolve spontaneously. This can be quite distressing for most women and it is therefore important to attend to a breast fungus as soon as it appears. Always consult with a medical doctor for the appropriate treatment or the fungal infection may persist, spread and affect surrounding skin.