Eczema is not a fungal infection, though the two can look similar and sometimes occur together
Eczema is an inflammatory skin condition caused by your immune system and skin barrier, not by a fungus. The confusion happens because fungal infections and eczema can both cause red, itchy, scaly patches on skin. But they have different causes, respond to different treatments, and require different approaches to manage.
If you have been told you have eczema, a fungus is not what is causing it. If you have been told you have a fungal infection, that is a separate problem from eczema—though you can have both at the same time, which complicates treatment.
Key Takeaways
- Eczema is caused by inflammation and a weakened skin barrier, not by fungus, bacteria, or anything you catch from another person.
- Fungal infections and eczema look similar but need different treatments—antifungal creams will not help eczema, and eczema treatments will not clear a fungal infection.
- A skin scraping or culture test can tell the difference, and your doctor can order one if the diagnosis is unclear.
- People with eczema have a higher risk of developing fungal infections on top of their eczema because the damaged skin barrier lets infections in more easily.
- If your eczema treatment is not working, ask your doctor whether a secondary fungal infection might be present alongside the eczema.
Why eczema and fungal infections look alike but are not the same
Both eczema and fungal infections produce red, itchy, scaly skin. Both can appear in patches and both can spread across the body. The visual similarity is why people sometimes wonder if eczema is fungal—the rash looks like something that could be contagious or caused by an organism.
The difference is in what is happening underneath. Eczema happens when your immune system overreacts to irritants or allergens, and your skin barrier (the outer layer that holds moisture in and irritants out) becomes damaged. A fungal infection happens when a fungus—usually a type called dermatophyte—grows on or in the skin. One is inflammation; the other is an organism.
This matters because the treatments are opposite. Eczema improves with moisturizers, topical steroids, and sometimes immune-suppressing medications. Fungal infections improve with antifungal creams, powders, or oral medications. Using the wrong treatment will not help and may delay getting better.
How to tell the difference between eczema and a fungal infection
Eczema usually appears in specific places: the hands, face, neck, inside the elbows, and behind the knees. It often runs in families and usually starts in childhood or early adulthood. It itches intensely, especially at night. The skin becomes dry, cracked, and inflamed, and it may weep clear fluid when scratched.
Fungal infections often have a raised border—a clear edge where the infection starts and stops. They may have a ring shape (which is why some are called ringworm, though there is no worm involved). Fungal infections often itch but are less likely to cause the intense, sleep-disrupting itch that eczema does. They are also more likely to appear in warm, moist areas: between the toes, in skin folds, in the groin, or under the breasts.
If you are unsure, your doctor can take a skin scraping or culture to check for fungus. This is a simple, painless test: the doctor scrapes a small amount of skin cells and sends them to a lab. The lab can tell within days whether a fungus is present. This test is worth doing if your rash is not responding to eczema treatment or if the pattern does not match typical eczema.
When eczema and fungal infection happen at the same time
People with eczema are more likely to develop fungal infections because the damaged skin barrier is easier for fungi to colonize. If you have eczema and suddenly your rash gets worse, spreads to a new area, or stops responding to your usual treatment, a secondary fungal infection may have developed on top of the eczema.
This is treatable but requires addressing both problems. Your doctor may prescribe an antifungal cream or oral medication for the fungal part while continuing your eczema treatment. Stopping eczema treatment to use only antifungal medication will not work—you need both.
Tell your doctor if you have eczema and notice a change in your rash: a new raised border, a ring shape, a shift to a different body area, or worsening despite your usual routine. These can signal a secondary infection that needs different or additional treatment.
What causes eczema if it is not a fungus
Eczema is caused by a combination of genetic factors and environmental triggers. If you have eczema, you were born with a skin barrier that does not hold moisture as well as it should and an immune system that overreacts to certain substances. This is not something you did wrong or caught from someone else.
Common triggers include soaps and detergents, fragrances, certain fabrics, stress, dry air, and allergens like dust mites or pet dander. Different people have different triggers. Managing eczema means identifying your triggers, protecting your skin barrier with moisturizer, and using prescribed medications when flares happen.
Why the confusion exists
The confusion between eczema and fungal infection is partly historical. Before modern diagnostic tools, doctors sometimes could not tell the difference visually and had to guess. Some older medical texts and websites still use imprecise language that blurs the line.
The confusion is also reinforced by the fact that both conditions improve with some of the same basic care—keeping skin clean and dry, avoiding irritants, and using moisturizer. But the prescription treatments are completely different, so getting the diagnosis right matters.
What to do if you have been diagnosed with eczema
If your doctor has told you that you have eczema, you do not have a fungal infection unless your doctor also said so. Eczema is managed with a consistent routine: daily moisturizing (usually with a fragrance-free cream or ointment), avoiding known triggers, and using prescribed medications during flares.
If your eczema is not improving with treatment, or if it suddenly gets worse, ask your doctor whether a skin culture or scraping would be helpful. This is especially important if your rash has changed in appearance, spread to a new area, or developed a clear border or ring shape.
Frequently Asked Questions
Can eczema turn into a fungal infection?
Eczema itself does not turn into a fungal infection, but people with eczema are at higher risk of developing a fungal infection on top of their eczema because the damaged skin barrier is easier for fungi to colonize. If this happens, you would have both conditions at once and would need treatment for both.
Will antifungal cream help my eczema?
No. Antifungal creams will not help eczema because eczema is not caused by fungus. Using an antifungal cream instead of your prescribed eczema treatment will delay improvement and may make your skin worse. If you think you might have a fungal infection, ask your doctor for a test rather than trying antifungal medication on your own.
Is eczema contagious like a fungal infection?
No. Eczema is not contagious. You cannot catch it from another person or pass it to someone else. Fungal infections can spread from person to person or from one part of your body to another, but eczema cannot.
Can a doctor tell the difference between eczema and fungal infection just by looking?
Usually, but not always. A skin culture or scraping is the only way to be certain. If your doctor is unsure or if your rash is not responding to treatment, ask for a test. It is simple, painless, and gives a definitive answer.
What if I have eczema and get a fungal infection—do I stop my eczema treatment?
No. You continue your eczema treatment and add antifungal medication for the infection. Stopping eczema treatment will make the eczema worse. Your doctor can prescribe both treatments to use at the same time.