Rise of the super skin fungus: It causes a painful rash, is drug-resistant and you can get it at the hairdresser. Yet doctors keep missing these vital symptoms

GPs are failing to spot the symptoms of a drug-resistant ‘super-fungus’ thought to be spreading throughout the UK, experts have warned.

Cases of the contagious infection have been reported in the US and France, and infectious disease doctors in the UK have been placed on alert for its arrival.

Experts believe the disease can be passed on through any form of skin-to-skin contact, including sports and hairdressers, putting the entire population at risk.

However, The Mail on Sunday learned a nationwide lack of testing for the infection means that, despite clear signs it is spreading among the population, health officials are yet to identify a single case.

Severe delays at NHS infection laboratories also mean that doctors who do send off skin samples suspected of containing the super-fungus can expect to wait as long as a month to get results. This increases the chances of patients passing it on in that time, and also means GPs and sexual health doctors are less likely to test for the infection in the first place, because they believe it will take too long.

The painful genital rash, known medically as trichophyton mentagrophytes genotype VII (TMVII), also known as the ‘Thailand fungus’, is a rare type of ringworm that was first spotted in Southeast Asia.

Experts say TMVII cannot be treated with antifungal creams, as most cases of ringworm typically are, and warn that doing so could make the infection even more resistant to drugs, prolonging the uncomfortable symptoms.

At present, research suggests TMVII is currently spreading primarily through sexual contact. Infection experts are now calling on the NHS to ensure GPs and sexual health clinics always test patients with TMVII symptoms, and to prioritise these suspected samples for testing to speed up the time it takes to get results.

‘For years, GPs have treated cases of ringworm with standard antifungal creams, but with this infection, that’s not going to work,’ says Dr Charlotte-Eve Short, a senior lecturer in the Department of Infectious Disease at Imperial College London.

‘The problem is, any doctor who sees this rash won’t necessarily think it is dangerous, so won’t see the need to take a skin sample and send that off to the lab.

‘That’s why we need to raise awareness of this condition. Failure to do so will lead to it spreading across the country and becoming even more resistant to the antifungal drugs we rely on.’

The arrival of TMVII in the UK is part of a wider health crisis as fungal infections grow increasingly resistant to available drugs.

These microscopic infections, which come from the same family of organisms as mushrooms, mould and yeast, typically spread through close contact, either via skin or physical surfaces.

The majority of the fungal diseases seen in the UK are skin infections like athlete’s foot and ringworm, which trigger itchy rashes, usually in crevices like the buttocks, genitals and armpits.

These skin diseases affect around one in six Britons every year. However, there are a number of deadly fungal infections, including candida auris, which spreads in hospitals and kills around a third of those infected. Another life-threatening fungal infection is aspergillosis, a lung disease that affects people with asthma and other breathing issues (see below).

For years, fungal infections have been treated with a small number of effective drug treatments, which usually come in a cream or tablet form.

However, research shows that the majority of fungal infections are learning to resist the attacks of these medicines. The primary reason for this is the overuse of prescription antifungal drugs – particularly in developing countries where such medicines are available over the counter.

Fungi reproduces and evolves far quicker than humans. This means, the more these organisms come into contact with antifungal drugs, the more likely it is that resistant strains – or super-fungi – will emerge.

Another trigger is the use of human antifungal treatments to protect crops and plants from fungal diseases. Many of the fungi which infect humans also live in soil, which, when they come into contact with such chemicals, provides further opportunity for the creation of these super-fungi.

The rise of antibiotic-resistant bacteria, which kill more than 5,000 Britons every year are also becoming increasingly common in the UK.

In response, the Government has ordered doctors to drastically slash antibiotics prescriptions in order to preserve the drugs that still work. The UK has also invested hundreds of million of pounds into finding new antibiotics.

However, experts say much less time and effort has been spent protecting the UK from the equally worrying threat of super-fungi.

‘Historically, there has been much more focus on bacteria than fungus,’ says Dr Neil Stone, a consultant in infectious diseases and microbiology at University College London Hospital.

‘However, the fact is, if we have a limited number of antibiotics, then we have even fewer effective antifungal drugs.

‘We are already seeing growing numbers of near-impossible to treat and deeply unpleasant fungal infections. And there’s a real threat that another deadly species could arise.

‘There are steps doctors and health officials could take today to limit this risk.’

The sexually-transmitted TMVII infection was first spotted in Southeast Asia several years ago. Experts say it likely arose in these areas because there are fewer restrictions on access to strong antifungal drugs, meaning there are more opportunities for the fungi to build-up resistance to their attacks.

In the past year, cases have been spotted in the US, France, Germany and Canada. A report, published by US health officials in July 2024, described how the condition can trigger itchy and painful lesions on the legs, groin, genitals, buttocks and face.  

These persistent marks, the Centers for Disease Control and Prevention paper added, sometimes led to scarring as well as secondary bacterial infections in the affected areas.

Every infection identified by US health officials proved resistant to antifungal creams, as well as several stronger

tablets. Those affected tended to be either gay men or men who had travelled to Southeast Asia for sex tourism.

UK health experts say they are keeping a close eye out for TMVII patients, and some believe they have seen cases, but so far have been unable to successfully test patients for the infection.

‘Sexual health clinics are on alert for TMVII and we are already seeing a noticeable rise in cases of ringworm which don’t respond to treatment,’ says Dr John McSorley, a consultant physician in sexual health and HIV at London North West University Healthcare NHS Trust.

‘There’s a good chance some of these are due to TMVII, but its hard to know because very few patients are getting tested.

‘That’s because these can take up to two months to return a result, which is far too long to wait.’

Experts say the long waiting times to get TMVII test results back is due, in part, to the spike in other fungal infections, including thrush, a form of yeast infection that affects the genitals.

‘The labs which carry out these tests are swamped at the moment with all these drug-resistant infections,’ says Dr Short. ‘This is leading to worrying delays.’

Identifying cases of TMVII is crucial, experts say, because this will determine what treatment patients require.

One of the commonly used treatment for drug-resistant fungal infections is called itraconazole – which is part of a wider group of antifungal drugs known as triazoles.

However, research suggests that TMVII is often resistant to itraconazole, as well as other triazole treatments.

Instead, studies show that an older tablet, called terbinafine appears more effective for combatting TMVII. Terbinafine also has fewer side effects than itraconazole which, if taken for an extended period, can damage the liver.

‘Doctors who suspect a patient has TMVII, so anyone with a genital ringworm rash that does not respond to creams, should be prescribing terbinafine,’ says Dr Short.

‘They don’t need to wait to get test results back to do this.’

However, experts say improving testing for TMVII will be crucial for limiting its spread in the UK. Ringworm, in all its forms, is on the rise.

In November 2024, haircare experts raised the alarm over rising cases of the fungal infections in young men which were linked to barbershops.

‘Barbershops are an obvious place for ringworm to be passed on,’ says Dr Short. ‘That’s because tiny cuts, even those invisible to the eyes, create an opportunity for these infections to get into the skin.

‘If towels aren’t cleaned properly, ringworm can be passed on that way too.

‘There’s also apparently been a rise in ringworm cases in the Judo [a form of martial arts] community. That’s because there’s a lot of skin-to-skin contact involved, so other forms of sport could be a risk too.

‘TMVII is currently being treated as a sexually-transmitted disease, but that’s only because that’s how it’s currently spreading. It can be passed on through any skin contact, and it will spread out into the community.

‘One step we could take is to ensure that any suspected TMVII sample is prioritised for testing at NHS laboratories, so we can get patients started on treatment sooner.

‘However, if we’re going to tackle the growing number of fungal infections, the Government also needs to increase funding for these labs.’

New antifungals may fail patients 

Patients with life-threatening fungal lung infections are running out of effective medicines, according to experts.

More than 3,000 people in the UK have chronic pulmonary aspergillosis (CPA), the often-incurable disease typically affects patients with severe asthma or chronic obstructive pulmonary disease.

CPA is cause by aspergillus, a type of mould often found in soil, compost, plants, dust, bedding and mattresses.

In January, 32-year-old Matthew Langsworth, from Leamington Spa, claimed he developed CPA from mould in his flat, that had been painted over. ‘My life has just been physically and mentally ruined by this ordeal,’ said Mr Langsworth.

Overtime, mould can build up in the lungs, obstructing breathing and triggering bleeds within the organs, increasing the risk of deadly bacterial lung infections.Research suggests that many strains of aspergillus are becoming drug-resistant.

Worryingly, very few new antifungals are in development. Largely due to the prohibitive cost of development, which can be upwards of £100 million.

A handful of new fungal treatments are set for approval in the UK. These include a treatment called olorofim.

However, experts say it could quickly become ineffective. This is due to the drug containing chemicals which are already exposed to soils where fungus can be found and may become resistant.

‘The new drugs coming through could really help, but we have to be careful of how they are used outside of medicine,’ says Dr Graham Atherton, of the National Aspergillosis Centre in Manchester.

‘If they are used in farming, then we are going to give the fungus a head start.’