What Is Fungus & Its Relationship to Massage Therapy?
Fungal infections resulting from massage are rare because massage therapists must adhere to strict standards of cleanliness for themselves and their work space. However, it is possible for an infection to be transmitted from client to therapist, and from therapist to client. The three most common skin infections transmitted are athlete's foot (tinea pedis), jock itch (tinea cruris) and ringworm (tinea corpora). Most skin fungus is transmitted through skin-on-skin contact, or through contact with an infected item.
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The Appearance of Fungus
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Fungal infections are difficult to diagnose because they often look like other, noncontagious, forms of dermatitis. Fungal infections can exist concurrently with noncontagious conditions, like eczema, and be easily ignored. Most fungal infections present as areas of raised, red and/or flaky areas of skin and certain types of fungus tend to affect specific areas of the body. Athlete's foot tends to appear as itchy, flaky areas on the feet and between the toes. Jock itch tends to appear as a red, itchy rash in the groin and genital area. Ringworm has a distinctive, round rash with scalloped edges. It can infect the scalp or areas of skin covered by clothing. Athlete's foot, jock itch and ringworm are all the same organism and can infect any area of the body.
How Fungus Grows
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Fungus thrives in warm, moist places like showers and locker rooms. Sweaty socks and underwear also can promote fungal growth. On the body it tends to infect places that are not exposed to sunlight, like the toes, the genital area and body creases. Most massage rooms are dry spaces, but therapists often use wet or damp tools and implements, like towel warmers, that may be breeding grounds for fungi. Wet massage spaces provide a greater risk because wet treatment rooms are ideal environments for fungi, as are pedicure massage stations and foot tubs.
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Why Fungus is a Problem
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Fungus is a problem in massage therapy because many skin fungi are extremely contagious. Tinea is difficult to get rid of--requiring several weeks, and even months, of treatment. If a massage therapist comes in contact with a skin fungus from a client, he is most likely to get it on his hands, forearms or feet. This means the therapist won't be able to work on clients until the condition clears. In addition, a small case of athlete's foot on a client can turn into a case of ringworm, if the therapist spreads the fungus during a massage. Also, if an infected therapist continues to take clients, she can infect other clients, which is very bad for business.
Preventing Transmission: the Facility's Responsibility
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Wet rooms should be cleaned regularly, aired out and allowed to dry thoroughly. Clients should be given water-resistant foot coverings, and the massage surface should be cleaned and disinfected between clients. In a dry massage setting, wet towel storage areas should have UV lights or other antifungal treatments to contain fungal growth, bedding and linens should be changed after each client, massage creams and oils should be in individual containers for each session, tools and implements should be thoroughly cleaned and disinfected after each client, and there should be enough cleaning tools available so as to not disrupt work flow. Additionally, massage tables should be stripped and wiped down at the end of the day, all linens should be stored off the floor, in a clean area, and all linens (including blankets) should be washed in soap and hot water.
Preventing Transmission: the Therapist's Responsibility
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If a therapist suspects a client has a fungus, he should first alert the client. Because therapists can't diagnose, they can't necessarily say "you have tinea corporis," but they can advise a client to have a rash checked. Rashes and broken skin are automatic contraindications for massage, meaning therapists should always avoid massaging those areas. In some cases, the therapist may refuse treatment rather than risk spreading the infection on the client's body, or infecting themselves. On the other hand, if a therapist has a suspicious rash, she should avoid working on clients until the rash is diagnosed and treated.
Preventing Transmission: the Client's Responsibility
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Clients should tell their therapists if they have any rashes or broken skin. Often, massage rooms are dimly lit and a therapist may not see a suspicious rash until after he has touched it. Even if the rash is not contagious, the client should alert the therapist. If the therapist avoids working on the area it protects the therapist and the client.
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