Fungal Skin Infections: Why Yours Keeps Coming Back
Ringworm has become dramatically harder to treat in India, and the main reason sits on the counter of every medical shop: steroid-containing combination creams.
Read articleTinea, commonly called ringworm, is a fungal infection of the skin that spreads in heat, sweat and shared clothing. It has become markedly harder to treat in India because of the widespread use of over-the-counter steroid-antifungal combination creams.
Symptoms
Not everyone gets every symptom, and the pattern can differ in older people, in people with diabetes and in children. These are the ones most often reported.
- Itchy red patches with a raised, scaly, advancing edge
- Ring-shaped lesions that widen outward over weeks
- Common in the groin, inner thighs, waist, underarms and under the breasts
- Intense itching, worse with sweating and at night
- Spread to family members sharing towels, clothing or bedding
- Discoloured, thickened nails when the nails are involved
When to see a doctor
Do not wait these out
If any of the following applies, arrange to be seen the same day. For anything sudden or severe, call 9281862028 or come straight to the emergency department at SIMS — it is open 24 hours and does not need an appointment.
- A rash that is spreading despite creams bought over the counter
- Rash with pus, severe pain or fever, suggesting added bacterial infection
- Extensive or recurrent infection, especially with diabetes or on steroid treatment
- Nail or scalp involvement, which needs oral treatment rather than cream alone
- Never use combination creams containing a steroid unless a doctor has prescribed them
Tests that may be advised
Your consultant will order only the investigations that change the plan. Most of the following are available on the SIMS campus, so results usually come back the same visit.
- Clinical examination, which is usually sufficient
- Skin scraping for microscopy (KOH mount)
- Fungal culture in resistant or recurrent cases
- Blood sugar testing, since extensive fungal infection can be the first sign of diabetes
- Nail clipping examination where nails are involved
How it is treated
Treatment is decided case by case — by how advanced the problem is, what else you are being treated for, and what you can realistically sustain. Broadly, it involves the following.
- Topical antifungal treatment applied to a wide margin beyond the visible edge, for the full prescribed duration
- Oral antifungal treatment for extensive, recurrent, nail or scalp infection
- Complete stopping of steroid-containing combination creams
- Treating all affected family members at the same time to break the cycle
- Loose cotton clothing, drying skin folds thoroughly, and washing and sun-drying clothes and bedding
- Control of blood sugar and of excessive sweating
This page is general information, not a diagnosis
Fungal Skin Infection can look like several other conditions, and the reverse is equally true. Nothing here can replace an examination, your test results and the judgement of the doctor treating you — and no medicine mentioned by name to a friend or relative should be started on the strength of this page. If you recognise yourself in it, book a consultation with the Dermatology department. If a symptom is sudden or severe, call 9281862028.
