Fungal Skin Infections in Humid Weather: Why They Keep Coming Back

Ringworm and similar infections are rampant in our climate, and steroid creams bought over the counter are making them dramatically harder to treat.

Fungal skin infection is among the commonest reasons people attend our dermatology clinic, and cases have become noticeably harder to treat over the last decade. The climate explains why they occur. The way they are treated at home explains why they persist.

What to look for

Typical ringworm is a ring-shaped patch with a raised, scaly, active border and a clearer centre, usually itchy. It favours warm, moist areas: groin, under the breasts, waistband, armpits, between the toes, and the scalp in children. On the feet it appears as soggy, peeling skin between the toes; in nails, as thickening and discolouration.

The steroid cream problem

This is the single most important thing in this article. Many combination creams sold without prescription contain a strong steroid alongside an antifungal. They relieve itching within a day, so they feel effective — but the steroid suppresses the skin's defences and lets the fungus spread further and deeper.

The result is a condition we now see constantly: extensive, oddly shaped patches with indistinct borders, thinned skin, stretch marks and pigmentation, in someone who has been applying a cream for months. It is far harder to cure than the original infection, and it needs longer treatment.

• Do not buy skin creams on a shopkeeper's or neighbour's recommendation
• Do not use a cream that was prescribed for someone else, or left over from a previous problem
• If a cream stops the itch within a day but the rash keeps spreading, stop it and bring the tube with you

Why it recurs even with correct treatment

• Treatment stopped as soon as it looked better. Antifungal treatment must continue for the full prescribed period — often two weeks beyond visible clearing.
• Only the visible patch was treated, while the feet, nails or scalp remained infected and reseeded the skin
• Other family members were not treated, so it passed back and forth
• Towels, clothes and bedding were shared
• The skin stayed damp all day — the underlying cause was never addressed

Keeping skin dry, which is most of the battle

• Dry thoroughly after bathing, especially in skin folds and between the toes
• Loose cotton clothing rather than tight synthetics; change out of sweaty or wet clothes promptly
• Do not share towels, combs, footwear or clothing
• Wash clothes in hot water and dry in direct sunlight; do not re-wear damp clothes
• Alternate footwear so each pair dries fully, and avoid closed shoes all day in the rain

Our dermatology consultants hold OP clinics several days a week. Bring every cream and tablet you have used, including anything bought without a prescription — it genuinely changes the diagnosis.

This article is general health information and is not a substitute for medical advice. Symptoms vary between individuals — please consult a doctor about your own situation. In an emergency, our casualty at Chettipadi is open 24×7.