Fungal infection (ringworm, 'daad'): why it keeps coming back and how to stop it

An itchy, red, ring-shaped patch in the groin, on the thighs, the waist or under the breasts. A cream from the chemist clears it in a few days, and then it comes back, bigger. If that sounds familiar, you are far from alone. Fungal skin infection, commonly called ringworm or "daad" (દાદર), has become one of the most common skin problems in India, and one of the most frustrating.

What it is

Ringworm has nothing to do with worms. It is an infection of the top layer of skin by fungi called dermatophytes. Doctors call it tinea, followed by where it is:

• Tinea cruris: groin and inner thighs
• Tinea corporis: body, waist, buttocks
• Tinea pedis: feet, between the toes (athlete’s foot)
• Tinea capitis: scalp, mostly in children
• Tinea unguium: nails

Typical signs are an itchy, red, ring-shaped patch with a raised, scaly edge that slowly spreads outwards, often clearer in the centre.

Why it is so common, and keeps coming back

1. Heat, sweat and humidity

Fungi love warm, damp skin folds. Long hours in tight jeans or synthetic clothes, two-wheeler rides and humid weather all help it grow.

2. The steroid cream problem

This is the biggest reason in India. Many popular creams sold over the counter combine a strong steroid with an antifungal and an antibiotic. The steroid quickly reduces itching and redness, so the patch seems to disappear. But steroids weaken the skin’s local defence, so the fungus keeps growing underneath, spreads wider, and comes back stronger when the cream is stopped. Over time the skin thins and the rash changes shape, making it harder to recognise and treat.

3. Stopping treatment too early

The itch stops in a few days, but the fungus lives on for weeks. Stopping when it looks clear is one of the most common reasons for relapse.

4. Spread within the family

Shared towels, clothes, bedsheets and close contact pass it between family members. Treating one person while others still have it leads to reinfection.

5. Clothes that are not fully dry

Fungal spores can survive in damp clothes, innerwear and towels. Clothes dried indoors during the monsoon are a common source.

How it is treated properly

• The right antifungal cream, without steroid, applied to the patch and 2 to 3 cm beyond the edge, twice daily.
• Continue for at least 2 weeks after the skin looks completely clear, usually 4 to 6 weeks in total. For long-standing or widespread infection, longer.
• Antifungal tablets when the infection is widespread, long-standing, on the scalp or nails, or has been treated with steroids. These must be taken for the full prescribed course.
• Antihistamine tablets at night if the itch disturbs sleep.
• Antifungal powder in skin folds to keep them dry.

Do not stop early, and do not switch between creams every few days.

Habits that stop it coming back

• Keep skin folds dry. Dry thoroughly after bathing, especially the groin, between the toes and under the breasts.
• Wear loose cotton clothes and cotton innerwear. Avoid tight jeans for long hours.
• Change innerwear and socks daily, and more often if you sweat a lot.
• Wash clothes properly and dry them fully in the sun if possible. Iron innerwear if you cannot sun-dry.
• Do not share towels, clothes or bedsheets, and treat every family member who has symptoms at the same time.
• Do not scratch. It spreads the infection to other areas.
• Control blood sugar if you have diabetes, as fungal infections are more common and stubborn with high sugar.
• Lose weight if skin folds keep rubbing, which keeps the area warm and moist.

When to see a doctor

• The rash keeps coming back, or has spread to large areas
• You have used steroid creams on it
• It is on the face, scalp or nails
• Several family members are affected
• You have diabetes or a weak immune system
• You are not sure it is a fungal infection, as eczema, psoriasis and other rashes can look similar

The bottom line

Ringworm is curable, but only with the right antifungal treatment for long enough, no steroid creams, dry skin folds, clean dry clothes, and treatment for everyone at home who has it. Quick fixes from the chemist are the main reason it keeps coming back.

If you are in Surat, Nayra Skin Clinic can confirm whether your rash is fungal, plan a full course of treatment, and help you break the cycle of recurrence.