Tinea (ringworm) is the most common fungal skin infection we treat. Indian tinea has a particular challenge — widespread misuse of steroid-antifungal combination creams has created resistant strains that need careful management.
Treatment plan
- Confirm diagnosis (KOH microscopy if uncertain)
- Stop any steroid-containing creams immediately (these mask infection while it spreads)
- Topical antifungal twice daily for 4 to 6 weeks (terbinafine or luliconazole preferred for resistant strains)
- Oral antifungal for extensive disease — terbinafine or itraconazole, 4 to 6 weeks
- Treat family members and disinfect items (clothes washed at high temperature, footwear sun-dried)
If your tinea has not cleared after 4 weeks of OTC cream, you likely have resistant disease or wrong diagnosis. Book a consultation for proper management.
Tinea — Frequently Asked Questions
Why is tinea so common in India?
Heat + humidity + sweat. India also has a rising prevalence of resistant Trichophyton strains over the last decade — partly driven by widespread misuse of OTC steroid-antifungal combinations.
Why does my ringworm keep coming back?
Three reasons: (1) treatment too short — needs 4 to 6 weeks, not 1 to 2; (2) re-infection from clothes/family; (3) "tinea incognito" — the rash was suppressed by steroid combo creams which then made it harder to treat.
What is tinea incognito?
Steroid-antifungal combination creams (commonly available OTC in India, often illegally) suppress the visible rash but allow the fungus to spread silently. The result: harder-to-treat resistant infections. We see this constantly.
When do you use oral antifungals?
Extensive infections, scalp/nail involvement, recurrent or resistant infections, immunocompromised patients. Terbinafine, itraconazole, or fluconazole — chosen based on type.
Can my family catch it?
Yes — through direct contact, shared towels, footwear. We recommend treating affected family simultaneously and disinfecting items.
How long does treatment take?
Body tinea: 4 to 6 weeks. Scalp tinea: 6 to 8 weeks oral therapy. Nail tinea: 3 to 6 months. Continue treatment for 1 to 2 weeks beyond visible clearance to prevent relapse.
