Every summer and monsoon season, our clinic sees a significant increase in fungal skin infections. This is not coincidental — the heat, humidity, and sweating of the Indian summer create precisely the conditions that dermatophytes and Malassezia (the fungi responsible for most superficial skin infections) require to thrive. Understanding what you are dealing with and treating it correctly the first time prevents the chronic, relapsing pattern that many patients fall into.

Tinea — Ringworm and Its Relatives

Tinea infections — caused by dermatophytes — are the most common fungal skin infections in India. Tinea corporis (ringworm of the body), tinea cruris (groin), tinea pedis (athlete’s foot), and tinea unguium (nail) are the primary presentations. The classic appearance is a circular, scaly, itchy patch with a raised border that spreads outward from a central area that may appear to clear. Tinea cruris in the groin — extremely common in Indian men during summer — presents as a well-defined red, scaly rash in the inner thighs and groin folds.

Treatment: topical antifungals (clotrimazole, luliconazole, terbinafine) for localised infections, continued for 1-2 weeks after clinical clearance to prevent relapse. Oral antifungals (terbinafine, itraconazole) for widespread, nail, or scalp infections. The most critical warning: do not use steroid-antifungal combination creams as first-line treatment. These products — widely available and widely misused in India — provide short-term symptom relief while allowing the fungus to proliferate beneath the steroid-mediated anti-inflammatory effect, producing the “tinea incognito” presentation: a widespread, atypical fungal infection made significantly harder to treat.

Tinea Versicolor

Tinea versicolor, caused by Malassezia furfur, produces hypo- or hyperpigmented patches — lighter or darker than surrounding skin — typically on the chest, back, and upper arms. It is extremely common in Indian summers. Treatment: topical ketoconazole or selenium sulphide shampoo applied to affected areas for 10-15 minutes before rinsing, daily for 2 weeks. Oral itraconazole for resistant or widespread cases. Pigmentation may take several months to normalise after the infection is cleared even with successful treatment.

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— Dr. Nishita Ranka | Consultant Dermatologist | Dr. Nishita’s Clinic for Skin, Hair & Aesthetics, Hyderabad