Ringworm (Daad) and Fungal Skin Infections: Symptoms and Treatment

A round, red, scaly patch that itches badly, especially when you sweat. It spreads a little, then turns up somewhere else, and the cream you bought from the corner shop seems to help for a few days and then everything comes back. This is ringworm, known in Urdu as daad, and in Pakistan’s hot and humid summers and monsoon it is one of the most common skin problems doctors see.

What is ringworm?

Despite the name, there is no worm involved. Ringworm is a fungal infection of the skin caused by fungi called dermatophytes, which feed on keratin in the top layer of skin, hair and nails. It spreads by touch, and also through shared towels, combs, clothes, bedding and damp floors. Pets can carry it too.

Types of ringworm

• Body (tinea corporis): round or ring-shaped patches on the trunk, arms or legs
• Groin (tinea cruris): itchy red rash in the groin and inner thighs, often called jock itch
• Feet (tinea pedis): peeling, cracked and itchy skin between the toes, known as athlete’s foot
• Scalp (tinea capitis): scaly patches with broken hair or bald spots, most often in children
• Nails (tinea unguium): thick, yellow, crumbly nails

Ringworm symptoms

• A red, scaly ring with a raised edge and a clearer centre
• Intense itching that gets worse with sweating
• Patches that slowly grow or multiply
• Dry, flaky or cracked skin between the toes
• Hair loss in scaly areas of the scalp

Why it keeps coming back

Doctors in South Asia are seeing more stubborn and widespread ringworm than before. Several habits make it worse:

• Steroid creams. Many creams sold across the counter combine a strong steroid with an antifungal. The steroid reduces itching quickly, but it also lets the fungus spread, changes how the rash looks, and thins the skin with long use. If the rash returns the moment you stop, ask your doctor before using the same cream again.
• Stopping treatment as soon as the itching eases, before the fungus is cleared
• Wearing tight, synthetic clothes and damp socks
• Sharing towels, razors or clothes within the family, so infections keep passing around

Treatment

Mild ringworm on the body usually clears with an antifungal cream or lotion such as terbinafine, clotrimazole, miconazole or ketoconazole, used for a few weeks. Keep using it for the time your doctor advises, usually for about a week after the rash seems to have gone, because the fungus can still be present on seemingly healthy skin.

Antifungal tablets such as terbinafine, itraconazole or fluconazole are prescribed when ringworm is widespread, on the scalp or nails, or does not respond to creams. They are prescription medicines, and your doctor may check your liver, particularly if you take other medicines or for longer courses. Nail infections need months of treatment, because the nail must grow out fully.

How to prevent ringworm

• Dry yourself thoroughly after a bath, especially the groin, underarms and between the toes.
• Wear loose, cotton clothes and change out of sweaty clothes quickly.
• Change socks daily and let shoes dry in the sun.
• Do not share towels, combs, razors or clothes, and use a separate towel while infected.
• Wash clothes, towels and bedding in hot water and dry them in the sun.
• Wear slippers in public showers and prayer-room wash areas.
• Treat other infected family members at the same time, and check pets for bald patches.

When to see a doctor

• The rash does not improve after two weeks of proper antifungal use
• The infection is on the scalp, nails or face, or is widespread
• It keeps returning after treatment
• You have diabetes or a weak immune system
• The skin is very red, swollen, painful or weeping, which can mean a bacterial infection as well

Key takeaways

• Ringworm (daad) is a fungal infection, not a worm, and it is very contagious.
• Antifungal creams work, but they must be used for the full course.
• Steroid-containing creams can make it worse and keep it coming back.
• Keep skin dry, wear cotton, and do not share towels or clothes.

Related medicines on Medimart

These antifungal medicines are commonly used for ringworm and other fungal skin infections:

• Terbinafine: a cream or tablet for fungal infections
• Clotrimazole: a widely used antifungal cream
• Miconazole: an antifungal for skin and nails
• Ketoconazole: a cream or shampoo for fungal skin problems
• Itraconazole: a prescription antifungal tablet
• Fluconazole: a prescription antifungal tablet

Prescription medicines are supplied only against a valid prescription. Please take them only as advised by your doctor.

Browse antifungal medicines and creams on Medimart with delivery across Pakistan. Prescription medicines are supplied only against a valid prescription.

This guide is for general information and does not replace advice from a doctor. If a rash is not clearing, please see a dermatologist.