Why is antifungal medicine not working for my skin problem?

Q. Why is antifungal medicine not working for my skin problem?

Answered by
Dr. Rashmi Singh
and medically reviewed by iCliniq medical review team.
This is a premium question & answer published on Jan 06, 2018 and last reviewed on: Nov 29, 2023

Hello doctor,

I am suffering from a skin condition for about four years in groin area as you can see in the attached pictures. There is a dark brown area with sharp borders on upper inner thighs where scrotum touches thighs. There is no itch, pain or burning sensation and it is not raised and also very plain. I went to a dermatologist and he diagnosed it as a fungal infection by just seeing it. After taking antifungal tablet and applying topical cream for about 35 days there is no noticeable improvement in the appearance of the affected area. If it is a fungal infection then it will itchy. I ignored it for four years because nothing seems serious in it. The picture was taken before treatment and all the others are of today. Can you see any improvement? I am getting married soon. Please tell me what is it. What treatment should I go for?



Welcome to icliniq.com.

I have gone through the pictures (attachments removed to protect patient identity). It does look like fungal infection with some post-inflammatory hyperpigmentation. We need to address the infection first and then proceed to pigmentation. Please tell what antifungals your dermatologist has prescribed.

Kindly revert in case of further questions.

Thank you.

Hello doctor,

For the first 15 days, the doctor prescribed tablet Itraconazole 100 mg once daily with Miconazole and Sertaconazole. Next 10 days, tablet Itraconazole 200 mg once daily with Terbinafine cream and next 15 days he prescribed Fluconazole tablet 200 mg once in a week with Sertaconazole nitrate cream. I want to know if it is fungal infection then why it is not responding to the medications. And it was not itching even before the medications as well. Suggest me the treatment for post-inflammatory hyperpigmentation.

Thank you.



Welcome back to icliniq.com.

Sometimes, candidiasis may not itch. Please get your blood glucose level checkedto rule out immunosuppression. If you apply depigmenting cream over infection, it would only worsen. Mix topicalSertaconazole and Hydrocortisone in the morning and night. Continue taking antihistamines like Cetirizine at night. Avoid wearing tight clothes. You can take tablet Fluconazole 100 mg four times a day for a week.

I hope this helps.

Thank you.

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