How can I treat my persistent ringworm-like skin patches?

Question

Hello doctor,

My skin has been developing ringworm-like patches and wounds that have persisted for the past two years. They form dark circles that disappear when I take medication, but reappear once I stop. The affected areas are very itchy, mainly on my buttocks, pubic area, and under my breasts.

Please help.

Thank you.

Answer 1

Hello,

Welcome to icliniq.com.

I have gone through your query and understand your concern.

From your description, you have been experiencing itchy, dark, and sometimes purple-colored skin lesions for about two years. These mainly appear in warm and moist areas such as the armpits, under the breasts, and the groin and buttocks. The lesions improve temporarily with medication but reappear once treatment is stopped.

From a family physician’s perspective with dermatology insight, this pattern is strongly suggestive of chronic recurrent fungal skin infection (chronic recurrent dermatophytosis). In such cases, superficial fungi grow easily in areas of heat, moisture, or sweat, and the infection can persist or recur if the treatment is incomplete or if certain risk factors are present. Frequent use of topical steroid creams can also mask the actual appearance of fungal infection and cause darker discoloration, a condition known as tinea incognito.

This condition often requires both adequate medical therapy and lifestyle modification for long-term control. Some common causes and contributing factors include incomplete or short antifungal treatments, reinfection from contaminated towels, underwear, or bed sheets, excessive sweating, tight or synthetic clothing, underlying conditions such as diabetes, and the use of combination creams containing steroids that can exacerbate fungal spread.

The following tests are recommended:

A skin scraping test (KOH (potassium hydroxide) test or fungal culture) is used to confirm the fungal infection.
A blood sugar test is performed to check for diabetes or metabolic imbalance.

Following daily measures can help:

Keep affected areas clean, dry, and well-ventilated.
Avoid tight or synthetic clothing; opt for light, cotton-based fabrics instead.
After bathing and thoroughly drying your skin, apply antifungal or talc powder to areas prone to moisture, such as the armpits, groin, and under the breasts.
Wash towels, undergarments, and bedsheets separately in hot water.
Avoid scratching the lesions to prevent the infection from spreading.
If you are overweight, gradual weight loss can help reduce friction and sweating.
Avoid using topical steroid creams unless prescribed by a doctor, as they can worsen fungal infections and discolor the skin.

If the infection persists despite topical treatment, an oral antifungal medication may be required for several weeks under medical supervision to achieve complete clearance. Please continue treatment as prescribed until it is fully completed, even if the lesions appear to improve earlier.

Please share your recent test results or more explicit photos for further evaluation. Please update me if your symptoms change. I will be happy to guide you further.

I hope I have answered your question.

Let me know if I can assist you further.

Thank you.