Login      Sign Up
 

Q. I have a fungal infection that occurs again and again. Please help.

Answered by Dr. Atishay Bukharia.


New
Do you have a question on Seborrhoeic Dermatitis or Fungal Infection? We have medical experts to help you right away. Ask a Doctor Now »
Image: I have a fungal infection that occurs again and again.  Please help.

Hi doctor,

Please take a look at my case of skin dryness and flaking on my face. This is a cyclic condition which occurs almost every 7-8 months. The dryness persists for 1-2 months during which I also have general body itching over hands, legs and under my ribs on the sides. The strange thing is that after 1-2 months this dryness spreads to scalp followed by heavy dandruff and very heavy hair loss. This time the dryness and flaking is very extreme.

I have attached seven photos. First three will show my skin condition. Fourth and fifth is how the skin flakes after scratching. Sixth one is important as it shows clearly how the skin condition proceeds from my forehead up towards my scalp. But, it has not yet reached inside my scalp. Last photo is a dark patch under the side of my ribs due to itching, which is present on both sides. I feel that I have some internal fungal or bacterial infection that shows up again and again in a cyclic manner. I am diabetic too. Please help with my condition.


Related Questions:
Please help me with my itchy scalp.
Please suggest some good shampoo for dandruff.
How can I cure dry skin around my lips that is peeling off?
 

Dr. Atishay Bukharia
MBBS, MD, DVL., SPECIALIST IN COSMETOLOGY AND SEXUALLY TRANSMITTED DISEASES ., MEMBER OF INTERNATIONAL SOCIETY
Cosmetology, Dermatology, HIV/AIDS Specialist, Plastic Surgery – Reconstructive And Cosmetic, Venereology

Hi,

Welcome to icliniq.com.

First of all I would like you to thank for giving me a perfect clinical history with perfect photographs (attachment removed to protect patient identity).

It is a crystal clear case of seborrheic dermatitis and is moderate in nature.

It is a fungal infection and is very chronic in nature. Like diabetes, it can only be controlled and cannot be cured permanently as the fungus causing it is a normal resident of skin. Whenever the condition becomes suitable for it, it proliferates.

The good news is that it is harmless. Diabetes can also cause severe seborrheic dermatitis, because increased sugar gives fungus a suitable environment to proliferate.

As I said already that it is a chronic condition, follow up is very necessary. Currently, I will give you medicines for a month. Make sure to review your condition after a month as the dose and course would be decided accordingly.

Prescription is as follows:

  1. Salisia KT Shampoo (Salicyclic Acid), twice weekly and keep it applied for 15 minutes for itchy scalp and dandruff.
  2. Tablet Nizral (Ketoconazole) 200 mg once daily for 28 days.
  3. Kz (Ketoconazole) cream, apply once in morning over affected part in face and body for itch and dryness.
  4. Apply Pacroma (Pimecrolimus) 1% ointment in night over affected part.

Recommended investigations are liver function test and renal function test. Once these investigations came out to be normal you can safely start tablet Nizoral.

Revert back after a month for review to a dermatologist online --> https://www.icliniq.com/ask-a-doctor-online/dermatologist

 

Hi doctor,

At present, I am in a country where tablet Nizral is banned. So I wanted to check with you, is this a safe medication to take? I just wanted to validate and confirm with you. Is there any danger or side effect? As soon as my project gets over, I will be back to my home and then will start tablet Nizral. Since I could not start the tablet, I applied Nizral solution on my face for 15 minutes just a couple of times. I was delighted to see my dryness and skin condition is almost gone. So, Nizral is probably the right medication. However, itch is still there and increasing all over the body. I know that this fungal infection is still in my body.  Do you think that a strong dose of tablet Nizral will get rid of it totally? Is there anything else I could take in conjunction? I want to get rid of this recurring problem once and for all. I also have diabetes as I had mentioned earlier and irritable bowel syndrome all my life. Please let me know this fungal infection name. Is it Candida?

 

Dr. Atishay Bukharia
MBBS, MD, DVL., SPECIALIST IN COSMETOLOGY AND SEXUALLY TRANSMITTED DISEASES ., MEMBER OF INTERNATIONAL SOCIETY
Cosmetology, Dermatology, HIV/AIDS Specialist, Plastic Surgery – Reconstructive And Cosmetic, Venereology

Hi,

Welcome back to icliniq.com.

I am very glad to know that the medicine responded well.

Nizral is Ketoconazole and it is United States FDA approved medicine for this purpose.

No doctor can guarantee permanent cure as the disease itself by nature is very recurring and occurs when a condition suitable for proliferation of fungus. The irony is that the fungus Malassezia is the normal resident of human skin.

You can also try capsule Sporanox (Itraconazole) 100 mg. Take two capsules twice daily for 10 days if Nizral is not available.

Just take healthy diet and do regular exercise. Nothing else is needed.

Revert back after a month for review to a dermatologist online --> https://www.icliniq.com/ask-a-doctor-online/dermatologist

 

Hi doctor,

I am reporting back to you regarding my recurring skin condition. As I mentioned earlier, applying Nizral/Salisia shampoo (concentrated, without water) over affected skin for a couple of nights helps to minimize the problem. KZ cream seems to be too mild and does not work well. However, when I took the oral course of tablet Nizral for a month, there was zero effect. I was expecting a drastic reduction after a full month of tablet Nizral. But there was no change. Should I try Sporanox? I also want to report that in addition to the skin problem there is a now new nail pitting problem. There is an unusual denting and irregularity of my middle finger nail and is now starting on another nail. Please see the attached photo of my nail. Could this be rather a case of psoriasis, eczema or alopecia areata? I read these names in the internet. Can you advise further course of treatment?

 

Dr. Atishay Bukharia
MBBS, MD, DVL., SPECIALIST IN COSMETOLOGY AND SEXUALLY TRANSMITTED DISEASES ., MEMBER OF INTERNATIONAL SOCIETY
Cosmetology, Dermatology, HIV/AIDS Specialist, Plastic Surgery – Reconstructive And Cosmetic, Venereology

Hi,

Welcome back to icliniq.com.

As I already told you that it is very recurrent in nature, apply DesOwen cream (Desonide) in daytime and Ketoconazole 2% cream at night.

Now, in nail you are having fungal infection known as onychomycosis (fungal infection of the nail).

  • For this you need to take capsule Sporanox 100 mg. Take two capsules in the morning and two capsules at night for seven consecutive days in a month for three months. This is a pulse therapy for onychomycosis. Of course, it will help in seborrheic dermatitis too.
  • Also apply Loceryl nail Lacquer (Amorolfine) four times in a week for three months.
  • Yes, these can be the manifestation of psoriasis and alopecia areata. But, I do not think that you are suffering from any of these diseases.
  • Yes, they can rarely occur de novo also. But, it would be wise to take the treatment for onychomycosis and revert back after a month.

Revert back after a month to a dermatologist online --> https://www.icliniq.com/ask-a-doctor-online/dermatologist

 
 
Ask your health query to a doctor online?
 
Ask a Doctor Online »
* guaranteed answer within 4 hours.

Related Questions & Answers


Can fungal infection cause low grade fever?
Query: Hi doctor, For around nine weeks now, I have had a low grade fever and that persists. Also, I feel a little upper throat fullness and mild sinus congestion. I have been in and out of primary care clinics many times looking for help.  I had two chest x-rays and they were clear. I also had blood test...  Read Full »
Dr. Anshuman Srivastava
Internal Medicine Physician

Answer: Hi, Welcome to icliniq.com. This is a chronic fever, which is called as pyrexia of unknown origin when we are unable to ascertain a cause. As your blood tests and x-ray are normal, lung infection is ruled out. Conditions causing chronic fever are numerous. Also, certain infections like tuber...  Read Full »
 
I developed itchy and dry skin after dyeing hair in salon. Can you have a look?
Query: Hello doctor, I have a question about my skin condition. I have developed a really itchy and dry skin after I dyed my hair. Here are the symptoms. I do not know what the condition is as my appointment is months away. Can I attach pictures?  Read Full »
Dr. Suvash Sahu
Dermatologist

Answer: Hi, Welcome to icliniq.com. I have seen your query and examined your given picture (attachment removed to protect patient identity). It seems you have developed allergic contact dermatitis to hair dye. Though you may not have had this on your previous exposure, now onwards you may have a severe re...  Read Full »
 
I have fungal infection in my ear.Is it mandatory to stay at the hospital overnight for a microsuction?
Query: Hello doctor, I was diagnosed with fungal ear infection yesterday. Doctor asked me to get admitted in the hospital for a microsuction to remove fungal debris. Is it mandatory to stay at the hospital overnight for a microsuction? Can microsuction be done as an out patient procedure without staying in...  Read Full »
Dr. A.k.srivastava
ENT Otolaryngologist

Answer: Hi, Welcome in icliniq.com.I would like to tell you that fungal infection in ear is quite common and it may be treated by: Cleaning the ear: Cleaning may be done by suction or syringing or by cotton swab. Antifungal ear drops to be used three or four times a day. Anti-inflammatory medicine to reliev...  Read Full »
 
 

Ask your health query to a doctor online?
 
Ask a Doctor Online »
* guaranteed answer within 4 hours.
 

Ask a Doctor Online

* guaranteed answer within 4 hours
 

Most Viewed


My nose is always blocked and has mucus. Kindly help.
Hello doctor,My nose is always blocked and have mucus, from past four months. To open up my nostrils, I have to use Otri ...Read more »
Child is showing tantrums and speaking bad words. Kindly help.
Hello doctor, My child is 2.7 years old but is very aggressive and does what should not be done. Never listens, shows t ...Read more »
Folic Acid - Uses | Dosage | Side effects | Drug Interactions | Warnings
Folic acid is the synthetic form of folate, which is a water-soluble vitamin B9. It is the crucial ingredient in the syn ...Read more »