There is an alarming increase in the incidence of superficial fungal infections of the skin in the last 2-3 years, it seems to be a sort of an epidemic. Thirteen years back when I joined a tertiary care corporate hospital, I just saw 2-3 patients of fungal infections in a month, as it’s a common ailment of skin in the summers and monsoon and no one comes to a tertiary care hospital for this. But in the last 2 years there has been an alarming increase in the number and now 50% of the OPD patients are these. The fungal infections are mainly seen in summers and monsoon, but this winter we continued to see these infections. The increase of superficial fungal infections is also phenomenal at the primary and secondary health care centres. This is a matter of concern for all of us. As the summers are approaching and I fear a further increase in the number of infections. If we try to understand the infection and the treatment options, we would be able to overcome this infection.
We need to know the reasons for this increase in number and then to correct them, to bring the infection in check.
Let us see first see the causes behind this increase in the number of infections.
First and foremost is the inappropriate use of medication. The availability and use of over the counter creams containing steroids e.g. Betnovate(the most notorious), quadriderm, fourderm etc, I am sure there are many more. These creams provide relief from itching and redness, but does not treat the fungus. And hence on stopping these creams the infections come back with a vengeance. The patient falls in a vicious cycle of infection and improper treatment.
The other main reason of rise in the infection is to not take the prescribed dose and duration of medicines. What happens when a patient is treated appropriately (by a dermatologist), here when he/she observe the itch and rash go away, they stop the treatment midway against their doctors advice and once again leads to re kindling of the infection which may be much more widespread and now also becomes resistant to medicines.
This self and wrong medication leads to widespread infection involving almost the whole body, such widespread infection earlier was usually seen in immunocompromised patients. Earlier the infection appears only in one part of the body say either the underarms or the groin area(being the most common areas), but the wrong treatment leads to a widespread infection involving almost the whole body, including the face.
The other major setback with this misuse of wrong medication is that the length of treatment and hence the cost of treatment has increased. Earlier a localised infection of a single area could be treated with local cream application alone, but now along with cream you have to take oral medicines too. Not only the duration of treatment but also the dose of medicines has doubled. The patient must have tried to save on the cost of medicines but knowingly or unknowingly he lands himself in spending much more money as the cost went up three times. If you are a healthy person and follow a good hygiene, just a few precautions would be able to contain the infection, and if these have not helped then you definitely need to see a dermatologist.
Follow the following advice to save yourself from the misery of this annoying superficial fungal infections of the skin.
- Daily baths with emphasis on drying all the body folds.
- Wash your clothes daily and dry them in the sun, if no sun then iron your clothes including the undergarments.
- Wear loose cotton clothes, do not wear tight fitting clothes especially leggings and jeggings.
- Wash hands with soap and water to prevent infections.
- If you have infection of the feet, clean your feet twice especially between the toes and also dry the toe clefts. Wear cotton socks, change and wash daily.
- Do not use these OTC creams, if you have and your problem has come back, go visit the dermatologist in Ludhiana.
- Last but not the least follow your doctors advice, take the full course of treatment, do not abandon the treatment midway. Go for your follow up, if you discuss it with your doctor, he/she will advise accordingly.
Stay healthy and infection free.