Ringworm (daad, fungal infection) often comes back because the treatment was stopped too early, because the cream contained a steroid, or because the fungus is a hard-to-treat strain. Creams that mix an antifungal with a steroid can make the rash look better while the fungus keeps spreading. Use a plain antifungal for the full course, and see a skin specialist if it keeps returning.
Why it keeps coming back
- Stopping too soon. NHS says you may need to use an antifungal every day for up to 4 weeks, and to keep using it for the full time even after the rash has gone.
- Steroid creams. Some creams combine an antifungal with a steroid. DermNet explains that the steroid calms the itch and redness, but the fungus keeps spreading underneath. The more steroid is used, the wider and less recognisable the infection becomes. When the cream is stopped, the itch flares again, so people put it back on.
- A resistant strain. CDC reports that a drug-resistant ringworm fungus called Trichophyton indotineae is widespread in South Asia. It often covers large areas of the body, is hard to treat and can resist terbinafine, a common first-choice antifungal. CDC lists antifungal-steroid combination creams among the factors behind it.
- Catching it again. Ringworm spreads through close contact with an infected person or animal, and through shared towels, combs and bedsheets (NHS).
What helps
- Ask the pharmacist for an antifungal without a steroid, and use it every day for as long as directed, even after the skin clears (NHS).
- If you have been using a steroid cream, DermNet advises stopping it. A doctor can guide you through the flare that may follow.
- Do not scratch, because this can spread the rash to other parts of the body (NHS).
- Do not share towels, combs or bedsheets, and wash towels and bedsheets regularly (NHS).
- Take a pet to the vet if it might have ringworm (NHS).
When to see a doctor
See a skin specialist (dermatologist) if ringworm hasn't improved with a pharmacy antifungal, keeps coming back, covers a large area, or is on the scalp, or if you have diabetes or a weakened immune system (NHS, CDC). Scalp ringworm usually needs prescription antifungal tablets and shampoo (NHS). Antifungal tablets are prescription medicines, so don't start them on your own.
Sources
General health information from the DoctorOS Team, not a diagnosis. For advice about your own situation, see a doctor.