As fungal infections rise, dermatologists flag rampant anti-fungal resistance

The damp weather and humid conditions after recent rains in Bengaluru have triggered a marked rise in fungal infections. Dermatologists warn that these infections are becoming increasingly difficult to treat due to growing anti-fungal resistance.

Superficial fungal infections such as tinea or ringworm are confined to the outermost layers of the skin, hair, or nails and do not invade deeper tissues or organs.

At ESIC Model Hospital in Rajajinagar, M.S. Girish, Senior Specialist and Head of Dermatology, said fungal infections now account for a significant share of his daily outpatient load. “Of about 120 patients I see in the OPD every day, around 30 come with fungal infections. Every fourth patient I see daily has a fungal infection and nearly 30% of these cases do not respond to basic medication,” he said.

Self-medication and resistance

According to Dr. Girish, self-medication and over-the-counter availability of anti-fungal creams are major drivers of resistance. “When used in large quantities or for prolonged durations, the fungus grows resistant. It is similar to anti-microbial resistance,” he explained.

He noted that incomplete treatment worsens infections. “Patients stop treatment once symptoms disappear, but relapse is common and often more severe. Some creams have less than the required anti-fungal strength, and repeated use builds resistance, forcing us to opt for advanced treatment,” he said.

Raising concerns over steroid-based creams, he said an unacceptable combination of topical steroids with anti-fungals is being used. “Overuse of steroids thins the skin. Itching may reduce temporarily, but this is not a solution,” he said.

Rule of Two

To address this, the Indian Association of Dermatologists, Venereologists, and Leprologists (IADVL) has issued a “Rule of Two.” Patients are advised to apply antifungal creams twice daily for at least two weeks after visible lesions have resolved, extending the application two centimetres beyond the infected area to ensure complete eradication and prevent recurrence.

Shireen Furtado, Senior Consultant – Medical and Cosmetic Dermatology at Aster CMI Hospital, said she is seeing a steady rise in patients with recurring fungal infections. “Ringworm, athlete’s foot, and nail fungus are becoming very common, and many cases are harder to treat than before. The main reason is that the fungus is slowly becoming resistant to the medicines we usually prescribe,” she said.

She stressed that misuse of creams and premature stoppage of medication fuel relapses. “Many people buy medicines directly from the pharmacy. Some contain steroids, which give temporary relief but worsen infections. Patients also stop treatment once itching or redness subsides, though the fungus remains and quickly grows back,” she explained.

Lifestyle and prevention

Dr. Furtado added that lifestyle factors are also contributing. “The damp and humid climate, sweating, tight clothes, and unhygienic practices add to the rise. Shared spaces like gyms, hostels, and swimming pools make it easy for fungus to spread,” she said.

Both doctors emphasised the need for public awareness and responsible use of anti-fungal medicines. Patients should consult a dermatologist instead of self-treating, complete the prescribed course, and follow preventive measures such as keeping skin dry, wearing clean clothes, and not sharing towels.