Ringworm infection

Dear Dr. Jen,

I have a ringworm infection on my right thigh. My dog and sister also had the same thing.  But theirs are gone. I have been applying an anti-fungal medicine for months but there are still bumps on the rash. Is there an oral medication that can get rid of this once and for all?

Fiona

Dear Fiona,

Fungal infections typically look like ringworms, with red rashes forming a circle and the center with some clearing. However, not all round rashes are fungal in nature. Circular rashes can also be nummular eczema, granulomas, tick bites, urticarial and dozen other skin conditions.

The best way to find out if it is indeed a fungal infection is to send some skin scrapings to the laboratory.  Some organisms will be identified if the fungus exists.

Most common ringworm infections respond well to anti-fungal creams in about two to three weeks of treatment.  More severe infections (those covering bigger surface areas) may need oral anti-fungal meds. If there is still a rash remaining after a few weeks of treatment, it can either be: one, the fungal medicine was mixed with some steroid; or two, it was not a fungal infection to begin with.

Months of having round lesions despite treatment doesn’t sound like it’s heading anywhere. Please have it checked by your local PDS dermatologist.  Time to have the diagnosis confirmed and the medication you have been applying evaluated.

Dear Dr. Jen,

I have dark scars on my elbows and knees.  I had them injected once a couple of years ago but that didn’t really help.  What other alternative treatment or home remedies can you recommend?

Donald

Dear Donald,

Asian skin, in general, has a tendency to darken after injury.  While injecting a scar may lighten it, this mode of treatment is reserved for elevated or keloidal scars. Lemon, calamansi, tomato juice, yoghurt and milk are all popular home treatments.  But the main concern for home remedies is that the concentration is not that controlled.  I have seen many patients with burned underarms from using lemon or calamansi.

There are a number of lightening creams available over-the-counter, too.  When these won’t do the trick, it’s time to explore more serious alternatives. A PDS derma may prescribe some stronger bleaching agents.  Regular peels are also available.  Glycolic acid peel is a good option.  Lastly, laser treatment for pigment reduction is also very effective.  As with most treatment regimens, multiple sessions are usually better to safely lighten any area.

Dr. Tan is a diplomate of Philippine Dermatological Society (PDS) and is affiliated with the Perpetual Succour Hospital (PSH). Information on PDS is at www.pds.org.ph. Questions or concerns regarding the skin may be sent by text to 0932 857 7070 or emailed to [email protected]; or coursed thru The Freeman – (032) 2531276, or thru PSH – (032) 2338620 and 2325929. Inquiries will be forwarded to Dr. Tan.