Private fungal skin infections clinic in London, same-day dermatology.

The main types

• Athlete's foot — itchy, scaly, cracked skin between the toes, or a dry scaling pattern across the sole.
• Ringworm — a spreading ring with a raised, scaly edge and clearer centre. Nothing to do with worms.
• Jock itch — an itchy red rash in the groin creases, usually spreading outwards, typically sparing the scrotum.
• Fungal nail — thickened, crumbling, yellow-white or brown nails, often starting at the outer edge.
• Scalp ringworm — scaly patches with hair loss in children. Creams do not work; oral treatment is required.

Treating skin infections properly

1. Use an antifungal cream such as terbinafine, clotrimazole or miconazole from a pharmacy.
2. Apply beyond the visible edge — a couple of centimetres of apparently normal skin around it, where the fungus already is.
3. Continue for one to two weeks after the skin looks normal. This is the step almost everyone skips, and the reason it comes back.
4. Treat both feet even if only one looks affected, and treat the groin and feet together — groin infection usually comes from the feet via a towel or underwear.
5. Keep the area dry. Dry between the toes thoroughly, change socks daily, alternate shoes so each pair dries out, and dry the groin before dressing.

Fungal nails

Nail infection is much harder to clear than skin infection, and it is worth confirming with a nail clipping sent for testing before committing to months of treatment — around half of thickened, discoloured nails are not fungal at all.

• Nail paints may work for early infection affecting the outer part of one or two nails, applied for six to twelve months.
• Oral terbinafine is considerably more effective and is usually needed for anything more than mild disease — typically three months for toenails, with liver function checked.
• The nail will not look normal immediately. It grows out slowly: fingernails take six months, toenails twelve to eighteen. Judge success by the new growth at the base, not the old nail.
• Treat the accompanying athlete's foot at the same time, or the nails will simply be reinfected.

Preventing recurrence

• Wear flip-flops in communal showers, changing rooms and around pools.
• Do not share towels, socks, shoes or nail clippers.
• Wash socks and towels at 60°C.
• Consider an antifungal powder in shoes if you are prone to recurrence.
• Treat the household pet if a child has ringworm — cats and guinea pigs are common sources.