Skin care and treatments in the monsoon

Key takeaways

• Fungal infections thrive in heat, humidity and sweat, and the monsoon in Mumbai provides all three.
• Ringworm in India has become more stubborn in recent years, and steroid combination creams are a major reason.
• Dry the skin folds, change wet socks and clothes quickly, and do not share towels.
• Switch to lighter gel textures, but keep moisturiser and sunscreen in the routine.
• Treatments like peels and laser hair reduction can usually continue, but an active infection should be treated first.

Why does skin misbehave in the monsoon?

Every year from June onwards, the pattern in my clinic changes. More itchy rashes in the groin and waist, white and brown patches on the chest, itchy bumps on the back, cracked skin between the toes, and breakouts. See, what happens is, skin likes to stay balanced, and constant moisture upsets that balance. Wet shoes all day, a damp shirt on the commute, and then a long day in air conditioning. Sweat cannot evaporate. Yeasts and fungi that are normally kept in check start to grow.

Which monsoon skin problems are most common?

DermNet notes that ringworm spreads through fungal spores, especially in warm, moist conditions, and through shared bedding, towels and clothing. It also lists hot, humid climates, crowded households, tight clothing and sweating as risk factors. For pityriasis versicolor, DermNet notes it is more common in hot, humid climates and often returns when warm, humid weather comes back.

Why is ringworm so hard to get rid of now?

This is a real problem in India. An expert review in the Indian Journal of Dermatology, Venereology and Leprology described an "epidemic-like" rise in chronic and recurrent ringworm, with whole families affected. The authors considered misuse of topical steroids, especially steroid-antifungal-antibiotic combination creams sold over the counter, possibly the most important reason for stubborn cases.

The steroid takes away the itch for a few days, so the cream seems to work. But the fungus keeps spreading underneath and the rash changes shape, which DermNet calls "tinea incognito". That is very important to understand. If you have an itchy rash in the rains, please do not reach for a mixed cream from the chemist. Get it examined, and treat everyone at home who has it at the same time.

What is a sensible monsoon routine?

Every day: 1. Bathe after you get wet or sweaty, and dry thoroughly, especially the groin, underarms, under the breasts, between the toes and the waistband area. 2. Change out of wet clothes and socks as soon as you can. Keep a spare pair of socks at work. 3. Wear loose cotton clothes. Avoid tight jeans and synthetic innerwear on humid days. 4. Do not share towels, clothes or combs. Wash towels often and dry them fully, in sun if you can. 5. Let footwear dry between uses. Open sandals on very wet days help.

For the face: - Gentle face wash twice a day. A salicylic acid wash if you are oily or acne-prone. - A light gel moisturiser instead of a heavy cream. - Sunscreen every morning. Cloudy days still carry UV, and Indian skin pigments easily. A gel or fluid sunscreen feels lighter in humidity. - No scrubbing. Damp, irritated skin damages easily.

If you are prone to fungal problems: your doctor may suggest using an antifungal shampoo as a body wash once a week through the season. DermNet describes this kind of maintenance to prevent pityriasis versicolor returning. My article on fungal acne explains the routine in more detail.

Can I get skin treatments during the monsoon?

Normally, yes. In some ways it is a practical season, because many people spend less time in strong sun. But a few rules apply: - Treat infections first. I will not do a peel or laser over an active fungal rash or infected acne. We clear it, then treat. - Laser hair reduction can continue. Keep the area dry and clean afterwards, and avoid tight, damp clothing on treated skin for a day or two. See my article on laser hair reduction in Indian skin. - Chemical peels can usually continue, with careful aftercare. Peeling skin needs moisturiser and sun protection even on grey days. My chemical peel aftercare article covers this. - Plan around travel. If you will be getting soaked on a long commute right after a procedure, choose a day when you can go home and stay dry. - Bring your creams. If you started anything for an itch, I need to know before any procedure.

When should I see a doctor?

• An itchy rash that is spreading or has lasted more than two weeks
• A rash that came back after a cream "worked" for a while
• Several people at home with the same itchy rash
• Painful, swollen, hot or pus-filled skin
• Cracks between the toes, especially if you have diabetes
• Breakouts that are deep, painful or leaving marks

How we approach this at Dr Tvacha

In the rainy months, a lot of my work at our Thane, Andheri, Bandra and Dahisar centres is untangling rashes that have been treated with the wrong cream. Under the Second Layer Skin Plan, I examine the skin, ask about everything you have applied, arrange a simple scraping test if it will change treatment, and give you a written plan for treatment and for prevention through the season. Tests are charged at actual cost. For body breakouts that worsen in the rains, see back and chest acne.

Written by

Dr Amit KarkhanisAesthetic Physician · MBBS, Dip. Dermatology (UK) · Reg. No. 2001/02/1124

Founder of Dr Tvacha, practising in Thane since 2005. Leads the weight loss and hair programmes.