Ringworm, athlete's foot, jock itch, or tinea versicolor? Get diagnosed and treated online with prescription antifungals from a board-certified provider — same-day availability in DE, MD & WA.

Board-Certified HIPAA-Compliant Same-Day Available DE · MD · WA

Book a Same-Day Visit →

Fungal Skin Infections — Types, Causes & Clinical Presentations

Superficial fungal skin infections — collectively termed "tinea" or "dermatophytosis" — are among the most common dermatologic conditions worldwide. They are caused by dermatophytes, a group of keratinophilic fungi that invade only superficial keratinized structures (skin, hair, nails) and do not penetrate living tissue in immunocompetent individuals. The three genera responsible for human dermatophytosis are Trichophyton, Microsporum, and Epidermophyton. Infections are classified by body site rather than by causative species, using Latin anatomical nomenclature: tinea corporis (trunk/extremities), tinea pedis (feet), tinea cruris (groin), tinea capitis (scalp), tinea unguium/onychomycosis (nails), and tinea versicolor (a distinct condition caused by Malassezia yeast, not a true dermatophyte).

Tinea corporis — commonly called "ringworm" despite having nothing to do with worms — presents as an annular, scaly plaque with a raised, well-defined erythematous border and central clearing. It is highly recognizable via photo assessment. Tinea pedis (athlete's foot) typically manifests as maceration, scaling, and fissuring in the interdigital spaces, often extending to the soles (moccasin pattern) or as vesicular lesions on the plantar surface. Tinea cruris (jock itch) presents as a well-demarcated, pruritic erythematous rash in the inguinal folds that typically spares the scrotum (in contrast to candidal intertrigo). Tinea versicolor, caused by Malassezia furfur, presents as hypo- or hyperpigmented patches with fine scale, most commonly on the upper trunk and shoulders, and is not pruritic.

our board-certified provider, evaluates fungal skin infections via photo and video assessment, with particular attention to lesion morphology, distribution, and the clinical hallmarks of each tinea subtype. The characteristic annular morphology of tinea corporis, the interdigital maceration of tinea pedis, and the perifollicular hypo/hyperpigmented macules of tinea versicolor are typically distinguishable via high-quality photographs, enabling confident clinical diagnosis and treatment initiation without the need for KOH prep or culture in most cases.

Fungal Infections We Treat Online

Antifungal Treatments — Topical, Oral & Special Cases

For most localized tinea infections — corporis, cruris, and limited pedis — topical antifungals are the first-line treatment. The allylamine class (terbinafine 1% cream or spray) and azole class (clotrimazole 1%, miconazole 2%, ketoconazole 2%) are both effective. Terbinafine is generally preferred for dermatophyte infections due to its fungicidal mechanism, shorter treatment duration (1–2 weeks), and lower relapse rates compared to azoles. Treatment duration for tinea corporis and cruris is typically 2–4 weeks; tinea pedis often requires 4 weeks with topical agents. The lesion should be treated for 1–2 weeks beyond apparent clearance to prevent relapse.

Oral antifungals are indicated for extensive or widespread disease, immunocompromised patients, folliculitis-pattern tinea, recurrent tinea pedis despite appropriate topical treatment, and tinea involving nail structures or the scalp. Oral terbinafine 250mg daily for 2 weeks is highly effective for tinea corporis and pedis. Fluconazole 150–200mg weekly for 4–6 weeks is an alternative for tinea versicolor and suitable for patients who prefer weekly dosing. Tinea versicolor treatment options also include topical ketoconazole 2% shampoo (applied as a body wash, left on for 5 minutes, repeated daily for 1–2 weeks) or selenium sulfide lotion 2.5%. Patients should be counseled that pigmentation normalization after tinea versicolor clearance may take months, regardless of treatment success.

Tinea capitis — fungal infection of the scalp — is a critically important special case. It requires systemic antifungal therapy (oral griseofulvin or terbinafine) and cannot be treated effectively with topical antifungals alone. Tinea capitis most commonly affects children and presents with patchy scalp hair loss, scaling, and sometimes kerion formation (a boggy, inflammatory mass representing severe infection). Appropriate evaluation of tinea capitis requires in-person assessment; your provider will identify this presentation via history and clinical features and refer to in-person care for proper management.