Skin and fungal infections

What a pharmacist can supply without a prescription

Topical antifungal creams for athlete's foot, ringworm and similar infections, aciclovir cream for cold sores, hydrocortisone cream at low strength for mild inflammatory rashes, medicated shampoos for scalp problems, emollients for eczema and dry skin, and a range of acne washes and topical treatments are all available without a prescription. Pharmacists in Ireland can also supply a defined set of medicines after a consultation, so it is worth asking rather than assuming.

What is prescription-only is the oral end of the same treatments and the stronger topicals: oral antifungals such as terbinafine or itraconazole, oral antivirals such as aciclovir or valaciclovir tablets, topical and oral retinoids, topical and oral antibiotics for acne, and stronger corticosteroid creams. The rule of thumb is that anything systemic or potent enough to need monitoring stays behind the counter. A pharmacist is also the right person to say when a self-treatable problem has stopped being one, which they do routinely.

Fungal nail infection

Fungal nail infection is treatable without a prescription in mild cases and usually is not in more advanced ones. Nail lacquers containing amorolfine are available over the counter and can work where only the outer part of one or two nails is affected and the base of the nail is spared. Where several nails are involved, the nail is thickened or crumbling, or the infection reaches the matrix at the base, topical treatment alone rarely clears it and an oral antifungal such as terbinafine is usually needed.

Two things slow people down here. First, confirmation matters: nail changes from psoriasis, trauma, lichen planus or simple age look similar, and treating those with an antifungal for months achieves nothing, which is why a clipping sent for testing is often requested before oral treatment. Second, oral antifungals need consideration of liver function and of interactions with other medicines, so they are a prescriber's decision. Toenails take a long time regardless of treatment, because the visible improvement is limited by how fast the nail grows out.

Athlete's foot, ringworm and other skin fungal infections

These generally respond to over-the-counter topical antifungals, and the usual reason they fail is stopping too early. Athlete's foot between the toes, ringworm on the body, and fungal infection in the groin or under the breasts are treated with creams containing terbinafine, clotrimazole or miconazole, and treatment is continued for a period after the skin looks normal, because the fungus persists after the redness settles.

Fungal infection of the scalp is the exception and needs oral treatment, particularly in children, because creams do not reach the hair follicle. Practical measures matter more than people expect: drying carefully between the toes, changing socks daily, not sharing towels, treating the shoes as well as the feet, and treating a household pet if it has bald scaly patches, since ringworm passes both ways. If the skin is weeping, spreading redness appears, the area becomes hot and painful or you develop a fever, that suggests bacterial infection on top and needs a doctor rather than more antifungal cream.

Thrush and cold sores

Vaginal thrush is treated with antifungal pessaries and creams, and pharmacists can advise on which options they are able to supply. Recurrent thrush, defined loosely as several episodes a year, deserves assessment rather than repeated self-treatment, because it can point to poorly controlled diabetes or another cause, and because a persistent itch is not always thrush. Thrush in pregnancy is treated differently and should be discussed with a clinician.

Cold sores are caused by herpes simplex virus and recur along the same nerve after a first infection. Aciclovir cream is available over the counter and works best when started at the tingling stage before the blister appears. Oral antiviral tablets are prescription-only and are reserved for severe or frequent recurrences, for cold sores in people whose immune system is suppressed, and for eczema herpeticum, which is a rapidly spreading painful rash in someone with eczema that needs urgent medical assessment. A cold sore near the eye, or eye pain and light sensitivity with one, also needs urgent assessment rather than a cream.

Acne and what needs a prescription

Mild acne is often managed with over-the-counter products, principally benzoyl peroxide, and it needs weeks of consistent use before it is fair to judge it. Beyond that, treatment is prescription-only: topical retinoids such as adapalene, topical antibiotic combinations, azelaic acid at prescription strengths, and for women sometimes a combined hormonal contraceptive chosen for its effect on acne.

Oral antibiotics such as lymecycline or doxycycline are used for moderate inflammatory acne, always alongside a topical treatment and for a limited period, because using them alone drives resistance and relapse. Isotretinoin, the treatment for severe or scarring acne, is prescribed under specialist supervision with strict pregnancy prevention requirements and monitoring, and it is not something any online service can start. Adult acne, particularly along the jaw and chin in women, is common and worth treating properly rather than repeatedly; scarring is far harder to fix afterwards than the acne is to treat now, which is the main argument for seeing someone early.

Renewing ongoing skin treatment

Where a skin treatment is established and unchanged and you simply need more of it, MEDINOW runs a written repeat prescription assessment at 19.90 euro. You complete a medical questionnaire with the exact substance, strength, form and how you use it, how long it has been prescribed, who prescribed it last, and whether anything has changed, and a doctor reads it and answers in writing. There is no video consultation, no phone appointment and no live chat.

What this does not cover is diagnosis. We do not identify a rash from a photograph, do not start a new topical or oral treatment for a skin problem nobody has examined, and do not prescribe isotretinoin or any treatment that requires specialist supervision or laboratory monitoring. A new or changing skin lesion is never a matter for a renewal service. The fee covers the medical assessment itself, not the issuing of a document. If the doctor declines on medical grounds, the fee is refunded. If you do not send the documentation the doctor asks for, the assessment counts as carried out and the fee is not refunded.

When to see a GP or a dermatologist

See a GP when a self-treated problem has not improved after a reasonable trial, when a rash is spreading, painful, blistering or weeping, when there is fever alongside it, when a skin problem keeps returning, or when it is affecting sleep, work or mood. Referral to dermatology follows from that assessment and is the route for severe or scarring acne, for suspected skin cancer, for chronic eczema or psoriasis that is not controlled, and for diagnostic uncertainty.

Some things should not wait for an appointment. A mole that is changing in size, shape or colour, bleeding or itching, or a new lesion that will not heal, should be assessed promptly. Spreading redness with heat, pain and fever suggests cellulitis and needs same-day assessment. A rash that does not fade when pressed with a glass, particularly with fever, headache or a stiff neck, is a 112 or 999 call. Widespread blistering, skin peeling, or a rash with facial swelling or breathing difficulty after starting a new medicine is an emergency and the medicine should be stopped straight away on medical advice.

Who wrote this page

This page was written by the MEDINOW editorial team and reviewed by lek. Damian Wojno, a doctor registered in Poland, PWZ no. 3211301. He is not on the Irish Medical Council register. Reviewed on 29 August 2026.

It is general information about how skin conditions are treated in Ireland and about which treatments need a prescription. It is not a diagnosis, and no skin condition can be diagnosed from a description or a photograph alone. Full details for any named medicine are in its Summary of Product Characteristics.

How this page was put together: the medicines, categories and rules described here were checked against the sources listed below rather than written from memory, and any figure we could not verify at source was left out instead of estimated. Where Irish practice differs from the rules of another country, the Irish position is the one stated on this page, and the Irish regulators named here are the HPRA for medicines, the HSE for health services, the PSI for pharmacy and the Irish Medical Council for doctors practising in Ireland. Corrections are welcome by email and are made to the page rather than argued about.