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What Is Ringworm? Symptoms, Causes, Diagnosis, Treatment, and Prevention
Ringworm (also called tinea or dermatophytosis) is a very common fungal infection of the skin and nails that has nothing to do with worms. The condition is called ringworm because it tends to cause an itchy, red, circular or ring-shaped rash. It can occur just about anywhere on the body and has different names depending on which part of the body it affects. Types of ringworm include:
- Tinea pedis (athlete's foot): Ringworm on the feet
- Tinea cruris (jock itch): Ringworm on the groin, inner thighs, and buttocks
- Tinea barbae: Ringworm on the beard area
- Tinea faciei: Ringworm on the face
- Tinea manuum: Ringworm on the hands
- Tinea capitis: Ringworm on the scalp
- Tinea unguium (onychomycosis): Ringworm on the fingernails and toenails
- Tinea corporis: Ringworm on other parts of the body, such as the arms or legs
The specific symptoms of ringworm depend on the location of the infection. They typically include:
- Itchy skin
- Red, scaly, or cracked skin
- A ring-shaped rash
- Hair loss
Symptoms of ringworm can be different depending on the specific part of the body that’s affected.
- Tinea pedis, or athlete’s foot: Skin may peel or become swollen, red, and itchy between the toes (particularly between the pinky toe and the one next to it). The soles and heels of the feet may also be affected. In severe cases, blistering of the feet can occur.
- Tinea cruris, or jock itch: Itchy, scaly red spots usually appear on the inner thighs
- Tinea barbae: Scaly, itchy red spots may be visible on the cheeks, chin, and upper neck. The spots may become crusty or fill up with pus, and hair loss may occur.
- Tinea faciei: Scaly, itchy plaques may be visible on the cheeks. Sometimes pustules and crusting are seen.
- Tinea manuum: Palms may have dry skin with deep cracks, and ring-shaped patches may appear on the back of the hand.
- Tinea capitis: Typically looks like a scaly, red, and circular bald spot on the scalp that is also itchy, and it can get bigger. Ringworm on the scalp is more common in children than adults.
- Onychomycosis: Nails become thick and abnormal in shape and color, and one or several nails may be affected.
Ringworm is contagious even before symptoms appear.
The most common fungi that cause ringworm are Trichophyton, Microsporum, and Epidermophyton. These are mold-like fungi called dermatophytes. Like other types of fungi, dermatophytes thrive in warm, moist areas. Here’s how you can contract ringworm.
- Direct, skin-to-skin contact with affected areas of an infected person's body
- Contact with items that have the fungi on them, such as clothing, combs, pool surfaces, and shower floors
- Pets: Cats and dogs, and especially kittens and puppies, are common carriers. Touching other infected animals, such as cows, goats, pigs, and horses, can also lead to an infection. Sometimes an animal’s infection looks like an area where the fur is patchy or scaly, but the signs may not always be visible. Be sure to take your pet to the veterinarian if you think it might have an infection.
Risk Factors
You're more likely to develop ringworm if you:
- Have wet skin for a long period of time (such as from sweating)
- Have nail or skin injuries
- Do not bathe or wash your hair regularly
- Have close contact with other people or animals
- Participate in contact sports such as wrestling
- Live or spend time in a hot, humid, tropical climate
- Share towels, clothes, razors, and other items without disinfecting or washing them
- Are obese
- Have diabetes
- Wear clothing that is too tight and chafes your skin
- Don’t wash and dry your feet well before putting on shoes and socks after using a locker room or pool
- Have a weak immune system
Your healthcare provider might be able to tell whether you have a ringworm infection just by looking at it. They also might take skin scrapings from or swab the affected area.
Diagnosing ringworm can be a little tricky, because it often resembles other conditions. For example, tinea corporis might be confused with eczema, psoriasis, or seborrheic dermatitis. A ringworm diagnosis can be confirmed with a fungal culture.
Prognosis of Ringworm
Pretty much every case of ringworm can be successfully treated, whether it’s with over-the-counter or prescription medication. Taking preventive measures can help you avoid spreading ringworm to other parts of your body or reinfecting yourself or others in the meantime.
Ringworm symptoms usually appear between 4 and 14 days after the skin comes into contact with dermatophytes.
Antifungal medicine may clear up a ringworm infection quickly, eliminating symptoms in just a few weeks.
When treated with nonprescription antifungal medication, ringworm on the skin like tinea pedis (athlete’s foot) and tinea cruris (jock itch) typically clear up within two to four weeks. Tinea capitis (ringworm on the scalp) usually needs to be treated with prescription antifungal medication for one to three months.
Some types of ringworm can be treated with over-the-counter medications, but other forms require prescription antifungal medication.
Medication Options
Treatment of ringworm depends on the location of the infection. Nonprescription antifungal creams, lotions, or powders that can treat tinea pedis (athlete’s foot) and tinea cruris (jock itch) include:
- clotrimazole (Lotrimin, Mycelex)
- miconazole (Aloe Vesta Antifungal, Azolen, Baza Antifungal, Carrington Antifungal, Critic-Aid Clear, Cruex Prescription Strength, DermaFungal, Desenex, Fungoid Tincture, Micatin, Micro-Guard, Mitrazol, Remedy Antifungal, Secura Antifungal)
- terbinafine (Lamisil)
- ketoconazole (Nizoral)
Prescription antifungal medications that can treat ringworm on the scalp include:
- griseofulvin (Grifulvin V, Gris-PEG)
- terbinafine
- itraconazole (Onmel, Sporanox)
- fluconazole (Diflucan)
- ketoconazole (Xolegel)
Alternative and Complementary Therapies
Tinea cruris (jock itch) can typically be treated with over-the-counter topical medications. Dermatologists also advise wearing breathable, cotton underwear. To relieve the symptoms of jock itch, the American Academy of Dermatology Association recommends applying a cool, wet washcloth to the area for 20 to 30 minutes two to six times a day. It’s important to use a clean washcloth each time and to use it only on the itch, and to wash it in hot, soapy water before using it again.
There has been some research into the use of herbal remedies in treating ringworm, but it is dated and has been mostly limited to animals, and the results of animal studies don’t necessarily translate to humans. A study in the Hong Kong Medical Journal found that a topical herbal formula of traditional Chinese medicines with antifungal properties was effective in treating athlete’s foot in guinea pigs, though not as effective as a topical antifungal medication. And a study in Mycoses found that an herbal formula of essential oils, applied topically, appeared to limit fungal growth in sheep affected with ringworm.
The Cleveland Clinic notes that aloe vera, apple cider vinegar, and other remedies may help treat the condition, but that there’s not much scientific evidence to support these recommendations.
Ringworm can be challenging to prevent, but there are a number of simple steps you can take to reduce your risk, or to prevent the infection from spreading to other areas of your body or to other people.
- Avoid sharing personal items such as clothing, towels, hairbrushes, and sports gear.
- Don’t wear heavy clothing for long periods of time if you’re in a warm, humid climate.
- Try to avoid excessive sweating.
- Wash your hands often and well.
- Shower right after playing sports and keep your uniform and gear clean.
- Avoid infected animals, and have your pets or animals checked for ringworm.
- Change your clothes, including your underwear and socks, every day, and wash them before wearing them again.
- Shower after exercising.
- Wear waterproof shoes in locker rooms, public or shared showers, and pool areas.
- Disinfect or throw out clothes and items that may be infected with ringworm, or that you wore while you had ringworm.
- Wash towels and bedding that you use while you have ringworm in hot, soapy water.
A fungal infection rarely spreads below the surface of the skin, so it's very unlikely to cause serious illness. But untreated ringworm can sometimes cause the fungus to grow in deeper levels of the skin. Known as Majocchi’s granuloma, this rash consists of raised bumps and pustules and can be difficult to treat.
People with weak immune systems, like those who have HIV/AIDS, may find it challenging to get rid of ringworm.
The Centers for Disease Control and Prevention estimates that more than 1 billion people get a fungal infection annually.
Some types of ringworm are more common in children than adults. The most recent research suggests most common infections in younger kids are tinea corporis (body ringworm) and tinea capitis (scalp ringworm), while teens and adults more commonly develop tinea cruris (jock itch), tinea pedis (athlete’s foot), and tinea unguium (ringworm of the nails). Tinea cruris is more common in males and very rare in females. Athlete’s foot is also more common in males. Tinea capitis occurs mostly in children from ages 2 to 10, and is rarely found in adults. Tinea unguium (ringworm of the nails) occurs more often in adolescents and adults rather than young children.
Ringworm often resembles other conditions, including eczema (atopic dermatitis). Eczema is a condition that makes your skin red and itchy. Like ringworm, it's common in children, but anyone can get eczema. Symptoms include itching and red to brownish-gray patches on the skin.
Human immunodeficiency virus (HIV) is a virus that attacks the immune system, making you more vulnerable to other infections and diseases (including ringworm). It is spread by contact with certain bodily fluids of a person with HIV. Without treatment, HIV can lead to acquired immune deficiency syndrome (AIDS).
- Ringworm is a common fungal infection that causes itchy, red, ring-shaped rashes, misnamed as involving worms (it does not).
- Ringworm is contagious, but understanding the signs and taking early treatment can make it much easier to manage.
- To reduce your chance of spreading the infection, remember to wash your hands frequently and avoid sharing personal items.
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