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Ringworm

(Tinea Infection; Dermatophyte Infection)

Definition

Ringworm is an infection of the skin. It may appear on the skin, nails, hands, feet, or scalp. There are no worms, some think the rash can look like a worm.

Causes

Ringworm is caused by a fungus. It can be found in warm, moist areas such as locker rooms, shower stalls, damp clothes, or soil. Both people and pets can pick up the fungus from these areas.

The most common way to get it is from skin to skin contact with someone who has ringworm. You can also pick it up from an infected pet. The fungus can also live on objects for a long time. It can be passed by sharing infected, clothes, hats, towels, and personal grooming items.

Risk Factors

Ringworm is more common in children 12 years of age or younger.

Factors that may increase your chances of ringworm:

  • Contact with surfaces, clothing, or personal grooming items used by an infected person
  • Skin-to-skin contact with an infected person or pet
  • Spending time in nurseries, schools, daycare centers, or locker rooms

Symptoms

Ringworm causes reddish patches with raised borders. They often appear as circles. The centers turn clear as the patch grows. This gives it a ring-like appearance. The patches:

  • May look pink or red on light-color skin and gray or brown on darker skin
  • Grow or spread to more areas over time
  • Can be very itchy

Symptoms may appear about 4 to 10 days after contact.

Diagnosis

The doctor will ask about your symptoms and past health. A skin examination will be done. Ringworm is often easily diagnosed by appearance. A sample of the affected area may be taken if it is not healing.

Treatment

Treatment can get rid of the infection. Options include:

Topical Treatment

Creams or powders may help to get rid of the fungus. Treatment is often given for at least 4 weeks.

Ringworm on the body, hands, or feet can often be treated with over-the-counter medicine. A prescription may be needed for ringworm that is more widespread or severe.

Oral Treatment

Pills may be needed for ringworm of the nails and scalp. Early treatment for scalp ringworm is important to prevent permanent hair loss. Prescription pills are given for:

  • Scalp ringworm: for at least 4 to 8 weeks
  • Nail ringworm: for at least 4 to 9 months

If your pet has ringworm they will need to be treated as well. Check with your pet's veterinarian for treatment.

Prevention

To help reduce your chances of ringworm:

  • Avoid contact with any infected person, animal, surface, or object.
  • Do not share personal hair grooming items, clothing, or shoes.
  • Wear sandals in locker room areas.
  • Avoid scratching during infection. This will prevent ringworm from spreading to other areas.
  • Wear clothing that minimizes sweating and moisture build-up.
  • Wear breathable shoes or sandals.
  • Keep moisture-prone areas of the body clean and dry.
RESOURCES:

American Academy of Dermatology
https://www.aad.org

Family Doctor—American Academy of Family Physicians
https://www.familydoctor.org

CANADIAN RESOURCES

Canadian Dermatology Association
https://www.dermatology.ca

Dermatologists
http://www.dermatologists.ca

REFERENCES:

Higgens EM, Fuller LC, Smith CH. Guidelines for the management of tinea capitis. Br J Dermatol. 2000;143(1):53-58.

Kakourou T, Uksal U, European Society for Pediatric Dermatology. Guidelines for the management of tinea capitis in children. Pediatr Dermatol. 2010;27(3):226-228.

Panackal AA, Halpern EF, Watson AJ. Cutaneous fungal infections in the United States: Analysis of the National Ambulatory Medical Care Survey (NAMCS) and National Hospital Ambulatory Medical Care Survey (NHAMCS), 1995-2004. Int J Dermatol. 2009;48(7):704-712.

Ringworm. Family Doctor—American Academy of Family Physicians website. Available at: https://familydoctor.org/condition/ringworm. Accessed February 15, 2020.

Tinea capitis. DynaMed website. Available at: http://www.dynamed.com/topics/dmp~AN~T116543/Tinea-capitis. Accessed February 15, 2020.

Last reviewed February 2021 by EBSCO Medical Review Board Daniel A. Ostrovsky, MD