Ringworm: Summary and Overview

Ringworm is a common fungal infection of the skin. The name is slightly misleading as it caused by a fungus, not a worm as the name suggests. Ringworm has different medical names according to where it grows. On the body, it is called tinea corporis; feet - tinea pedis (also called athlete's foot); groin area - tinea cruris (also called jock itch); scalp - tinea capitis; and beard - tinea barbae.

Children are most susceptible to ringworm, although anyone can develop it. Studies suggest that an individual has a 20-30% chance of developing this skin infection in his or her lifetime.

Ringworm - Causes

Ringworm is caused by several fungi species that are collectively called dermatophytes (meaning skin fungi). It can easily spread from one person to another. You can catch ringworm if you touch someone who has the infection, or if you come into contact with items contaminated by the fungus, such as combs, brushes, shower, bath or pool surfaces, bedding and linen, and unwashed clothing,

You can also catch ringworm from pets, such as dogs or cats that carry the fungus. Additionally, you can get ringworm from ferrets, rabbits, goats, pigs and horses.

The fungus that causes ringworm thrives in warm, moist areas. Ringworm is more likely when you are often wet (such as from sweating) and from scratches and minor injuries to your skin, scalp, or nails.

Ringworm - Symptoms

The symptoms of ringworm depend on the body part affected:

• Skin (tinea corporis): When fungus affects the skin of the body, it often produces the round spots of classic ringworm. It's characterized by an itchy, red circular rash with healthy-looking skin in the middle.
• Scalp (tinea capitis): Ringworm of the scalp commonly affects children, mostly in late childhood or adolescence. Areas that are infected appear bald with small black dots, due to hair that has broken off. The condition also produces round, scaly, red and inflamed patches of skin. Other symptoms include pus-filled sores and a fever of around 100°F.  The scalp is itchy and you may have swollen lymph nodes in the neck.
• Feet (tinea pedis): Ringworm of the feet is also called athlete's foot. It can produce skin cracking, white and soggy toes, scaling, and itchiness.  Moccasin-type athlete's foot doesn’t cause itching, but the sole and heel becomes dry and flaky with loose, white scales that appear. Vesicular or blistered athlete's foot causes sore, fluid-filled blisters that occur between the toes and on the arch and sides of the foot.
• Groin (tinea cruris, also called jock itch): Causes itching in the groin, thigh or anus. It can also cause red, raised, scaly patches in these areas that may blister and ooze. 
• Beard (tinea barbae): Ringworm of the beard causes swelling and marked crusting, is often accompanied by itching, sometimes causing the hair to break off.

Ringworm - Diagnostic Tests

Most of the time your doctor can diagnose all forms of ring worm (body, scalp, feet, groin, beard) by examining your skin. Tests are not usually necessary. For scalp ringworm, your doctor may examine your skull under a blue light (called a Wood's lamp) in a dark room. If tests are necessary, he or she may order a KOH (potassium hydroxide) test, a skin lesion biopsy, or skin culture.

Ringworm - Treatment Options

For most cases of ringworm (skin, feet, groin), treatment involves keeping the skin clean and dry and applying an over-the-counter medication. Choose anti-fungal medications or drying powders or creams that contain miconazole, clotrimazole, or similar ingredients. Wash the sheets and your nightclothes for every day that you are infected. If it is ringworm of the body, apply the medication at least twice per day. Ringworm should respond to treatment within a few weeks. If it does not get better when you are correctly applying the medication and frequently washing and drying the area, go to your doctor for a stronger medication. You may also need antibiotics to treat skin infections from strep or staph that are caused by scratching the area.

Scalp (tinea capitis) and beard ringworm (tinea barbae) require slightly different treatment. If you have tinea capitis, your doctor will prescribe you an oral medication that contains griseofulvin (Grifulvin V, Gris-Peg), terbinafine hydrochloride (Lamisil), or itraconazole (Sporanox ) which you should take for four to eight weeks. Your doctor will probably also prescribe you a medicated shampoo such as one that contains ketoconazole (Nizoral, Extina, Xolegel, Kuric) or selenium sulfide (Dandrex, Exsel, Selsun Blue). You should wash all towels every time they are used by an infected person. You should soak your combs and brushes for an hour per day in a mixture of half water and half bleach for three days.

If you have ring worm of the beard, apply a hot, moist compress to the area to help drain the affected follicles. Your doctor will likely prescribe antibiotics to be taken orally, e.g. dicloxacillin (Dycill or Dynapen) or applied to the skin, e.g. mupirocin (Bactroban).  An antifungal medication may be necessary too.

A number of natural remedies have anti-fungal properties, and can be effective ringworm treatments especially if the infection is in the early stages. The advantage is that these remedies do not have the same side effects. Some of the anti-fungal medications are carcinogenic. These natural remedies are often cheaper too. Tea Tree oil has antiseptic, antiviral, antibacterial and antifungal properties, and studies show it is effective against dermatophytes such as ringworm. It can applied to the skin, beard, feet, or scalp.  Aloe gel or cream have anti-fungal and anti-bacterial properties and can be applied to all forms of ringworm.

Ringworm - Prevention

Ringworm is difficult to prevent because it is caused by common and highly contagious fungi. However, there are a number of things that you can do to lower your risk, including showering after exercise, using clean towels, keeping your feet clean and dry, and washing them with soap after using a public pool. Don’t share towels, clothing, combs and brushes. If you encounter an animal or pet with fur or hair that’s missing, avoid touching or petting it because bald patches are classic signs of animal ringworm.

Ringworm - Conclusion

Ringworm is a skin infection that is causes by a fungus. While common and highly contagious it is also easily treatable, and should go away a few weeks after beginning your treatment program

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