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Ringworm: Treatment and Prevention

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Ringworm is one of the most common skin problems. Ironically it has little to do with rings and nothing to do with worms. The circular spreading rash, a common presentation, led to the antiquated idea that it had something to do with a parasite (which it does not).

The medical term which refers to a lot of common fungal skin infections is tinea derived from Latin for worm or larvae. Obviously that hasn’t done much except add to the confusion. The origin of this condition is a group of microscopic fungi that that invade the skin causing a variety of rashes. These rashes are not always circular. They are easy to recognize when they are by the expanding red ring with clearing in the middle. However, the rash can vary from small red bumps, splotches or patches accompanied by flaking scaling and more often than not itching. Although it prefers and flourishes in warm, moist areas of the body, it can occur on any area of the skin.

It can most commonly be found on the feet, groin, armpit, and under breasts where it tends to be warm and moist. It can also occur in somewhat open dry areas like the face, scalp, extremities and torso. The classic circular lesion tends to grow and expand
while the central area of redness appears to clear. It usually is associated with intense burning or itching. Scratching too much can create and secondary bacterial infection.

There are other conditions that mimic this, but a ring-like lesion is fairly characteristic of a fungal infection. If the lesion occurs in the scalp, hair loss in the center of the area is characteristic. In the area of a man’s beard, the hair may also break off and possibly develop a crusted area while retaining the overall circular appearance. We have come to understand that some scalp dandruff is actually another type of low grade fungal infection that causes the chronic flaking. Most people are familiar with athlete’s foot, which is merely fungal infection in a typically warm moist area. It usually results in breakdown of the skin with cracking, flaking, redness, itching and some times small blisters. In some parts of the skin it will appear as a broad, red itching splotch without cracks, or any circular shape. Fungal infection of the nail turns it yellow to dark
brown in color, thickened and can create deformity of the nail contours. So ringworm is common, but there are many different appearances to fungal skin infections.

Fungal infections — generally known as dermatophytes — are highly contagious and can be spread multiple ways. However it does require direct contact with an infected person, animal, object or even soil. They do thrive in warm moist areas, but can establish
a presence on any body part.

Diagnosis is usually by the characteristic appearance. However, a health care provider may do a painless scraping of infected skin for viewing under a microscope or culture in the lab. There are several antifungal products available as topical creams at the pharmacy without a prescription. Clotrimazole (Lotrimin), miconazole (Monistat-Derm), ketoconazole (Nizoral) and terbinafine (Lamisil) are a few of the broader spectrum choices. These can be very effective with proper use. For more severe cases, oral Lamisil tablets or another drug may be necessary by prescription to clear the condition completely. Over-the-counter products are not effective against fungal involvement of the nails.

Preventing fungal infections entirely is a challenge, but a thoughtful common sense approach can minimize your risk.

1. Don't share clothing, sports gear, towels, or sheets.

2. Wear slippers in locker rooms and public pool & bathing areas.

3. Shower after any sport that includes skin-to-skin contact.

4. Wear loose-fitting cotton clothing.

5. Change your socks and underwear at least once a day.

6. Keep skin clean and dry. Dry yourself completely after showering.

7. Take your pet to the vet if it has a rash or patches of missing hair. It could be a sign of a fungal infection.

With little effort and expense, being a good observer will keep you out of trouble. Should you develop a rash, consult someone early to be sure what you have. Early recognition and treatment can be easy and even inexpensive.

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About Bruce Kaler M.D.

  • jav

    its easy to understand.