Ringworm – Medinformer

What is ringworm?

Ringworm belongs to a cluster of fungal skin infections known as tinea, which also include athlete’s foot, jock itch and onychomycosis (nail infection).^{2, 3}

Common types of tinea

Athlete’s foot, as the name suggests, occurs on the foot and is known as tinea pedis
Jock itch occurs on the groin and is known as tinea cruris
Nail infection is tinea of the toenails or finger nails and is known as tinea unguium
Ringworm of the scalp occurs on the head and is known as tinea capitas

Ringworm of the body is known as tinea corporis

What causes ringworm?

Not all fungi cause skin disease. Developing on the top layer of the skin, ringworm is caused by a type of skin fungi called dermathophytes.^4a,5a Skin fungi feed on surface keratin found in skin, nails and hair. ^5b Breeding in warm, moist environments ringworm is more likely to occur in tropical climates, gyms, locker rooms, public showers and swimming pools.^6a

Signs and symptoms

Signs and symptoms vary from person to person. Typically, ringworm begins as a scaly, sometimes slightly raised, red patch of skin, which can become itchy and, in some cases, may burn. The patch develops a border that expands outward forming a roughly circular ring. It may form blisters or begin to ooze.^1b
Scalp ringworm may begin as a small pimple-like sore that becomes patchy, scaly or has dandruff-like flakes. It can cause hair to fall out or break into a stubble, resulting in a tender, sometimes red, bald patch.^7a

Who is at risk?

Ringworm is a common skin condition that occurs in people of all ages but most common in children and adolescents and some people are more at risk than others.^{5c, 8a}
You are at higher risk if you:

Have health issues such as diabetes, obesity or a weakened immune system from a serious illness or long-term use of medication
Live in a warm climate
Live in close contact with other people (military barracks, boarding school)
Sweat heavily
Take part in contact sports such as rugby, American football or wrestling ^{4b, 6b, 7b, 8b}

Ringworm can spread through:

Direct human to human skin-to-skin contact with an infected person or if an infected person touches the infected area and then touches another part of their body
Direct animal to human skin-to-skin contact by touching an infected animal
Object / surface to human contact by touching a surface or object that an infected person or animal has touched or rubbed against recently (bedding, clothing, towels, razors, hair brushes)
Soil to human contact from touching infected soil (although this is rare and may occur if you have prolonged contact with infected soil)^{4d, 7c, 8d}

Diagnosis and treatment

While usually not serious, without treatment, the fungal infection can develop a more serious bacterial infection or spread to other parts of your body.⁹
Your doctor may diagnose ringworm simply by looking at it, making a diagnose based on location and appearance, particularly if it presents with the telltale circular markings typical of the condition. ^{5d, 10} However, other skin conditions such as psoriasis and certain types of eczema may look like ringworm so, your doctor may perform other tests such as taking a skin scraping for microscopic examination.
In most cases, over-the-counter antifungal creams will usually clear up the infection although scalp ringworm may require an antifungal shampoo.^8e If your condition does not clear up within 2 weeks or worsens, see a doctor or dermatologist for a thorough diagnosis and prescription-strength anti-fungal medication.^{4e, 11}

Prevention or stopping it from spreading

There are steps you can take to reduce your risk or and if you have it already, to stop it from spreading. This includes:

Washing your hands regularly with soap and water, especially after playing with pets
Keep common or shared areas clean (gyms, locker rooms, public showers and swimming pools)
Drying your skin thoroughly with a clean towel after swimming or showering
Showering as soon as possible after exercising or playing sport
Keeping cool and dry and reducing your chances of sweating heavily – for example, avoid thick clothing in warm weather
Change your clothes, particularly underwear and socks every day
Do not touch infected animals and regularly check for patches of skin with missing fur or patches with brittle or broken hairs – if you suspect your pet may have ringworm, take them to the vet
⦁ Do not share personal items (clothing, sports gear, towels, bed linen, razors, hair brushes)
⦁ Wash your clothes, linen and towels in hot water at 140F (60C) ^{1c, 4f, 8f}

Medical References

⦁ Healthline. Ringworm. Available at: https://www.healthline.com/health/ringworm. Accessed 23 April 2019. ⦁ Johns Hopkins All Children’s Hospital. Athlete’s Foot. Available at: https://www.hopkinsallchildrens.org/Patients-Families/Health-Library/HealthDocNew/Athlete-s-Foot?id=2102. Accessed 23 April 2019. ⦁ Better Health Channel. Tinea. Available at: https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/tinea. Accessed 23 April 2019. ⦁ Mayo Clinic. Ringworm (body). Available at: https://www.mayoclinic.org/diseases-conditions/ringworm-body/symptoms-causes/syc-20353780. Accessed 23 April 2019. ⦁ MedicineNet. Ringworm. Available at: https://www.medicinenet.com/ringworm/article.htm. Accessed 23 April 2019. ⦁ Centers for Disease Control and Prevention. Available at: https://www.cdc.gov/fungal/diseases/ringworm/risk-prevention.html. Accessed 23 April 2019. ⦁ Kids Health. Ringworm. Available at: https://kidshealth.org/en/parents/fungal-ringworm.html. Accessed 23 April 2019. ⦁ American Academy of Dermatology. Ringworm. Available at: https://www.aad.org/public/diseases/contagious-skin-diseases/ringworm. Accessed 23 April 2019. ⦁ Michigan Medicine. Ringworm of the Skin. Available at: https://www.uofmhealth.org/health-library/hw65253. Accessed 23 April 2019. ⦁ Healthline. Learn the Signs: Is it Nummular Eczema or Ringworm? Available at: https://www.healthline.com/health/nummular-eczema-vs-ringworm ⦁ Medline Plus. Fungal Culture Test. Available at: https://medlineplus.gov/lab-tests/fungal-culture-test/. Accessed 23 April 2019.

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