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}

• 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

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 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

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}

• 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}

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}

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}

Canex T is an antifungal cream that works by stopping the fungus that causes the ringworm infection from growing. Packaged in an easy to use cream format, simply apply thinly to the affected area and the skin that surrounds it. Generally, treatment is about 3-4 weeks and an additional 2 weeks after symptoms have disappeared to prevent relapse. Always wash your hands before and after application. Talk to your doctor if your condition persists after 4 weeks of treatment or worsens at any stage.

Once your infection has cleared it is possible to get it again. So, make the necessary lifestyle changes by following the Prevention or stopping it from spreading guidelines and share them with your friends and family.