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Ringworm: what is it, what does it look like and how is it treated?

Image source: University of Arkansas

 

Ringworm isn’t a worm despite its name, it is a fungus and acquired its name because of the circular-shaped lesions which appear on the skin look and which resemble worms arranged in the shape of a ring. The clinical name for ringworm is Dermatophytosis.  Sometimes ringworm is called, Tinea, which is just a general description followed by the part of the body where the ringworm infection is located, for example, Tinea Corporis, ringworm of the body or Tina Capitis – scalp ringworm.

Ringworm is caused by three different types of fungi:

  • Trichophyton
  • Microsporum
  • Epidermophyton

These fungi live in the soil which is one way of catching ringworm but more commonly it is passed by other infected humans or by animals who can also contract ringworm when they are outside.

What are the signs and symptoms of ringworm?

Ringworm usually appears as red patches to start with – they can be itchy or scaly and have raised areas which are called plaques. The infection can take a couple of weeks to manifest itself and will begin with irritated red areas of skin which can easily be dismissed as something else.

Pityriais rosea - a picture of ringworm

What does Ringwork look like? (image source: NHS)

As the infection progresses, the patches will start to develop a more intense redness on the outside resembling a ring and these edges can sometimes feel raised.  Blisters and pustules may also emerge but not always.  Symptoms can vary depending on where on your body the ringworm is located:-

  • Scalp ringworm – this can begin with just increased scale before patches develop which are itchy
  • Athlete’s foot – this is ringworm between the toes, it can be intensely itchy and develop sore red areas and lesions
  • Jock itch – this is ringworm on the inner thighs and groin area of males and is characterized by redness, itching, and soreness

Ringworm is confirmed on its signs and symptoms but if there is any doubt about the diagnosis, a skin scrape can be sent to the lab by your doctor to confirm the presence of fungus.  Ringworm can sometimes look like eczema and some types of psoriasis so it can be easy to confuse the two in the early stages.

Treatment for ringworm

Treatment depends on where the ringworm has manifested itself.  Athlete’s foot and Jock itch can be treated simply by the application of topical anti-fungal products like creams and sprays to kill the fungus.  Lifestyle changes can also help prevent the infection from spreading to other members of the household as Athlete’s foot is notoriously easy to share.  Stubborn outbreaks can also be treated with prescription based oral medication.

Lifestyle measures are probably just as important if not more important than over the counter or prescription treatments otherwise the incidence of reinfection is almost unavoidable.

lotriminAF treatment for ringworm

LotriminAF – treatment for ringworm containing clotrimazole

  • Over-the-counter (OTC) medications and antifungal skin creams may be recommended for use inlcuding clotrimazole, miconazole, terbinafine, or other related ingredients.
  • If you have Athlete’s foot then only ever wear clean socks and change them regularly during the day if your feet become hot and sweaty – the fungus thrives in moist, dark conditions. For Tinea Corporis, clothing and bedding need daily washing and this is far more of a chore.  Anything that comes into contact with your body can harbor the fungus so this means stripping bed linen every morning and washing it and only wearing clothes once before they are machine washed
  • Make sure your skin is always thoroughly dry after the bath or shower – residual moisture which is then trapped by clothing or bed sheets will encourage the fungus to thrive. Prolonged exposure to water such as excessive showering or bathing will soften the skin and may it more vulnerable to fungal infection. Regular swimming is another trigger compounded by the heightened risk of infection at public swimming baths and health spas
  • Try and wear loose clothing in breathable fabrics over the areas of skin which are infected as this promotes an environment which the fungus dislikes
  • Don’t share clothing, towels or hairbrushes with other people
  • If you have pets, clean and disinfect their living area and bedding regularly
  • Wash your hands after you touch them
  • Always wear shoes in public swimming areas or showers at the spa

Ringworm is stubbornly persistent so treatments have to be thorough and rigorous otherwise it can be hard to eliminate the infection.

Homemade remedies for ringworm

Home remedies are popular to help kill the fungus and some people prefer them over chemical-based anti-fungal products.  You can try:-

  • Apple cider vinegar – soak cotton wool balls in apple cider vinegar and use them to saturate the affected areas of skin
  • Coconut oil – coconut oil is one of several essential oils with anti-fungal properties – it is a particularly lovely scalp treatment as it brings a shine to the hair and smells really fragrant, a good way of masking the presence of anti-fungal creams and sprays. Tea tree oil is another favorite. Always mix essential oils in a base or carrier oil of which coconut oil is one such and olive oil or Jojoba oil another. They are too strong to be applied undiluted to human skin
  • Turmeric – the curry spice you have bound to have in your kitchen cupboard, this can be made into an orange paste and applied to the skin. Beware, it will stain skin and clothing with a yellow/orange color which is really hard to remove

Home remedies can complement a pharmaceutical-based treatment regime. Ringworm needs prompt management because it is horribly contagious and if you don’t get on top of it quickly then you risk spreading it to other parts of your body as well as other members of the household.  You can catch ringworm from your pets and its presence is easy to spot as their hair will fall out leaving bald patches in a telltale circle. The patches will become crusty or scaly and may be itchy.

Untreated ringworm or ringworm which is not effectively managed can cause other problems such as permanent hair loss from scalp ringworm, nail deformities and in severe cases, scarring of the skin. Ringworm can usually be cleared up within two to four weeks of its first appearance but only if treatment protocols are rigorously adhered to. Speak to a medical professional if you are unsure.

References / Further Reading

Ringworm (CDC) – https://www.cdc.gov/fungal/diseases/ringworm/index.html

Ringworm (MedlinePlus) – https://medlineplus.gov/ency/article/001439.htm