Did you know ‘ringworm’ is not caused by a worm but is actually a fungal infection? Surprised? Let us take a closer look at one of the most common fungal infections: ringworm.
What is ringworm?
Basically, ringworm is a common skin infection caused by a fungus, which mostly thrives in warm and moist areas, such as moist surfaces, the skin, and household items like garments, towels, and bedding. It is a contagious infection that can spread through contact and has derived its name ‘ringworm’ because it results in itchy, red, circular (ring-shaped) rashes. Anyone can be affected by this infection, and the infection can arise on the neck, trunk of the body (torso), arms, groin, armpits, or legs.
Ringworm is known by many different names. The medical term for this condition is ‘tinea corporis’, where tinea means fungus, and corporis refers to the body. Ringworm is also known by other names depending on where it is found on the body; for instance, ringworm on the scalp is also known as ‘tinea capitis’.
How does ringworm appear?
Ringworm typically appears as a flat, discoloured patch that can be red in people with fair skin or brown in people with darker skin tones. The patch is ring-shaped or circular, with a scaly, raised, border.
Who is prone to ringworm?
The ringworm disease can affect people of any age. One is highly prone to contract ringworm if they:
- have a compromised immune system or suffer from an autoimmune disorder such as lupus,
- engage in high-contact sports, for instance, wrestling (this type of ringworm fungal
- infection is known as tinea gladiatorum),
- have excessive sweating (hyperhidrosis),
- make use of public showers or common locker rooms,
- are closely associated with animals that may have ringworm.
Symptoms of Ringworm
The following symptoms typically appear between 4 and 14 days after the skin is exposed to the fungi causing ringworm:
- Ring-shaped (circular) scales or plaques
- Patches with an elevated, round border
- Itchy skin
- Bald spots or loss of hair in the area affected
How communicable is ringworm?
Ringworm is contagious. It can live on the skin, on surfaces, and in soil. A ringworm infection can be transmitted in a variety of ways, both direct and indirect, including:
- From one person to another
This occurs when someone comes into close contact with the skin of a ringworm patient.
- From animal to human
This occurs as a result of contact with a ringworm-infected animal. Cats and dogs can both transmit the infection to humans. Ringworm can also be transmitted to humans by horses, ferrets, pigs, rabbits, and goats.
- Inanimate object to human
Ringworm can be contracted via indirect contact with items such as ringworm-infected hair, clothing, bedding, shower stalls, and shower stall floors.
- From soil to person
In rare cases, ringworm infection can be transmitted through prolonged contact with infected soil.
How is ringworm diagnosed?
If a doctor suspects a ringworm infection, they will examine the skin and may run some tests.
Ringworm will be diagnosed by the doctor after examining the affected area of the skin by using a black light. It may fluoresce (glow) under the black light, based on the type of fungus.
A doctor may use the following approaches to confirm a ringworm diagnosis:
- In the case of a skin biopsy or a fungal culture, the doctor will collect a sample of the skin or blister discharge and send it to a laboratory to be tested for the fungus presence.
- A KOH exam involves the doctor scraping a small region of an infected area onto a slide and adding some drops of potassium hydroxide (KOH) to it. The KOH dissolves normal skin cells, allowing the fungus to grow.
Treatment for ringworm
The treatment of ringworm depends on where the infection is, and how severe it is. In many cases, the doctor may advise taking an over-the-counter (OTC) medication available at the local pharmacy. If the ringworm infection is on the skin, an OTC antifungal lotion, cream, or powder may suffice. Clotrimazole, terbinafine, and miconazole are three of the most commonly used OTC medications.
In most cases, one needs to apply the medications to the skin for approximately 2 to 4 weeks to ensure that the fungus that caused ringworm is killed. In this way, the chances of the infection recurring also reduce.
OTC treatments are unlikely to be effective if the ringworm occurs on the scalp or at multiple locations on the body. The doctor will write a prescription for it.
Maintain a close eye for symptoms that worsen or do not resolve within 2 weeks. If they do not, contact a health care provider right away.
Modifications to one’s lifestyle
In addition to over-the-counter and prescription medications, the doctor may advise managing the ringworm infection at home by asking the patient to:
- Wash bedding and clothing on a daily basis to help keep their surroundings clean,
- Thoroughly dry the skin after bathing,
- Wear loose fitting clothes in affected areas,
- Treat all affected skin areas, as not treating them will result in a recurrence.
Complications from ringworm
Ringworm can extend to the other parts of the body if it is not treated. This will also increase the risk of infecting others. Other potential complications of the condition are:
- Hair loss and scarring dark marks on one’s skin, particularly if the patient has dark skin,
- Deformities of the nails,
- Secondary infections due to bacteria entering the broken skin, which is common in children,
- Majocchi’s granuloma (a rare infection in which the fungus has spread to the deeper than normal layers of the skin).
How can ringworm be avoided?
Ringworm thrives in moist, warm environments. For months, the fungus can survive on towels, clothes, sheets, and household surfaces. Ringworm prevention entails the following steps:
- The socks and underwear must be changed on a daily basis, or more often if they become soiled or damp.
- One must shower immediately after participating in contact sports or exercising.
- At public locker rooms, pools, and showers, you should wear sandals or shower shoes.
- After showering, you must thoroughly drying the skin, particularly between the toes.
- Washcloths, towels, sheets, combs, garments, and other private hygiene items should not be shared.
- Hot water and detergent should be used to wash clothes, athletic gear, sheets, and towels.
- Surface disinfection with disinfectants (e.g., Lysol) or bleach must be used for cleaning.
- After coming into contact with animals, hands must be washed thoroughly.
- A compromised immune system or residing in a warm, humid climate raises the risk of contracting a fungal infection.
Home remedies for ringworm
While there are many medications available for treating ringworm, natural remedies can be effective to some extent. However, the majority of the evidence for using these remedies is anecdotal.
The following are some home remedies for ringworm:
- Tea tree oil
- Coconut oil
- Soap and water
- Essential oils
- Apple cider vinegar
- Aloe vera
- Lemongrass oil
- Powdered liquorice
Home remedies should not replace prescribed antifungal medications. Instead, talk to a physician about any of the remedies you would like to try in addition to the proven treatments.
When to see a doctor?
If the symptoms do not improve or do not respond to therapy within 2 weeks, see a physician. One should also see a doctor if they work in a position where they could potentially transmit it to others, for instance a teacher.
In some cases, ringworm may not respond to alternative therapies or over-the-counter medications. A doctor will issue a prescription for either a topical or oral antifungal medication.
Ringworm is a fungus-induced skin infection. It can occur on any part of the body, including the toes and fingernails.
It typically manifests as a (circular) ring-shaped rash with red, scaly, or itchy skin. Loss of hair in the area affected is also possible.
Ringworm can be transmitted through direct contact with an infected individual, from infected animal to person, or by touching objects that have previously been touched by someone infected.
Ringworm can be avoided by avoiding contact with infected people and not sharing hats, bedding, towels, or other products with them. One can also prevent it by thoroughly drying themselves off after taking a shower.
Ringworm can be treated with over-the-counter topical fungicidal medications. Visit a doctor if there is a suspect of having ringworm.