The term ‘ringworm’ is misleading. It is not a worm and is not always shaped like a ring. Ringworm is a fungal skin infection, also known as tinea. It is usually temporary but can sometimes persist and spread. Ringworm (antifungal) medicines are the preferred treatment for clearing up infections ranging from mild to severe.
Let us dive into the details of ringworm disease, ringworm treatment medications, and its side effects.
What is ringworm?
Ringworm is a fungus that targets the hair, skin, and nails. It is caused by dermatophytes, fungi that thrive in moist and warm environments. Ringworm is highly contagious and can be spread through direct contact with an infected person, animal, or object. It can also be contracted through contaminated soil or gym equipment.
Symptoms of Ringworm
The symptoms of ringworm vary depending on the location of the infection. Ringworm of the body, also known as tinea corporis, appears as a red, scaly rash that can be itchy and make one feel uncomfortable. The rash may also have raised, circular borders and a clear centre, giving it the characteristic ‘ring’ appearance. Ringworm of the scalp, or tinea capitis, causes hair loss, scaly patches on the scalp, and itching. Tinea unguium, or ringworm of the nails, causes thickening, discoloration, and separation of the nails.
How is ringworm diagnosed?
The diagnosis of ringworm is typically done through a physical examination and may also involve taking a sample of the affected area for laboratory analysis. The sample can be examined under a microscope to identify the type of fungus causing the infection.
What are the treatment options for ringworm infection?
When dealing with ringworm, the first line of treatment is typically antifungal medications. The type of medication used and the duration of treatment will depend on the location and severity of the infection. Additionally, lifestyle changes will aid in clearing the infection and preventing future infections.
Topical antifungal medicines are sufficient to resolve limited or localised infections in a couple of weeks. Oral (systemic) antifungals will be prescribed for approximately four to eight weeks to treat severe or persistent infections. The ringworm treatment with medicines has an excellent outcome. Most tinea infections can be treated in 2 to 4 weeks. Tinea infections, on the other hand, can last for months if left untreated.
Drug treatment does not entirely remove dermatophyte spores from the body, and they can survive on the skin for an extended period, causing future ringworm outbreaks.
Lifestyle changes are recommended to both prevent and treat re-infection. These changes may include:
- Wearing loose clothing
- Avoiding scratching the affected area
- Washing the body and hair on a regular basis to keep the infection from spreading to other areas of the body
- Drying the skin completely when it is wet
Medication for Ringworm
Depending on the nature and location of the infection, ringworm will be primarily treated using topical or oral antifungals. Treatment for localised infections is typically initiated with topical antifungals. Oral antifungals will only be used for more severe or persistent infections. Tinea capitis (ringworm of the scalp) is a particularly tough fungal infection, and systemic antifungals are frequently used as first-line therapy.
In some cases, a combination of topical and oral antifungal medications may be used for more severe or widespread infections. In addition, people with weakened immune systems, such as those with HIV/AIDS or diabetes, may need long courses of treatment to clear the infection effectively.
It is important to note that while these medications are effective in treating ringworm, they will only work if one sticks to the instructions and treatment period as prescribed by the doctor. It is also important to finish the course of medication, even if symptoms have improved, to prevent the fungus from returning.
In most cases, ringworm can be effectively treated with over-the-counter antifungals applied topically (also known as ringworm medicine cream in layperson’s terms). The medicine for ringworm for the skin application can be available as a lotion, ointment, cream, foam, spray, or shampoo. Clotrimazole, terbinafine, and miconazole are among such medicines; however, a physician may recommend prescription antifungals if needed. Antifungal medicines work by killing the fungus while interrupting its ability to make cell walls.
Systemically administered antifungals
Ringworm treatment medicines taken orally are significantly more effective against ringworm infection but have more side effects. As a result, they are only used when topical antifungals fail or if the infection is severe. It may require several weeks of systemic antifungal therapy to clear a stubborn infection. Terbinafine, itraconazole, griseofulvin, and fluconazole are all prescription-only systemic antifungals. These drugs, like topical antifungals, kill fungus cells (except for griseofulvin).
Patients suffering from scalp ringworm are frequently given a selenium sulphide shampoo in combination with systemic antifungals, as scalp ringworm is an infection that is particularly difficult to treat. Selenium sulphide is a ‘cytostatic’ agent (rather than an antifungal), which means it inhibits the growth of skin or fungal cells.
Common ringworm side effects
Ringworm is usually treated with antifungal medications, either topical or systemic (oral). Because topical antifungals are only applied to the skin, they have few and minor side effects. Systemic antifungals may have more side effects.
Antifungals applied topically
Topical antifungals usually have few and minor side effects. When applied to the affected skin, most people experience site reactions such as itching, skin irritation, burning, or stinging. Allergic skin reactions are among the most serious but rare side effects and can necessitate hospitalisation.
Antifungals with systemic action
Systemic antifungals are associated with considerably frequent and severe adverse effects as compared with topical antifungals. Headache, abdominal pain, diarrhoea, and indigestion are the most common side effects of the systemic antifungals. The severity of the side effects is determined by the type of the antifungal medicine used. Griseofulvin and ketoconazole, for example, can cause liver damage. Terbinafine can result in a lupus-like skin reaction; therefore, it is recommended not to give it to patients who already suffer from lupus. All systemic antifungals have the potential to cause severe, even fatal, allergic skin reactions.
Selenium sulphide is a relatively safe medication with only minor side effects. Skin irritation and burning are the most common side effects of this medicine, but it can also cause minor hair loss or hair discoloration.
Home remedies for ringworm
Antifungal medications are used to treat ringworm. Most cases of ringworm can be cleared up with over-the-counter topical antifungals in a few weeks. Other home remedies, when combined with antifungal medications, can help accelerate recovery and prevent the spread of infection.
Remember that ringworm is infectious. It is spread through direct contact with the skin or with surfaces or objects such as clothes, towels, sheets, floors, or hairbrushes. Furthermore, a ringworm infection can spread to other parts of the body or cause re-infection from previously infected surfaces or objects. Therefore, good hygiene practises are important to help prevent the spread of the infection and speed up the healing process. These include washing hands frequently, keeping the skin clean and dry, and not sharing personal items, like towels or combs, with others. One should also avoid scratching the affected area, as this can cause the infection to spread and make symptoms worse.
It is also a good idea to avoid wearing tight or synthetic clothing, which may trap moisture and create an environment conducive for the fungus to grow. Wearing loose cotton clothing and keeping the affected area dry is the key to successful healing.