Ringworm, also called as dermatophyte infection, dermatophytosis, or tinea, is a skin infection caused by a fungus.
The word ‘ringworm’ is misleading because the infection is a result of a fungus instead of a worm. This infection causes a lesion that looks like a worm (ring-shaped), hence the name.
Ringworm is typically used to refer to tinea corporis (ringworm infection of the body). The names of ringworm infections vary depending on where the infection occurs.
Ringworm can infect both animals and humans. On affected areas, the early ringworm first appears as discoloured, often scaly patches or spots. These spots are usually red on fair skin and brown on darker complexions.
Signs and symptoms of ringworm
The precise symptoms of ringworm disease are determined by the site of infection. They usually consist of:
- Itchy skin
- Scaly, cracked, or red skin
- Circular (ring-shaped) rash
- loss of hair at the affected area
Ringworm infection symptoms can vary depending on the region of the body that is affected.
- Feet
Athlete’s foot, also known as tinea pedis, is a type of ringworm infection that affects the feet. It is common in people who walk around barefoot in public places where the infection has a higher chance of spreading, such as showers, locker rooms, and swimming pools.
This begins as scaly, dry, swollen skin between the toes and can spread to the sole and heel. Its symptoms include:
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- Itchy skin
- Scaly, cracked, or red skin
- Circular (ring-shaped) rash
- loss of hair at the affected area
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- Face
Tinea faciei (facial tinea) usually appears on the cheeks, presents as itchy, scaly, plaques. Occasionally, pustules and crusting can be observed. - Hands
Ringworm of the hand, also known as tinea manuum, is generally triggered by touching another infected area, including the foot or groin. Infection of the hand can manifest as deep cracks with dry skin that may appear on the palms, and circular (ring-shaped) patches may show up on the backside of the hand. - Groin
Tinea cruris, also known as jock itch, is a ringworm infection that affects the skin near the genital area (groin), buttocks, and inner thighs. It is most prevalent in men and teen boys.
This typically begins as a red, grey, or brown itchy rash where the leg meets the body. Itching may worsen post-workout and may not improve despite the use of anti-itch cream. - Beard
Ringworm of the beard, also known as tinea barbae, affects the chin, cheeks, and upper neck, causing bald patches and could appear as folliculitis, acne, or itchy, scaly, red spots. If these spots become crusty and filled with pus, loss of hair at the affected area may occur. Some people report fatigue and swollen lymph nodes. - Scalp
Ringworm of the scalp, also known as tinea capitis, frequently begins as isolated scales in the scalp and progresses to scaly, itchy, bald patches. It is most prevalent in children. Hair may break or fall out around the affected area, and bald patches may form. - Nails: Onychomycosis, also known as tinea unguium, is a nail ringworm infection that primarily affects the toenails because footwear frequently provides a warm, moist environment that favours fungi growth.
Affected nails may thicken and become abnormal in shape and colour, and they may affect one or more nails. They may even break or lift away from the nail bed. Onychomycosis is frequently seen in individuals who have had athlete’s foot for a long time.
- Body
The term ‘ringworm’ most commonly refers to tinea corporis (body ringworm). This form frequently manifests as patches with the distinctive circular ring-shaped pattern on the torso or limbs, though it can appear on any part of the body.
Causes of Ringworm
Ringworm is caused by approximately 40 unique species of fungi in the Microsporum, Trichophyton, and Epidermophyton genera.
Ringworm is contagious even before the symptoms of the infection appear.
The ringworm disease is a result of mould-like fungi known as dermatophytes. Dermatophytes, similar to other varieties of fungi, grow in warm, moist environments. Ringworm can be contracted by:
- Direct skin-to-skin contact with infected people’s affected areas of the body.
- Touching fungi-infested items, including garments, pool surfaces, combs, and shower floors.
- Playing with dogs and cats, particularly puppies and kittens, that are carriers of ringworm. Touching infected animals, including goats, cows, horses, and pigs, can also cause an infection. An animal’s infection may appear as a patchy or scaly area of fur, but the signs are not always visible. If individuals suspect their pet has an infection, take it to the veterinarian right away.
Risk factors of ringworm
Any of the following can increase the chances of getting ringworm:
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- Having sweaty skin for an extended period of time (this may be due to excessive sweating)
- Skin or nail injuries
- Not showering or shampooing hair regularly
- Having close contact with other individuals or animals
- Taking part in contact sports like wrestling
- Residing in or spending more time in a tropical, hot, and humid climate
- Sharing clothes, towels, razors, and other products without decontaminating or washing them
- Wearing tight-fitting outfits chafes your skin
- Moreover, those who are overweight, have diabetes, and have a compromised immune system are at a high risk of contracting ringworm infection.
- reover, those who are overweight, have diabetes, and have a compromised immune system are at a high risk of contracting ringworm infection.
Diagnosis of the ringworm fungal disease
A healthcare provider may be able to tell if one has ringworm simply by looking at it. They may also collect scrapings from the area affected.
Ringworm can be difficult to diagnose because it frequently resembles other conditions. For instance, tinea corporis may be mistaken for psoriasis, seborrheic dermatitis, or eczema; tinea capitis may be mistaken for alopecia areata; and toenail ringworm may resemble dystrophic toenails (changes in composition and texture) caused by trauma to the nails. A fungal culture can be used to confirm a ringworm diagnosis.
Treatment of ringworm
Some ringworms can be treated with over-the-counter (OTC) medications, but others require antifungal prescriptions.
Options for Medications
The site of the infection is critical in determining the treatment of ringworm. OTC antifungal lotions, creams, lotions, or powders for tinea pedis and tinea cruris include:
- Clotrimazole
- Miconazole
- Terbinafine
- Terbinafine
Prescription medications that can be used to treat scalp ringworm include:
- Griseofulvin
- Itraconazole
- Fluconazole
- Terbinafine
Prevention from Ringworm
Ringworm can be difficult to prevent, but there are a few simple steps an individual can take to lower their risk or prevent the spread of infection to other parts of the body or to other people.
- Personal items, including towels, clothing, hairbrushes, and sports equipment, should not be shared.
- If individuals live in a hot, humid climate, avoid wearing thick clothes and shoes for prolonged periods of time.
- Avoid excessive sweating.
- Hands should be washed frequently and thoroughly.
- Shower immediately after participating in sports and keep the uniform and equipment clean.
- Avoid infected animals, and have the animals or pets checked for ringworm.
- Change clothes every day, including the underwear and socks, and wash them before wearing them again.
- Shower after working out.
When to consult a doctor?
See a physician if a ringworm has appeared on the skin and have already used an OTC antifungal medicine for two weeks with no improvement. The doctor may be able to write a prescription for something stronger.
OTC treatments will not work if the infection is on the scalp. Make an appointment with the doctor in order to receive a prescription medicine that can be taken orally.
There are several conditions that resemble scalp tinea but are not. See a physician if there is a scaly, itchy scalp and associated with hair loss. They will figure out what is causing it and determine the most effective treatment for it.
Complications in Ringworm
Fungal infections rarely spread below the skin’s surface; they are less likely to result in serious illness. However, if left untreated, ringworm can end up causing the fungus to progress into deeper layers of the skin. This rash, known as Majocchi’s granuloma, is characterised by elevated bumps and pustules and is difficult to treat.
Ringworm can be difficult to treat in people with compromised immune systems, such as those with HIV/AIDS.
