Not to be confused with roundworm (a parasite that can live in the intestines and causes diarrhea and fever), ringworm is a highly contagious fungal infection that is more common in children rather than adults.
Nearly half of ringworm cases in the U.S. occur in children under 15 years old with males being far more susceptible than females.
If you come into direct contact with an infected person or animal or touch a contaminated surface, you may contract ringworm.
Ringworm gets its name from the circular ring-like shape the rash causes.
Tell-tale signs of a ringworm infection include red, itchy, scaly skin, and in some areas, hair loss.
Fortunately, ringworm is rarely fatal unless left untreated. It can be diagnosed, treated, and prevented with the right care.
In this article, I will discuss the symptoms of ringworm and what causes it.
I’ll also go over how to prevent it and when to see a doctor.
Once you have come into contact with the fungi that cause ringworm, it is soon after that symptoms typically manifest.
The incubation period can be anywhere between 4-14 days depending on the location of the body that is affected.
In most cases, symptoms of ringworm on the skin generally appear faster than symptoms on the scalp.
The following are common symptoms of ringworm:
- Red, scaly, cracked, itchy skin anywhere on the body
- A clear or scaly ring-shaped rash
- Red bumps on the skin
- Slightly raised, expanding rings
- Hair loss
- Discolored, thick, or brittle fingernails or toenails
Ringworm can affect any part of the body including your fingernails and toenails.
Symptoms will vary depending on which part of the body has become infected:
- Body (tinea corporis): If ringworm appears on your body, it is usually an itchy, circular rash with clearer skin in the middle.
- Beard (tinea barbae): If you have facial hair, it may be easy to spot ringworm that affects your face. You may notice itchy, scaly, red spots on the cheeks, chin, beard, and upper neck. These spots might crust over or fill with pus. Hair loss is also a likely symptom of tinea barbae.
- Feet (tinea pedis): Also known as “athlete’s foot,” ringworm on the feet manifests as red, swollen, itchy skin between the toes, particularly the pinky toe. The skin may be scaly to touch, and in more severe cases, blisters may form on your feet.
- Groin (tinea cruris): Ringworm of the groin is also referred to as “jock itch” and presents itself as scaly, itchy, red spots that typically appear in the skin folds of your thigh.
- Scalp (tinea capitis): Red, itchy, scaly, circular bald spots on the scalp are tell-tale signs of ringworm. The bald spot may grow in size or more may emerge accompanied by hair loss or brittle hairs at the infected site. Ringworm on the scalp is typically more common in children than adults.
- Nails (onychomycosis, also called tinea unguium): Ringworm can affect the toenails (and in some cases, the fingernails) due to footwear that provides a warm, moist environment for the fungi to grow. Tell-tale symptoms include thicker or discolored nails that may even begin to crack or lift away from your nail bed.
Ringworm is caused by mold-like parasites that live on the dead tissues of your skin and can be spread in various ways, typically through other humans, animals, and the environment.
- Humans: Humans can spread the fungal infection by having direct skin-to-skin contact with an infected person.
- Animals: Animals, especially pets, can be likely carriers of ringworm. Touching an animal with ringworm, especially kittens and puppies, can cause you to contract the infection. You can also get ringworm from other animals including cattle, goats, rabbits, and birds. A tell-tale sign that an animal has ringworm is that they may have hairless, circular, or irregularly shaped patches of scaling, redness, or crusting. You may notice them scratching these areas too. Be sure to always wash your hands with warm, soapy water after coming into contact with an animal you suspect has ringworm. If you have just adopted a new pet, organize a vet checkup to ensure they are clear of the infection.
- Objects: Ringworm can live on various fabrics and surfaces and can be easily transferred through direct skin contact. It’s important to wash and dry all bedding, towels, clothing, and other fabrics thoroughly and regularly disinfect surfaces.
- The environment: While it is rare, ringworm can be transferred to humans through contact with infected soil. However, this would typically require prolonged exposure for the infection to occur.
Stages of Ringworm
Since there is an incubation period with ringworm infection, you won’t know you have it as soon as you contract it.
Ringworm emerges in stages from the initial contact:
- Day one: This is the period of exposure when you make first contact with an infected person, animal, or object.
- Day two to ten: This is referred to as the incubation period, the period before symptoms emerge and when the fungus spores colonize the skin. For tinea corporis, the incubation period usually lasts about 4-10 days.
- Symptoms period: This is the time when symptoms emerge and will remain until treated. For tinea corporis, symptoms usually appear about 4-10 days after exposure.
- Day two to five after treatment: Healing typically begins in this period with the aid of antifungal creams. During this time, you will be less contagious.
- Beyond 14 days: You will notice your skin slowly repairing, and symptoms will become more manageable.
Because ringworm is so contagious, it is best to start treatment at the first signs of symptoms to avoid the infection from spreading on your body and to others.
Is Ringworm Contagious?
Ringworm is a highly contagious fungal infection and it can be transmitted from one person to another for as long as the fungus spores stay alive.
Fungal spores can live up to 12-20 months on a person or animal.
This is why it is imperative to disinfect any objects that an infected person or animal comes into contact with including bedding, towels, couch cushions, sports gear, and clothing.
With the right treatment, ringworm can disappear after four weeks of treatment making a person not contagious anymore.
While anyone can get ringworm, those with a weakened immune system such as those with HIV/AIDS may struggle to get rid of the infection.
There are a few other risk factors that can increase your chances of contracting the infection.
- Living in a warm, humid climate
- Using public showers or locker rooms, especially being barefoot in these areas
- Participating in contact sports
- Being in close contact with animals
- Sharing personal items with a person who may have ringworm
- Sweating excessively or wearing heavy clothing that causes you to sweat
- Wearing tight shoes or clothes that chafe your skin
- Having diabetes
- Being overweight
If you suspect you have ringworm, visit your healthcare provider.
Your doctor will usually diagnose ringworm by first doing a physical examination of your skin.
They may use a black light to view the affected area; depending on the type of fungus, ringworm infection may fluoresce under black light.
In some cases, where further confirmation is needed, your doctor may do a skin biopsy or fungal culture.
This involves taking a sample of your skin or discharge from a blister and sending it to a lab to test for the presence of fungus.
It is important to treat ringworm to prevent the infection from spreading to other areas of your body or to other people. If left untreated, potential complications include:
- Skin scarring including dark marks left on the skin
- Hair loss
- Nail deformities
- Secondary infection due to bacteria entering broken skin
To avoid long-term health complications that can arise from ringworm, seek treatment as soon as possible.
Because ringworm is highly contagious, it is important that you regularly disinfect your environment.
The fungal spores can live on objects such as bedding, towels, couch cushions, and other surfaces.
Consider the following prevention methods:
- If you have a weakened immune system, limit your contact with people and animals.
- Keep your skin clean and dry.
- Dry your feet thoroughly after you shower.
- Avoid touching the ringworm lesion.
- Wash your hands thoroughly after treating the lesion with topical ointments.
- Wear open-toed shoes that allow your feet to breathe and stay dry.
- Avoid walking barefoot on surfaces that are wet or may be infected such as public restrooms, showers, or pools.
- Regularly change your socks and underwear.
- Wash your hands thoroughly with soap and running water after touching pets or other animals that may have ringworm.
- Regularly disinfect and clean pet living areas.
- Don’t wear heavy clothing in warm, humid environments where you are likely to sweat.
- Keep your fingernails and toenails short and clean.
- Don’t share clothing, towels, sheets, or other personal items with others.
- Regularly wash your sheets, towels, and clothing and dry them thoroughly before storing them away.
- If you’re an athlete involved in close contact sports, don’t share sports gear with other players. Keep your uniform and sports gear clean and dry and shower immediately after your practice session or match.
As soon as symptoms emerge, it is best to start treatment to avoid spreading the infection to others or other areas of your body.
Most cases of ringworm on the skin can be treated with over-the-counter medications such as antifungal creams, lotions, or powders.
These can be applied directly to the infected site for approximately two to four weeks to kill off the harmful fungal spores that are living on the body.
Over-the-counter antifungals include:
- Clotrimazole (Lotrimin, Mycelex): This is a topical fungal cream, spray, or solution that you put directly on your skin. The right treatment for you will depend on where the ringworm infection is on your body.
- Ketoconazole (Xolegel): Available as a cream or shampoo, ketoconazole is an antifungal medicine used to treat skin infections caused by a fungus (yeast). It can also prevent ringworm from coming back.
- Miconazole: A U.S. Food and Drug Administration (FDA) approved antifungal medication, miconazole can be applied to the infected site to kill off harmful fungi living on the skin.
- Terbinafine (Lamisil): Terbinafine is available as a cream, gel, or spray and treats ringworm, athlete’s foot, jock itch, and pityriasis versicolor. For athlete’s foot, you can use terbinafine in a liquid form.
Always read the label and use it only as directed.
Contact your healthcare provider if the infection doesn’t go away or continues to spread.
If you have ringworm on the scalp or a more serious case of ringworm, you may require prescription medication.
Ringworm on the scalp can be harder to treat.
Antifungal medications in the form of oral medicines that are taken for one to three months might be prescribed to you by your doctor.
Common prescription medications include:
- Fluconazole (Diflucan): This antifungal medication is available in oral form and can be effective in treating cases of ringworm.
- Itraconazole (Onmel, Sporanox): Itraconazole is a broad-spectrum antifungal agent that is used to treat cases of ringworm. It can be administered intravenously or in oral form.
- Terbinafine: As well as being available as a cream, gel, or spray, terbinafine comes in tablet form by prescription for more serious cases of ringworm.
There are several home remedies for ringworm you can try to alleviate symptoms.
While there is no scientific evidence to support their use over OTC antifungal treatments, they can be used effectively in conjunction with prescription and OTC medications.
These treatments include:
- Apple cider vinegar: This remedy has strong antifungal properties and can be applied topically by using cotton balls soaked in undiluted apple cider vinegar over affected areas of skin. You can apply the mixture 3 times a day to treat ringworm.
- Coconut oil: You can apply coconut oil to your skin to improve ringworm symptoms as it has both microbial and antifungal properties. For best results, warm the oil until it becomes liquid and apply it to the skin or scalp 1-3 times a day.
- Tea tree oil: Tea tree oil has antifungal and antibacterial properties that your skin can greatly benefit from. Apply tea tree oil directly to the affected area(s) 2 or 3 times per day with a cotton ball or swab. Dilute the tea tree oil if you have sensitive skin.
- Turmeric: With numerous benefits including antibacterial and anti-inflammatory properties, turmeric is excellent for calming irritated skin. You can mix turmeric with water to form an antifungal paste and then apply it directly to your skin. Allow the paste to dry on your skin before washing it off and then patting your skin dry with a clean towel.
When to See a Doctor
Some more mild cases of ringworm can go away on their own with the aid of home remedies and self care. However, this generally takes a lot longer than cases where ringworm is treated with OTC antifungals. Visit a doctor if you notice the infection spreading.
If you are treating ringworm with medicine and symptoms persist or get worse, or you experience side effects from the medications you are taking, you should speak with a healthcare provider. They will be able to determine the best treatment plan for you.
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