Definition

Ringworm is a fungal infection of the skin. Despite its name, it has nothing at all to do with worms. The fungal infection may appear on the skin, nails, hands, feet, or scalp.

Causes

Ringworm is caused by microscopic skin fungi that live on the outer layer of the skin. You can get ringworm from direct skin-to-skin contact with infected people or pets. It is also transmitted by sharing hats and personal hair grooming items, and through contact with locker room floors, shower stalls, seats, or clothing used by an infected person.

Risk Factors

Ringworm is more common in children 12 years of age or younger.

Factors that may increase your risk of developing ringworm include:

• Contact with surfaces, clothing, or personal grooming items used by an infected person
• Skin-to-skin contact with an infected person or pet
• Spending time in nurseries, schools, daycare centers, or locker rooms

Symptoms

When ringworm appears on the skin, it makes circular, reddish patches with raised borders. Eventually, the patches grow larger, and the centers of the patches turn clear, giving a ring-like appearance.

Symptoms of ringworm on other parts of the body vary, for example:

• Scalp, tinea capitis —begins with small bumps on the head that grow larger and form a circular pattern
  • Hair may become brittle and break, forming scaly, hairless patches.
• Hands, tinea manus—affects the palms and spaces between the fingers
• Feet, tinea pedis or athlete’s foot—may cause scaling between the toes, or thickening and scaling on the heels or soles
• Nails, tinea unguium —causes fingernails and toenails to become yellow, thick, and crumbly
• Groin, tinea cruris or jock itch—causes a chafed, reddish, itchy, sometimes painful rash in the groin
• Body, tinea corporis—produces flat, scaly, round spots on the skin
• Face, tinea faciei—produces red, scaly patches on the face

Ringworm symptoms on the body usually appear 4-10 days after exposure. Scalp symptoms will appear in 10-14 days.

Diagnosis

You will be asked about your symptoms and medical history. A skin examination will be done. Ringworm is often easily diagnosed by appearance. However, symptoms may be similar to other conditions. A sample of the affected area may be taken for testing.

Treatment

Treatment can be oral (taken by mouth) or topical (applied to skin):

Prevention

The following steps may prevent ringworm:

• Avoid contact with any infected person, animal, surface, or object.
• Do not share personal hair grooming items, clothing, or shoes.
• Wear sandals in locker room areas.
• Avoid scratching during infection. This will prevent ringworm from spreading to other areas.
• Wear clothing that minimizes sweating and moisture build-up.
• Wear breathable shoes or sandals.
• Keep moisture-prone areas of the body clean and dry.

Family Doctor—American Academy of Family Physicians http://www.familydoctor.org

The College of Family Physicians of Canada http://www.cfpc.ca

Kakourou T, Uksal U; European Society for Pediatric Dermatology. Guidelines for the management of tinea capitis in children. Pediatr Dermatol. 2010 May;27(3):226-8.

Panackal AA, Halpern EF, Watson AJ. Cutaneous fungal infections in the United States: Analysis of the National Ambulatory Medical Care Survey (NAMCS) and National Hospital Ambulatory Medical Care Survey (NHAMCS), 1995-2004. Int J Dermatol. 2009 Jul;48(7):704-12.

Tinea capitis. DynaMed website. Available at:
http://www.ebscohost.com/dynamed
Updated December 3, 2014. Accessed January 12, 2015.

Tinea infections: athlete’s foot, jock itch, and ringworm American Academy of Family Physicians website. Available at:
http://familydoctor.org/familydoctor/en/diseases-conditions/tinea-infections.html
Updated April 2014. Accessed January 12, 2015.