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RingwormIntroduction Ringworm is not a worm. It is a general term for a common fungus infection of the skin. It is called ringworm because the infection often appears as a round shape or ring. The general medical name for these infections is 'tinea', though the full name depends on the location of the infection on the body. For example, ringworm on: the head, usually the scalp, is tinea capitis the body, tinea corporis the groin, tinea cruris the feet, tinea pedis (athlete's foot) the nails, tinea unguium the beard area, tinea barbae. Ringworm is particularly common among children, but people of any age can catch it. Please note that athlete's foot and fungal nail infections are treated in more detail in separate topics on this site (see 'related articles' section for more information). Symptoms The infection often appears in a round, ring shaped patch. It is red or silvery, with scales, and is itchy. The edge is red and may be raised. The ring spreads outwards and the centre may heal and go back to a normal skin colour. There may be several patches, not just one, and they may blister and ooze pus. Patches can range from a few millimetres to a few centimetres in size. Scalp and beard infections may cause patches of baldness. In scalp infections, the lymph nodes at the back of the neck may become swollen and tender. Inflammation and scaling are usually fairly mild and may look like a patch of dandruff. Nails with ringworm may become thick and discoloured, and will sometimes start to crumble. See fungal nail infections topic in 'related articles' section for further information. Causes Fungal spores are all around us, in the soil, on people, and on animals. The fungi that cause ringworm generally enter the body through a break in the skin. If you have a scratch or cut, or if you have broken skin because of a condition such as eczema, this may get infected. Ringworm is also more likely to thrive in warm damp areas. Places where you sweat a lot, such as in the groin and under the arms, are frequently affected. Animals can have ringworm and can pass it on to humans. Pets such as dogs, cats and hamsters are among the most common animals that get ringworm. Children who come into close contact with their pets; farmers; and people that work with animals, are more at risk. Ringworm can also be caught through person-to-person contact, sharing combs or unwashed clothes, and from surfaces inside showers or beside swimming pools. Fungal groin infection and athlete's foot are often found in the same person. The spores from one area can spread to other parts of the body. Treatment Antifungal creams are effective in clearing most cases of ringworm on the body (apart from scalp and nail infections). Powders, lotions and creams are available over the counter from your pharmacist, and if you catch the infection early on, you may not need to see your GP. Visit your GP if you are not sure whether you have ringworm, if the infection is severe, or if it does not respond to self-treatment after around 4 weeks. Antifungal creams Over the counter antifungal creams usually include drugs such as clotrimazole and miconazole. Your GP may prescribe slightly different drugs such as imidazoles (ketoconazole) or terbinafine. You should follow the instructions on the packet or the advice given to you by the GP. You may need to use the creams for up to 4 weeks. You should continue using treatments for 1-2 weeks after the skin has healed. If the patch of infection is very inflamed (swollen) or irritated (red and sore), your GP may prescribe a topical corticosteroid (applied to the skin) to soothe these symptoms. This may be used if you have an area of eczema that has become infected with ringworm. Fungal nail infections are treated with a range of nail paints and tablets (see fungal nail infections topic in 'related articles' section for further information.). Scalp ringworm Scalp ringworm is treated with antifungal tablets. The most commonly used drug is called griseofulvin, and you usually have to take it for up to 10 weeks. It should not be used if you are pregnant, and men should not father a child within 6 months of treatment. It has an unpleasant taste, which may discourage children from taking the full course of treatment, so newer antifungal drugs such as ketoconazole are sometimes used instead of griseofulvin. A shampoo containing selenium or povidone-iodine may be used as well as antifungal tablets (ask your GP for advice). It is important to have a hygienic routine to help heal ringworm: Keep affected skin clean and dry, taking extra care when drying yourself after bathing or showering. Don't share towels and wash bedding and nightclothes frequently (every day if possible). Wash the affected area thoroughly but gently, every day. Change underwear and socks daily. Avoid scratching and touching the affected area. Pets also need to be checked and treated where appropriate, to prevent repeat infection. The use of essential oils which are fungicidal can be beneficial. Lavender essential oils combined with Myrrh essential oil or Tea Tree essential oil used on its own are the best. Other oils which can help are Cypress, Lemon and Tagetes. If the ringworm has affected the scalp then try using Rosemary essential oil in alcohol and rub into the whole scalp. |
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