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Tinea Infections (Ringworm): Causes, Symptoms, and Treatments

ringworm
Submitted and Medically Reviewed By: Dr. Mavra Farrukh

Overview

Ringworm(tinea infections) is a common fungal infection of the skin.

Various fungi, depending on their location on the body, cause ringworm. Although the term is misleading, it is not caused by an actual worm but by fungi on the skin, also known as dermatophytes. First, let’s look at this infection’s causes, symptoms, treatment and prevention. 

What is tinea corporis (ringworms)?

Ringworm or dermatophytosis, or tinea infection, is a fungal skin infection.

The name ringworm is due to the shape of the lesion caused by this fungal infection that resembles a worm in the form of a ring.

Tinea infection can affect humans and animals both. The lesion looks like scaly patches and discolored patches on the affected areas. These patches can appear red on lighter skin or brownish on darker skin.

It is typically used to describe tinea corporis (ringworm of the body) or tinea capitis (ringworm of the scalp). However, it’s sometimes used to describe tinea infection in other locations, such as tinea cruris (ringworm of the groin). 

There is a possibility that ringworm can spread from one area of the body to another.

Regions of the body commonly affected include:

  • scalp
  • feet
  • hands
  • nails
  • groin

What causes ringworm in humans?

There are different species of fungi that can cause ringworm. These fungi can live on your skin or reside on other surfaces, specifically damp areas. They can survive as spores in the soil for an extended period.

The fungi can be transmitted to humans in four different ways:

  • Human to human. You can catch the infection by coming in contact with a person who has ringworm or if you share personal items to use, including combs or towels. The disease is spread among children by sharing articles sheltering the fungus. 
  • Object to human. Fungi typically thrive in cold, damp environments. Coming in contact with a contaminated surface can make you catch this fungal infection.
  • Animal to human. You can get ringworm after touching an infected animal. If the animal has come in contact with specific items and you feel those, you can get tinea corporis. Cats and dogs are well-known sources, but several animals can also spread the fungi.
  • Soil to humans. Humans or animals can get ringworm after direct contact with the ground with fungi spores.

What Are the Symptoms?

Symptoms can vary depending on the site of the infection. In case of a skin infection, the following symptoms may occur:

  • itchy skin
  • scaly patches that are red, brown, or grey
  • a round, circular pattern rash or red circle rash
  • raised areas of skin called plaques
  • patches resembling a ring with darker colour on the outside 
  • patches with well-defined and raised edges
  • multiple overlapping rings
  • loss of hair 
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Most common types of tinea infections

The appearance of ringworm may vary depending on which part of the body is infected, depending on the location of the body that different names know the fungal infection. 

The most common ringworm tinea types include the following:

Athlete’s foot (tinea pedis). 

This condition is the ringworm infection of the foot, typically affecting teen and adult males. Sweating, wearing tight socks and shoes, and not drying the feet after swimming or bathing can result in an athlete’s foot. Some symptoms include: 

  • Scaling of the feet
  • Whitening of skin in between the toes
  • Itchy rash on the feet
  • Blisters on the feet
  • Peeling of skin
  • Stinging, or a burning sensation

This rash begins as dry, scaly skin between the toes. It can then spread to the heel as well. 

Jock itch (tinea cruris). 

This is when ringworm affects the genital area. This form of ringworm may be hard to cure. Males are more likely to be affected by this condition. Warm weather conditions have a close association with developing a fungal infection. A groin rash in females is very rare. Symptoms of jock itch usually include:

  • Itching in the groin region
  • Discomfort in the groin area
  • Reddish ring-like patches in the groin region

The infection does not usually involve the scrotum.

Scalp ringworm (tinea capitis). 

Scalp ringworm is highly contagious and prevalent amongst children. It affects the age group of 2 to 10. It is an infrequent occurrence in adults. Some common symptoms of scalp ringworm include:  

  • Itching 
  • Red, scaly rash on the scalp
  • Hair loss 
  • Rash on another area of the body

Ringworm of the scalp may progress into a kerion, a large, tender lesion over the area where the initial tinea infection appears. Ringworm scalp and body can be another presentation. This results from a hypersensitivity reaction to the ringworm and can be associated with a rash that may be present on another area of the body and tender lymph nodes in the neck region. Ringworms on the scalp often start as scaling in the scalp and progress to intense itching, and scaly bald patches can develop. Ringworm on the head can result in hair loss.

Nail infection (tinea unguium). 

This is a finger or toenail infection, characterized by a thickened and deformed nail. This condition typically affects the toenails as compared to the fingernails. It occurs mainly in adults. Symptoms of nail ringworm may include:

  • Yellowish color to the nails
  • Thickening of the nails

Body ringworm (tinea corporis). 

This skin infection is characterized by a tinea corporis rash that resembles a ring. That can occur anywhere on the body or the face. tinea infection on a lip, eyelid, and forehead come under this term/category.

It can occur in any age group but is seen more often in children. It is more common in warmer climates. The symptoms of body ringworm may include:

  • Itching 
  • Red, circular lesion with raised edges
  • The middle of the lesion clears or becomes less red

Ringworm of the beard(tinea barbae)

This infection affects the cheeks, chin, and upper neck and can lead to bald patches. Some common symptoms include:

  • Bald patches
  • fatigue 
  • swollen lymph nodes.

This condition can be mistaken for folliculitis, acne or another skin condition. It is best to consult a doctor for a definite diagnosis. 

Ringworm of the hand( tinea manuum)

This is usually caused by touching another affected area on your body, for example, your groin. Infection of the hand may present with the following symptoms:

  •  dry skin
  •  deep cracks on the palm
  •  circular patches on the back of the hand

Ringworm Risk Factors

Some factors that increase your risk of developing ringworm include:

  • living in a warm and humid climate
  • participating in contact sports, like wrestling 
  • frequent use of public showers 
  • excessive sweating
  • wearing tight shoes 
  • having diabetes
  • being obese
  • coming in close contact with animals
  • having a weakened immune system

Ringworm stages

Symptoms of ringworm do not appear immediately. It may take two weeks or more before a ring-shaped rash appears. The stages are as follows:

  • Initial stage. During this stage, a discolored, rough patch of skin usually appears. The affected area can be dry and scaly. This stage is termed as early ringworm.
  • Second stage. During this stage, the lesion increases in size. The center of the rash can be clear, healthy skin surrounded by a scaly area. This is also known as advanced ringworm.

Since ringworm is contagious, treatment should be started right away to prevent its spread. 

Getting a ringworm diagnosis

Ringworm can be diagnosed based on a medical history and a physical exam. The lesions of ringworm can be identified easily based on a physical exam. Additionally, the doctor may use a black light to view the affected area. Some types of fungus glow under black light. 

Your diagnosis may be confirmed by the following tests:

  • A skin biopsy or fungal culture: A sample of your skin or discharge from a blister is sent to a lab for testing.
  • KOH exam: A small area of the affected skin is scaped onto a slide, and drops of potassium hydroxide (KOH) solution are placed on it. The KOH helps visualize the fungus under the microscope. 
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Medications used to treat ringworm.

There are multiple treatment options. Ringworm of the body, jock itch, athlete’s foot is usually treated with topical antifungal:

  • creams
  • ointments
  • gels
  • sprays

However, severe cases require oral medications.

Ringworm of the scalp or nails or recurring may require prescription-strength oral medications, such as terbinafine or griseofulvin.

Commonly used over-the-counter (OTC) medications and antifungal skin creams include: 

  • Clotrimazole
  • Miconazole
  • Terbinafine

How to get rid of ringworms

Some additional measures that may help prevent or cure recurring ringworm in the same place infection at home include:

  • washing bedding and clothing daily 
  • wearing loose clothing in affected areas
  • drying your skin correctly after bathing
  • treating all infected areas to prevent a recurrence 

Ringworm home remedies

People have tried several home remedies for ringworm for decades. Unfortunately, no proper scientific evidence backing these, but they have proven effective. 

Some treatment options include:

  • Coconut oil. People apply coconut oil to the affected area of the skin. Usually, coconut oil is used on the site several times a day.
  • Apple cider vinegar. Cotton balls soaked in apple cider vinegar are another remedy to treat ringworm.
  • Turmeric. The application of turmeric paste is used as turmeric has antifungal properties.

Ringworm essential oils

Essential oils are concentrated extracts from plants or flowers. Tea tree oil for ringworm is a popular remedy many people use to keep the infection in check. Some essentials oils people use to treat tinea infections include:

  • tea tree oil
  • oregano oil
  • lemongrass oil

These oils often need to be diluted as with carrier oils such as coconut oil as they are concentrated. 

Although anyone can get ringworm, the infection is prevalent among people who own pets such as cats and dogs, as the animals can pass it on to humans.

Ringworm in humans may have a slightly different presentation. You should look for the following signs in your pets:

  • hairless circular patches of skin 
  • scaly patches
  • whitish areas around the claws

You can develop dermatophytosis if you come in contact with fungi from prolonged water exposure or if you have minor skin injuries.

Using a public shower or pool makes you more susceptible to fungal infections.

Ringworm during pregnancy

If you get ringworm during pregnancy, certain medications that are safe to use include

  • clotrimazole 
  • ciclopirox 
  • naftifine
  • terbinafine

However, the best option is to talk to your doctor before taking any medications while pregnant.

Oral medications are not usually recommended to treat fungal infections during pregnancy. You should have a discussion with your doctor before using any medicines if breastfeeding.

Conditions confused with ringworm.

Ringworm vs eczema

Ringworm can be confused with another condition known as nummular eczema

Both conditions can present with a ring-like round lesion on the skin. These lesions are often scaly and itchy.

A person with ringworm usually has few ring-like patches compared to an individual with nummular eczema. Moreover, unlike tinea infections, nummular eczema doesn’t have a clearing in the centre.

Furthermore, ringworm can have bumps, while nummular eczema doesn’t. If the two conditions are very much alike, your doctor may take samples of the skin and it to the lab for testing.

Antifungal creams don’t help treat nummular eczema, while corticosteroid creams do.

Ringworm vs psoriasis

Psoriasis can resemble ringworm as well. Plaque psoriasis is a skin disorder due to immune dysfunction that results in plaques on your skin.

Plaque psoriasis appears as pink plaques with white scales on people with lighter skin. On darker skin, it seems as grey scales with purple patches.

Small plaques can look like lesions caused by ringworm. Both ringworm and psoriasis can cause scaling and itching.

However, ringworm usually has a circular appearance with a clearing in the middle. There is typically a single of few lesions. 

Psoriasis lesions don’t have a clearing in the middle. The skin lesions are usually larger and involve more areas of your skin, such as your elbows, knees and lower back. 

Ringworm complications

If ringworm is left untreated, it can spread to other body areas. It can also be spread to other people. Some potential complications include:

  • dark marks left on your skin
  • nail deformities
  • hair loss and scarring
  • secondary infection that is a result of bacteria entering broken skin
  • Majocchi’s granuloma is a rare disease caused by the fungus entering deeper layers of the skin

The complications of tinea capitis can cause permanent hair loss. Therefore to prevent such complications, it is best to consult a doctor immediately for treatment. 

Preventing ringworm

Having healthy habits and adopting hygienic behaviors can help prevent ringworm. Some tips to avoid it include:

  • washing your hands frequently
  • keeping your uniform clean if you play sports
  • keeping your skin clean and dry
  • changing your socks and underwear daily
  • disinfecting pet living areas
  • wearing shoes while showering or walking in public areas
  • avoid sharing personal items like clothing, towels etc

When to Consult a Doctor 

If you have ringworm symptoms, talk with our doctor at Your Doctors online for treatment recommendations. It is essential to start treatment soon to prevent a fungal infection spread. 

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FAQs on Tinea Infections Answered by Your Doctors Online Team

What do ringworms look like?

Ringworm can present with the following symptoms:
itchy skin
scaly patches that are red, brown, or grey
a round, circular pattern rash or red circle rash
raised areas of skin called plaques
patches resembling a ring with darker colour on the outside 
patches with well-defined and raised edges

Does ringworm itch?

Yes, a red circular rash caused by ringworm can lead to itching. 

Does ringworm go away by itself?

In healthy individuals, ringworm can disappear, but it can take a long time for symptoms to settle. Untreated infections, however, have a possibility of spreading. 

How do I get rid of ringworm fast?

Over-the-counter creams, sprays, gels and oral medications are used to eliminate this fungal infection. 

How to cure ringworm in the private part?

Antifungal creams or oral antifungals are prescribed to treat ringworm. The treatment varies on the severity of the infection. 

How do you identify ringworm?

It can be diagnosed based on a medical history and a physical exam. The lesions of ringworm can be identified quickly based on a physical exam. In addition, some tests, such as skin biopsy, may be done. 

Which cream is best for ringworm?

Commonly used over-the-counter (OTC) medications and antifungal skin creams include: 
Clotrimazole
Miconazole
Terbinafine

Doctors Treating this Issue
dr asim cheema

Dr. Asim Cheema

Internal Medicine

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