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Ringworm, or tinea, refers to several types of contagious fungal infections of the top layer of the skin, scalp, and nails. It is called ringworm because the itchy, red rash has a ring-like appearance.

Ringworm has nothing to do with worms. This fungal infection can affect different parts of the body.

This article will cover ringworm’s causes, symptoms, diagnosis, and treatment.

Different types of ringworm affect different parts of the body.

  • Scalp ringworm (tinea capitis): Scalp ringworm is common in younger children, and it occasionally affects adults.
  • Body (skin) ringworm (tinea corporis): This can affect infants, children, and adults.
  • Groin infections (tinea cruris): Also known as jock itch, this is more common among people who sweat frequently, such as athletes, and people with diabetes.
  • Tinea pedis: Athlete’s foot is a foot infection that usually affects the skin on the soles, sides, and toes. It can cause stinging, burning, redness, and itching.
  • Tinea unguium: Also known as onychomycosis, it is an infection of the nail bed.
  • Ringworm in the beard area: This affects people who can grow facial hair, and it often results from contact with an animal or human who has ringworm.

Different types of ringworm have different symptoms.

Scalp ringworm

  • Small patches of scaly skin appear on the scalp.
  • Patches may feel tender or painful and can be inflamed.
  • Hair breaks away on or near the patches.
  • Kerion, or large inflamed sores, form on the scalp, and they may ooze pus.

A person with scalp ringworm may have a slight fever and swollen glands or lymph nodes, but this is uncommon.

Body or skin ringworm

Symptoms include:

  • a rash with a ring-like appearance
  • skin may be red and inflamed around the outside of the ring, but it may look normal in the middle
  • merging rings
  • rings feel slightly raised
  • itchiness, especially under the rash

Groin infection

There may be:

  • itchiness, especially in and around the groin
  • redness and a burning sensation in the affected area
  • flaky and scaly skin on the inner thighs
  • symptoms worsen when walking, running, or exercising
  • tight clothing makes symptoms worse

Beard area

Ringworm in the beard area can involve:

  • redness, swelling, and pus-filled bumps
  • hair loss, which usually resolves after treatment
  • swollen glands
  • raw, open skin and raised, soft, spongy patches that weep
  • tiredness

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Ringworm is caused by a type of fungus called dermatophytes. This fungus eats keratin, which is a type of protein that makes up the:

  • nails
  • hair
  • outer layer of the skin

Dermatophytes attack the skin, scalp, hair, and nails because those are the only parts of the body with enough keratin to attract them.

Dermatophytes are microscopic spores that can survive on the surface of the skin for months. They are very resilient and can also survive in:

  • the soil
  • towels
  • combs
  • other household objects

Dermatophyte spores can spread from:

  • human to human
  • animal to human
  • object to human

If a person or animal has a ringworm infection, they may deposit fungal spores on objects and surfaces they touch. Anyone who touches those objects may contract a ringworm infection.

Children usually show symptoms when they have a ringworm infection, but many adults do not. The older an individual is, the more likely it is that their immune system will protect them. However, they may still be a carrier.

The stages in which ringworm develops depend on the type of ringworm.

On the body, patches grow slowly in size, and more patches can appear on other parts of the body. The center of the patch may clear, leaving a ring. If there are several rings, they may merge.

Athlete’s foot tends to start between the toes before spreading to the bottoms or sides of the feet, or both. The skin between the toes can then turn white and become soft.

On the nails, ringworm starts with a thickening of the skin under the nail, followed by a thickening and discoloration of the nails. Over time, the nails will lift, crumble, and disappear.

In the groin, the first sign is usually an itchy rash in the crease where the leg meets the body. This can spread to the:

  • groin
  • inner thigh
  • waist
  • buttocks

A doctor can typically diagnose ringworm or a groin infection after examining the affected area and asking the patient about their medical history and symptoms.

They may take a small scraping of the skin, which will not hurt, and examine it under a microscope to look for characteristics of fungi.

The doctor will assess whether the skin problem is being caused by some other disorder, such as psoriasis. Further testing is not usually needed unless symptoms are particularly severe.

If symptoms have not improved after treatment, the doctor may remove a small piece of affected skin and send it to a lab for analysis.

Treatment depends on the type of ringworm.

Scalp ringworm

The most common treatments for scalp ringworm are oral antifungal medications (tablets). However, the choice of medication will depend on the type of fungi involved.

Terbinafine (Lamisil): The side effects are normally mild and do not last long. They may include a decrease in appetite, pain in the muscles and joints, and an upset stomach. People with a history of liver disease should not take terbinafine.

Griseofulvin (Grisovin): The side effects, which usually go away fairly quickly, may include:

Antifungal shampoos: These help prevent the spread of ringworm and may speed up recovery, but they do not cure it. Various antifungal shampoos are available for purchase online.

Skin ringworm and groin infection

Most cases are treated with antifungal creams. Individuals should read the product instructions carefully — antifungal creams do not all have the same instructions. These can be purchased over the counter or online.

If symptoms are severe, or if they cover a large area of the body and do not respond to over-the-counter (OTC) medications, a doctor may prescribe a prescription-strength topical medication.

A doctor may also prescribe an oral medication (taken by mouth). Oral medications can have some side effects, including:

Other types of ringworm

Itraconazole (Sporanox): This oral medication is sometimes used to treat fungal infections in the fingernails and toenails. Side effects can include:

  • nausea
  • irregular heartbeat
  • abdominal pain
  • mild diarrhea
  • vomiting

Fluconazole (Diflucan): This oral medication is often used to treat more serious fungal infections, including thrush, vaginal yeast infections, and urinary tract infections. Some side effects can include:

  • insomnia
  • nausea
  • vomiting
  • abdominal pain
  • dry mouth
  • diarrhea

There are plenty of OTC medications for fungal infections too. Many of these are topical medications and sprays.

Caring for the skin during infection

Caring for the skin properly can help speed up recovery:

  • Wash the skin gently.
  • Dry the skin thoroughly but gently.
  • Pat the skin with a towel in tender areas, but do not rub.
  • Make sure any folds and areas between the toes are dried thoroughly.
  • Change socks or underwear more often than usual if they cover an area with an infection.
  • Always treat the feet and groin at the same time, as infection often spreads from one area to another.
  • When possible, wear loose-fitting clothing and undergarments, such as boxers.

The following tips may help prevent the spread of ringworm if it occurs in a household:

  • If a pet is the source of the infection, it should be treated by a vet.
  • Everyone should wash their hands regularly and thoroughly with soap.
  • All household members should check themselves for signs of ringworm.
  • People should not share combs, hairbrushes, clothing, bed linen, towels, or footwear.
  • Anyone who has ringworm should not scratch affected areas, as this increases the risk of spreading the infection.
  • People should avoid walking around the house with bare feet.
  • Clothes should be washed in hot water with antifungal soap.

Keeping cool and wearing loose clothing may help reduce the risk.

Complications

Fungal infections rarely spread below the surface of the skin. The risk of any serious illness is very small. However, without treatment, ringworm can spread from one part of the body to another.

If the skin is broken, bacteria may enter and cause an infection.

People living with HIV, those undergoing cancer treatment, and other issues that weaken the immune system are more likely to experience a spreading of ringworm. It is more difficult to get rid of the infection if the immune system is weak.

The following risk factors either increase the chances of developing ringworm or make the symptoms worse:

  • being under age 15
  • having a weakened immune system
  • using medications that lower the immune system
  • living in a warm, humid climate
  • being close to people or animals with a ringworm infection
  • sharing clothing or towels with someone who has the infection
  • having hyperhidrosis, a condition in which a person sweats more than usual
  • playing contact sports, for instance, wrestling
  • wearing tight clothing