RINGWORM

General Information

DEFINITION--Fungus (tinea) infection of the skin. This is transmitted by person-to-person contact or by contact with infected surfaces, such as towels, shoes or shower stalls.

BODY PARTS INVOLVED--Ringworm can involve the scalp (tinea capitis); skin (tinea corporis); groin skin (tinea cruris); nails (tinea unguium); feet (tinea pedis); skin with beard (tinea barbae)

SEX OR AGE MOST AFFECTED-- Adolescents and adults. It is more common in males than females.

SIGNS & SYMPTOMS--

Lesions that itch (sometimes) and have the following characteristics:

• On the scalp, lesions cause patchy hair loss and scaling scalp.
• On body skin, lesions are red, circular, flat, scaling and have well-defined borders.
• On the bearded area of the face, lesions cause an itchy, scaling rash under the beard.
• On the feet: see Athlete's Foot in the Illness section.
• Of the nails: see Paronychia in the Illness section.

CAUSES--Fungus infection with one or more of 5 different fungi.

RISK INCREASES WITH

• Crowded living conditions.
• Contact with infected animals.
• Day care centers or schools.
• Immunosuppression due to illness or drugs.
• Chronic moisture and chafing of the skin.

HOW TO PREVENT--

The fungi are so prevalent that total prevention is impossible. To minimize risk:

• Get treatment for pets that have skin problems.
• Carefully dry feet after bathing in tub or shower or swimming.
• Good personal hygiene.
• Don't share headgear (hats, combs, brushes).
• Avoid tight shoes or underwear that may rub or chafe the skin.

What To Expect

DIAGNOSTIC MEASURES--

• Your own observation of symptoms.
• Medical history and physical exam by a doctor.
• Microscopic exam of skin scrapings in potassium hydroxide solution.
• Laboratory culture of skin scrapings.
• Examination with ultraviolet light (Wood's lamp) for ringworm on the scalp.

APPROPRIATE HEALTH CARE

• Self-care after diagnosis.
• Treatment is usually with topical medications; other specific care depends on location of infection.

POSSIBLE COMPLICATIONS--Secondary bacterial infection of ringworm lesions.

PROBABLE OUTCOME--Usually curable with treatment, but may take weeks to months depending on location. Recurrence is common and ringworm becomes chronic in 20% of cases.

How To Treat

GENERAL MEASURES--

• For infection on the body: Carefully launder all clothing, towels or bed linens that have touched the lesions.
• Keep the skin dry. If the area is red, swollen and weeping, use compresses made of 1 teaspoon salt to 1 pint water. Apply 4 times a day for 2 to 3 days before starting the local antifungal medication.
• For infection of the scalp, shampoo the hair every day. Have the hair cut short, but don't shave the scalp (wear clothing that can be sterilized). Repeat this procedure every 2 weeks, or whenever the hair grows back.
• For infected beard, let beard grow. If necessary for you to shave, use electric shaver and not a blade.

MEDICATION--Your doctor may prescribe:

• Topical antifungal drugs in the form of creams, lotions or ointments. Treatment may continue after symptoms disappear to eradicate the fungi and prevent recurrence.
• In widespread infections or nail infections, an oral antifungal (usually griseofulvin) may be prescribed.

ACTIVITY--No restrictions.

DIET--No special diet.

Call Your Doctor If

• You have symptoms of ringworm.
• Ringworm lesions become redder, painful and ooze pus.
• Symptoms don't improve in 3 or 4 weeks, despite treatment.
• New, unexplained symptoms develop. Drugs used in treatment may produce side effects.