Ringworm is a skin infection caused by a fungus. Treatment with an antifungal cream usually works well.
What is ringworm?
Ringworm is a fungal skin infection. (It is not due to a worm as its name implies!) There are many types of fungal germs (fungi) and some can infect the skin, nails, and hair. This leaflet just deals with ringworm of the skin (sometimes called tinea corporis). Other leaflets deal with fungal infections of the scalp (scalp ringworm), foot (athlete's foot), groin (tinea cruris), and nails.
How can you catch ringworm?
- From person to person via touching an infected person, sharing towels, etc.
- From animals. Some dogs, cats, and other pets have fungal infections on their skin. They can pass on the infection, especially to children. (Animals can be treated too if you suspect a pet is the cause. See your vet.) Farm animals can also be a source. Touching a farm gate where infected animals pass through may be enough to infect your skin.
- Fungi are common and an infection may seem to occur for no apparent reason. These may occur because you have come into contact with fungi that are in the soil or that have contaminated objects that you touch.
What are the symptoms?
A small area of infected skin tends to spread outwards. It typically develops into a circular, red, inflamed patch of skin. The outer edge is more inflamed and scaly than the paler centre. So, it often looks like a ring that becomes gradually larger - hence the name ringworm. Sometimes only one patch of infection occurs. Sometimes several patches occur over the body, particularly if you catch the infection from handling an infected animal.
The rash may be mildly irritating, but sometimes it is very itchy and inflamed. The rash may vary depending on which type of fungus causes the infection. Sometimes fungal skin infections look similar to other skin rashes, such as psoriasis.
For a list of websites that contain pictures of skin conditions, including those of fungal skin infections, see www.patient.co.uk/showdoc/1097/
What is the treatment?
You can buy an antifungal cream from pharmacies, or get one on prescription. There are various types and brands - for example, terbinafine, clotrimazole, econazole, ketoconazole, and miconazole. These are good at clearing fungal skin infections.
- Apply the cream to the surrounding 4-6 cm of normal skin in addition to the rash.
- Apply for as long as advised. This varies between the different creams, so read the instructions carefully.
- For skin that is particularly inflamed, your doctor may prescribe an antifungal cream combined with a mild steroid cream. This would normally be used for no more than seven days. You may need to continue with an antifungal cream alone for a time afterwards. The steroid reduces inflammation and may ease itch and redness quickly. However, the steroid does not kill the fungus and so a steroid cream alone should not be used.
An antifungal medicine taken by mouth is sometimes prescribed if the infection is widespread or severe. For example, terbinafine, griseofulvin, or itraconazole tablets.
Not all treatments are suitable for everyone. Women who are pregnant or breast-feeding, people with other conditions or who are on other medication, or children aged under 12 may not be able to use certain types. Check with your doctor or pharmacist if you come into one of these groups.
You do not need to stay off work or school once treatment has started. To prevent passing on the infection, do not share towels. Also, try not to scratch the rash, as this may spread the fungus to other areas of your body.
Further reading & references
- Fungal skin infection - body and groin; NICE CKS, May 2009
- Andrews MD, Burns M; Common tinea infections in children. Am Fam Physician. 2008 May 15;77(10):1415-20.
- Fungal skin infections; DermNet NZ
- Rashid R et al; Tinea in Emergency Medicine, Medscape, Mar 2011
- Rotta I, Cristina A, Rodrigues P, et al; Efficacy and Safety of Topical Antifungals in the Treatment of Dermatomycosis: A Br J Dermatol. 2012 Jan 11. doi: 10.1111/j.1365-2133.2012.10815.x.
Disclaimer: This article is for information only and should not be used for the diagnosis or treatment of medical conditions. EMIS has used all reasonable care in compiling the information but make no warranty as to its accuracy. Consult a doctor or other health care professional for diagnosis and treatment of medical conditions. For details see our conditions.
Dr Tim Kenny
Dr Laurence Knott
Dr Tim Kenny