Ringworm (Fungal Rash)

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 fungus 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 'out of the blue'. 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 of ringworm?

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 for ringworm?

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, miconazole, and sulconazole. 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.

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.