Ringworm: Facts and FAQs

Ringworm is a very common skin condition and often the name can be misleading. Below you will find some of the commonly asked questions and facts about it.

Basics

What is ringworm?

Ringworm is a fungal infection that can involve skin, hair, and nails.

Is ringworm caused by a worm?

Despite the name, ringworm has no connection to worms. It is caused by fungi.

Which fungus causes ringworm?

Ringworm occurs due to a group of fungi called dermatophytes. These include:

Trichophyton
Microsporum
Epidermophyton

What is the medical term for ringworm?

The medical or technical term for ringworm is “tinea” or “dermatophytosis”.

What are the different types of ringworm?

Depending on the area involved, ringworm can be of several types. These include:

Tinea pedis: Ringworm of the foot
Tinea unguium: Ringworm of the nails
Tinea manuum: Ringworm of the hand
Tinea cruris: Ringworm of the groin
Tinea corporis: Ringworm of the body
Tinea capitis: Ringworm of the scalp
Tinea faciei: Ringworm of the face
Tinea barbae: Ringworm of the beard

What is the difference between ringworm and jock itch?

Ringworm is a broad term used for infection caused by dermatophytes while jock itch is the ringworm of the groin region. In other words, jock itch is a type of ringworm.

Why is it called ringworm?

The name “ringworm” comes from its characteristic appearance of rash. It starts as a small patch and as the rash expands, the central area clears. The periphery or edges are usually red and may be slightly elevated. This gives it the appearance of a ring.

What is the incubation period of ringworm?

The incubation period is the time between exposure to the fungus and the appearance of symptoms. On average, ringworm has an incubation period of 1-2 weeks.

For ringworm of the skin, it usually takes 4 to 10 days.
For ringworm of the scalp, it usually takes 10 to 14 days.

Presentation

Is ringworm itchy?

Yes, it is usually associated with itching.

What are the symptoms?

The symptoms of ringworm vary with the area involved. In general, it leads to the following symptoms:

Circular ring-shaped rash with a clear center and red and elevated periphery or edges.
Scaliness.
Itching.
Hair loss.
Discolored, thick, and brittle nails.

Can ringworm occur without ring-shaped lesions?

Ringworm may present with circular red ring-like patches but not always. Some people may not see the classic clearing in the center so it can appear as a red or pink patch.

In addition, on some areas like the palm of the hand, it may appear as red and scaly patches and may not form rings.

Spread

Can ringworm spread through clothes?

Yes, ringworm can spread through clothes. In fact, it can spread through contaminated personal things like towels, bedding, pillows, combs, shoes, etc.

In the right environment, ringworm can survive for 1-2 years on the surface.

If one has ringworm, clothes, socks, and bedding should be changed daily. Everything should be washed with detergent and hot water.

Should I cover my ringworm when I sleep?

Do not cover the ringworm rash with Band-Aid or any occlusive dressing. This can trap moisture and worsen the fungal infection.

Instead, wear comfortable or loose breathable full-length clothes. This may prevent the spread of the fungus.

Diagnosis

How is it diagnosed?

Your doctor may diagnose it based on its appearance. In some cases, they may do additional tests to confirm it.

These may include:

KOH test: For this skin scrapings are taken from the infected area. They are put on a slide and 1-2 drops of potassium hydroxide are added and then the slide is examined under a microscope.
Fungal culture: A sample is taken and sent to a lab for culture.
Skin biopsy: A small skin sample is taken from the affected area and sent to a lab, where it is examined by a pathologist under a microscope.

Treatment

Does ringworm go away on its own?

Mild cases of ringworm of the skin may go away on their own in a healthy individual. However, there is no guarantee and it may take a lot longer to clear.

In some cases, the infection can become chronic or can go deeper into the skin tissues. Ringworm of the scalp, beard, and nails are unlikely to go away on their own.

Is ringworm treated with antibiotics?

No, typically ringworm is treated with antifungals. In some cases, the patches may get secondarily infected by bacteria. In such a case, antibiotics may be prescribed by your doctor.

How to cure ringworm fast?

The fastest way to cure ringworm is to start treatment with antifungals. For mild cases, over-the-counter antifungals may be adequate.

For severe cases, ringworm of multiple body sites and ringworm of the scalp, beard, or nails will require prescription topical or oral antifungals.

Outcome

Can ringworm leave a scar?

Ringworm can sometimes leave behind an area of hyperpigmentation or dark mark after healing. This is usually seen in people with darker skin tones.

Rarely, if the infection is severe, it can lead to permanent scar on the skin. It may fade over time and can become less noticeable.

Are ringworm bald spots permanent?

Ringworm can lead to patches of hair loss. If treatment is started early or in mild cases, the hair will grow back.

However, if the scalp or beard is not treated or the infection is severe, the hair loss can be permanent. So, it is important to treat the ringworm on the scalp and beard.

Note: Ringworm of the scalp or beard cannot be cured with over-the-counter antifungals. You will need to see a doctor and will require oral antifungal medication to completely get rid of the fungus. This will prevent complications like hair loss and scarring.

Is ringworm dangerous?

Ringworm is usually not serious and can be treated with antifungals. However, if left untreated, it can spread to others. In addition, it can lead to complications, especially in people with weakened immune systems or underlying medical conditions like diabetes.

These complications include:

Spread of infection to other parts of the body.
Secondary bacterial infection.
Majocchi’s granuloma – Occurs due to the penetration of fungal infection deeper into skin tissues.
Patches of permanent hair loss.

If you have any of the symptoms below, you should see a doctor:

Pus or foul-smelling discharge.
Spreading rash.
The area of infection is swollen and hot to the touch.
Systemic symptoms, such as fever and chills.
Ringworm affects the scalp, beard, or nails.

Future infections

Can you get ringworm more than once?

Unfortunately, yes. Having ringworm once doesn’t mean you will be immune to it. If you get exposed to the fungus again, you can get ringworm.

In addition, certain factors may increase one’s chance of getting it. These include a weakened immune system, diabetes, being overweight, excessive sweating, living in hot and humid environments, etc.

Can you prevent ringworm?

One can follow certain measures to avoid this infection:

Keep your skin clean and dry.
Take a bath after excessive sweating.
Change your clothes including undergarments and socks daily.
Wear clothes made of breathable material and avoid tight-fitted clothes.
Do not walk barefoot in public places like pools, gym areas, shower rooms, etc.
Shower after any session of contact sports like wrestling.
Air out your feet after wearing socks for an extended time.
Wash your hands after touching pets or animals.
If you get ringworm, treat it as soon as possible to avoid the spread of infection.
If your pet has a suspicious scaly patch, get it examined and treated.