What Is It?

Ringworm, also called tinea, is a skin infection caused by fungi, microscopic organisms that are similar to yeast and molds. It does not have any relation to worms, but is called “ringworm” because the infection can produce ring-shaped patches on the skin that have red, wavy, wormlike borders.

Although ringworm can affect almost any portion of the body from head to toe, it favors places that are dark and moist, such as skin in the groin area, the spaces between the toes and the deep skin folds of obese people. People can catch ringworm in several different ways, including:

• Direct skin-to-skin contact with an infected person
• Playing with, or caring for, an infected pet or farm animal
• Using an infected person’s clothing, shoes or personal grooming items such as combs, brushes or towels
• Sharing an infected child’s toys, especially stuffed toys
• Touching a contaminated surface — Some common high-risk surfaces include floors in bathrooms, showers and locker rooms; shower stalls; gym mats; and pool decks, especially at school or community pools. In general, any surface that is used by many different people can carry ringworm, especially if the surface is also wet or damp. Even contaminated carpets and couches can spread the infection.

Depending on its specific location, tinea may be known by a more common name, such as athlete’s foot or jock itch. The various types of ringworm include:

• Ringworm of the scalp — This infection, also known as tinea capitis, causes patches of hair loss on the scalp. It is especially common among children aged 3 to 9, particularly children who live in crowded conditions in urban areas. Scalp ringworm spreads on contaminated combs, brushes, hats and pillows, and it may occur in epidemics in schools and day-care centers.
• Barber’s itch (ringworm of the beard) — This fungal infection affects bearded areas of the face and neck in adult men.
• Ringworm of the body — Ringworm of the body, also known as tinea corporis, involves the non-hairy skin of the face, trunk, arms or legs. Of all types of ringworm, tinea corporis is the one that most often produces the classic, ring-shaped patches with wormlike borders. Ringworm of the body occurs in people of all ages and races, with women affected as often as men.
• Jock itch (ringworm of the groin) — This infection, also known as tinea cruris, typically causes itchy, scaly, red patches of skin on the groin area. It most often affects teen-age and adult men, especially those who are obese, or who wear tight-fitting underwear. It is the most common type of tinea.
• Athlete’s foot (ringworm of the foot) — Athlete’s foot, also known as tinea pedis, is the second most common form of tinea. In some individuals, the fungus attacks not only the skin of the foot but also the toenails. Athlete’s foot is often acquired by walking barefoot on contaminated floors, especially in gyms and locker rooms.

Doctors estimate that at least 20 percent of all people will develop tinea at some time during life. People with a higher-than-average risk of fungal skin infection include people who live in hot, humid climates; athletes, especially swimmers; children in day care; people who work with animals; obese people with deep, moist skin folds; and anyone whose immune defenses are weakened by illness (HIV, organ transplant, some cancers) or by medications.

Symptoms of ringworm vary, depending on the site of the infection:

• Ringworm of the scalp — Symptoms can include a diffuse, itchy, scaling of the scalp that resembles dandruff; itchy, scaly, round patches of hair loss on the scalp; black-dot ringworm in which stubs of broken hairs form a dotted pattern on the scalp; or kerion, a thick, nodular, patch of inflamed skin that may ooze pus
• Barber’s itch — Symptoms often include kerion and crusted skin. Bearded areas of the face and neck are affected.
• Ringworm of the body — This infection produces itchy, red, scaly, round patches with a raised border. Individual patches are usually less than 5 centimeters (2 inches) in diameter, and may occur singly or in groups of three to four.
• Jock itch — Jock itch causes red, scaly patches that may itch or burn. These patches usually occur on the groin area and upper thigh, but not on the penis or scrotum.
• Athlete’s foot — Athlete’s foot produces areas of redness, scaling or cracked skin on the feet, especially between the toes. The affected skin may itch or burn, and the feet may have a strong odor.

If you have symptoms of athlete’s foot, ringworm of the body or jock itch, you often can make the diagnosis yourself. Begin by asking yourself whether you are at risk of these infections. For example, do you have an athletic lifestyle that routinely exposes you to pools, gyms, locker rooms and other places where fungi thrive? Do you live or work in crowded conditions? Have you shared clothing, shoes, towels or personal-grooming items with other people? Have you recently been exposed to a person or animal that has patchy hair loss or areas of scaly, red skin? If you answered yes to any of these questions, then you probably have tinea.

On the other hand, if your symptoms involve the scalp or beard, you should not attempt to diagnose and treat the problem yourself. You should be checked by a health-care professional. Your doctor will review your symptoms and risk factors, and then examine your skin. In many cases, the ringworm can be diagnosed based on your history, symptoms and skin findings. Sometimes, however, your doctor may need to scrape gently an area of skin to check for ringworm fungi under the microscope. A few affected hairs may be examined as well. If necessary, a tiny sample of skin or hair may be sent for laboratory culture to isolate and identify the particular type of fungus causing the infection.

With proper treatment, both jock itch and ringworm of the body usually improve within one to two weeks. Ringworm of the scalp or beard may take a few weeks longer. However, athlete’s foot can be a chronic problem that comes and goes over many years. This can be caused in part by an active lifestyle that keeps the feet moist and sweaty.

To help prevent tinea, try the following suggestions:

• Avoid sharing anyone else’s clothing, shoes, towels or personal-grooming items (hairbrushes, combs, makeup brushes).
• If your child goes to sleepover parties, provide a sleeping bag, pillow and blanket from home.
• Bathe regularly and dry your skin thoroughly afterwards. Be especially careful to dry the area between your toes and under your breasts.
• Wear clean socks and underwear every day. When possible, choose absorbent cotton socks and underwear rather than synthetic fabrics. At the gym, keep an extra pair of socks in your locker to replace sweaty socks after a workout.
• Wear sandals, flip-flops, shower shoes or other protective footwear when you walk through locker rooms or shower rooms or near pools.
• If you care for a pet or farm animal that develops areas of hair loss or scaly patches, take the animal to a veterinarian for a checkup.

If you have jock itch, athlete’s foot or ringworm of the body, you usually can begin treatment yourself with a nonprescription antifungal cream, lotion or powder. Check the medication’s label for the type of skin symptom it treats, the list of active ingredients and the way it should be applied. Some of the nonprescription medications available include terbinafine (Lamisil), tolnaftate (Tinactin), miconazole (Micatin and other brand names), clotrimazole (Lotrimin, Mycelex) and undecylenic acid (Desenex and other brand names). Be sure to follow the directions carefully when you apply the medication. If your symptoms do not improve significantly after you have used a nonprescription medicine for approximately two weeks, call your doctor. Your doctor may suggest a prescription antifungal medication that will cure the problem. For extremely stubborn infections, the antifungal medication may be taken by mouth rather than being applied to the skin.

If you have ringworm of the scalp or beard your doctor may treat you with an oral antifungal medication, such as itraconazole (Sporanox) or griseofulvin (Grisactin and other brand names). In addition, you will have to apply antifungal creams to your hair and scalp. Complete treatment can take up to two months.

Make an appointment to see your doctor if you have symptoms of ringworm that involve the scalp or beard. For other forms of ringworm, call your doctor if nonprescription medicine does not improve your skin problem after two weeks of treatment.

If your immune system is weakened by illness or medication, contact your doctor promptly whenever you develop any unusual skin symptoms. In particular, people with diabetes should have skin symptoms, especially on the feet, checked as soon as possible.

Although treatment may take several weeks, antifungal medication almost always cures ringworm infections. Hair eventually regrows, and scarring is rare.

However, people do not develop immunity to tinea. Because it is possible to catch the fungus again, follow the suggestions outlined in the Prevention section above to avoid recurrence.

Diseases and Conditions Center

All ArmMed Media material is provided for information only and is neither advice nor a substitute for proper medical care. Consult a qualified healthcare professional who understands your particular history for individual concerns.