Ringworm is very common, especially among children, and may be spread by skin-to-skin contact, as well as via contact with contaminated items such as hairbrushes. Ringworm spreads readily, as those infected are contagious even before they show symptoms of the disease. Humans can contract ringworm from animals; cats and dogs are often carriers. It should be noted that any contact sports such as wrestling has a risk of contracting the fungal infection through skin-to-skin contact.

Types

A number of species of fungi called dermatophytes cause ringworm. Members of the genera Trichophyton and Microsporum are the most common causative agents. These fungi attack various parts of the body and lead to the following conditions:

Tinea corporis affects the arms, legs, and trunk
Tinea capitis affects the scalp
Tinea cruris (jock itch) affects the groin area
Tinea pedis (athlete's foot) affects the feet
Tinea unguium affects the fingernails and toenails
Tinea versicolor

Symptoms and diagnosis

The most well known sign of ringworm is the appearance of one or more red raised itchy patches with defined edges. These patches are often lighter in the center, taking on the appearance of a ring. If the infected area involves the scalp or beard area, then bald patches may become evident. If the nails are affected, they may thicken, discolor, and finally crumble.

Doctors can diagnose ringworm on sight, or they may take a skin scraping. This is examined under a microscope, or put on an agar plate in a microbiology laboratory and allowed to grow. Some of the fungi fluoresce under a black light examination.

Topical antifungal drugs containing miconazole and clotrimazole, available by perscription or over the counter, are used to clear up the infection.

Definition

Ringworm is a common fungal infection of the skin. The name is a misnomer since the disease is not caused by a worm.

Description

More common in males than in females, ringworm is characterized by patches of rough, reddened skin. Raised eruptions usually form the circular pattern that gives the condition its name. Ringworm may also be referred to as dermatophyte infection.

As lesions grow, the centers start to heal. The inflamed borders expand and spread the infection.

Types of ringworm

Ringworm is a term that is commonly used to encompass several types of fungal infection. Sometimes, however, only body ringworm is classified as true ringworm.

Body ringworm (tinea corporis) can affect any part of the body except the scalp, feet, and facial area where a man's beard grows. The well-defined, flaky sores can be dry and scaly or moist and crusty.

Scalp ringworm (tinea capitis) is most common in children. It causes scaly, swollen blisters or a rash that looks like black dots. Sometimes inflamed and filled with pus, scalp ringworm lesions can cause crusting, flaking, and round bald patches. Most common in black children, scalp ringworm can cause scarring and permanent hair loss.

Ringworm of the groin (tinea cruris or jock itch) produces raised red sores with well-marked edges. It can spread to the buttocks, inner thighs, and external genitals.

Ringworm of the nails (tinea unguium) generally starts at the tip of one or more toenails, which gradually thicken and discolor. The nail may deteriorate or pull away from the nail bed. Fingernail infection is far less common.

Causes & symptoms

Ringworm can be transmitted by infected people or pets or by towels, hairbrushes, or other objects contaminated by them. Symptoms include inflammation, scaling, and sometimes, itching.

Diabetes mellitus increases susceptibility to ringworm. So do dampness, humidity, and dirty, crowded living areas. Braiding hair tightly and using hair gel also raise the risk.

Diagnosis

Diagnosis is based on microscopic examination of scrapings taken from lesions. A dermatologist may also study the scalp of a patient with suspected tinea capitis under ultraviolet light.

Treatment

Some infections disappear without treatment. Others respond to such topical antifungal medications as naftifine (Caldesene Medicated Powder) or tinactin (Desenex) or to griseofulvin (Fulvicin), which is taken by mouth. Medications should be continued for two weeks after lesions disappear.

A person with body ringworm should wear loose clothing and check daily for raw, open sores. Wet dressings applied to moist sores two or three times a day can lessen inflammation and loosen scales. The doctor may suggest placing special pads between folds of infected skin, and anything the patient has touched or worn should be sterilized in boiling water.

Infected nails should be cut short and straight and carefully cleared of dead cells with an emery board.

Patients with jock itch should:

Wear cotton underwear and change it more than once a day
Keep the infected area dry
Apply antifungal ointment over a thin film of antifungal powder.

Shampoo containing selenium sulfide can help prevent spread of scalp ringworm, but prescription shampoo or oral medication is usually needed to cure the infection.

Alternative treatment

The fungal infection ringworm can be treated with homeopathic remedies. Among the homeopathic remedies recommended are:

Sepia for brown, scaly patches
Tellurium for prominent, well-defined, reddish sores
Graphites for thick scales or heavy discharge
Sulphur for excessive itching.

Topical applications of antifungal herbs and essential oils also can help resolve ringworm. Tea tree oil (Melaleuca spp.), thuja (Thuja occidentalis), and lavender (Lavandula officinalis) are the most common. Two drops of essential oil in 1/4 ounce of carrier oil is the dose recommended for topical application. Essential oils should not be applied to the skin undiluted. Botanical medicine can be taken internally to enhance the body's immune response. A person must be susceptible to exhibit this overgrowth of fungus on the skin. Echinacea (Echinacea spp.) and astragalus (Astragalus membranaceus) are the two most common immune-enhancing herbs. A well-balanced diet, including protein, complex carbohydrates, fresh fruits and vegetables, and good quality fats, is also important in maintaining optimal immune function.

Prognosis

Ringworm can usually be cured, but recurrence is common. Chronic infection develops in one patient in five.

It can take 6-12 months for new hair to cover bald patches, and 3-12 months to cure infected fingernails. Toenail infections do not always respond to treatment.

Prevention

Likelihood of infection can be lessened by avoiding contact with infected people or pets or contaminated objects and staying away from hot, damp places.

For Your Information

Books

Cummings, Stephen, and Dana Ullman. Everybody's Guide to Homeopathic Medicine. Los Angeles, CA: Jeremy P. Tarcher, 1984.
Shaw, Michael. Everything You Need to Know About Diseases. Springhouse, PA: Springhouse Corporation, 1996.
Other
Athlete's Foot, Jock Itch and Ringworm. http://www2.ccf.org/ed/pated/kiosk/hinfo/docs/0039.htm (7 April 1998).
Ringworm. http://www.thriveonline.com/health/Library/pedillsymp/pedillsymp361.html (5 April 1998).
Ringworm. http://www.yourhealth.com/ohl/1282/html (7 April 1998).

Gale Encyclopedia of Medicine. Gale Research, 1999.

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