What is a Ringworm?
Justin Creel, MD, FAAD
From Zachary to Natchez and all across the South, ringworms are common harmless conditions that have nothing to do with worms. In fact, they are caused by a specific type of fungus known as dermatophytes, and tinea is the term for their infection of skin, hair, or nails. Thankfully, infections are rather harmless and do not invade the body. Infections are quite contagious and can spread to multiple sites or individuals. Most cases, however, tend to come from environmental exposures. The fungus thrives in moist, humid environments (hence the Southern predilection) and are commonly found in places such as soil, showers, damp floors, sheets, brushes, hats, and gyms. They can also infect pets or animals and then subsequently spread to humans. The appearance of tinea, as well as its symptoms, will vary based on the body part that’s infected. In fact, “ringworms,” athlete’s foot,” and “jock itch” are all subtypes caused by the same infection!
Tinea Corporis - Body
Better known as “ringworm,” the skin often appears like a red, scaly ring with clearing in the center. Sometimes, rings will be partial/broken, multiple/numerous, or even “snake-like” or irregularly shaped.
Tinea Cruris - Groin
Better known as “jock itch,” the skin is typically red, itchy, and limited to the folds. It commonly starts as a small patch that may slowly enlarge with time. Patches may be in the shape of a round ring, 1 to 2 inches wide, and they may or may not have associated flaking.
Tinea Pedis - Feet
Better known as “athlete’s foot,” the skin is usually moist and flaky between the toes, with diffuse dryness and scaliness limited to the sole. Less commonly, there may be rings on the tops of toes or feet, and in severe cases they may be associated blisters. It is common for patients to have associated nail involvement, and this often serves as the primary source for subsequent reinfection.
Tinea Capitis - Scalp
Primarily seen in kids, the scalp may show flakes of skin resembling dandruff. There may also be pus bumps or patches of hair loss or broken hairs. In some, the fungus causes more inflammation with redness, crusting and weeping. There may even be enlargement of lymph nodes in the neck (ie “swollen glands”). When hair loss occurs, it is usually temporary, as long as treatment is timely and sufficient.
Onychomycosis - Nails
Primarily seen in the toes of older adults, nails are typically thickened with yellowish discoloration. There is often buildup of loose skin and fungus underneath the nail, which may be more pronounced at the outer edge or border.
There are numerous over-the-counter and prescription meds available. In short, treatment will vary based on infection type, source, and severity. Typically, the most effective topical treatment is over-the-counter butenafine cream (Lotrimin Ultra) - it should be applied twice daily for 2 weeks unless otherwise directed. Of note, involvement of hair or nails will almost always require oral meds and should be addressed in a timely manner to prevent irreversible damage.
Lastly, there are several simple ways we can help reduce the spread and recurrence of these infections. Avoid sharing hats, combs, brushes, pillowcases, and towels. Keep hair accessories clean. Towel dry well after bathing. Pay special attention to feet and body folds, including the skin between your toes. Wear sandals or flip flops in locker rooms, as well as public showers and pools. Change socks at least daily. And keep any rashes covered with bandages or clothes.
For more information or to schedule your appointment, please call our office at 225.654.1124!