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Ringworm is a fungal infection which can affect any part of the body, but is more commonly found around the scalp, nails, feet and groin.

The medical term for ringworm is tinea. Other medical terms are added to describe the area of the body affected. For example, tinea capitis (the scalp), tinea coporis (the body), tinea cruris (the groin), tinea pedis (the feet), tinea unguium (the nails).

Ringworm is extremely common affecting people of all ages. It is not serious but it can be irritating and unsightly.
Despite its name, ringworm is not caused by a worm but is caused by a fungus, the most common of which is called a dermatophyte. The fungus lives on dead skin or nails and thrives in warm, damp places. It is therefore particularly likely to appear in areas of the body prone to sweating such as between the toes (tinea pedis or athlete’s foot) or in the groin (tinea cruris).

The fungus is highly contagious and is spread by direct contact with people or animals that have the infection. It can also be spread indirectly through shared towels or footwear and by contact with the damp floor of changing rooms and swimming pools. Children and adults who come into close contact with animals are at risk of becoming infected.

People with eczema or other skin complaints may be particularly susceptible to catching ringworm probably because the skin’s natural ability to act as a barrier to the fungus is impaired.
Ringworm on the skin usually appears as circular or oval-shaped, itchy red patches, which gradually grow in size from a few millimetres to a few centimetres. As the infection spreads, the centre may heal and return to its normal colour, giving the impression of a ring, from which the condition gets its name.

When the feet and toes are affected, a condition commonly referred to as athlete’s foot, the skin between the toes becomes red and itchy and the skin may peel and crack causing the whole area to blister and become very sore. If left untreated, the fungus may eventually spread to the toenails which turn yellow, thicken, become brittle and crumble.

Ringworm infections of the scalp or the beard may cause areas of hair loss.

Skin that has been broken may become infected by bacteria, causing yellow, pus-filled cuts.
Ringworm can usually be easily treated with antifungal preparations. Treatment is best started as soon as possible as the infection is harder to treat if it spreads, particularly if it spreads to the toenails.

A wide variety of topical preparations is available for direct application to the part of the body affected. Creams containing clotrimazole, econazole, ketoconazole, miconazole or terbinafine may be used for the treatment of ringworm on the body, groin or feet. Best results are obtained if use of the antifungal preparations is continued for two weeks after symptoms have disappeared. If the area is highly inflamed, preparations combining the topical steroid hydrocortisone with the antifungal agent may help reduce redness and swelling.

Sprays or powders containing the antifungal agent tolnaftate are particularly suitable for treating athlete's foot. The spray and powder can also be used on footwear, helping to reduce infection.

A lacquer containing the antifungal agent amorolfine can be used if the ringworm has spread to the nails. The lacquer must be applied regularly every week and it may take up to a year to rid the infection. Alernatively, a skin solution containing tioconazole can be applied twice daily for 6 to 12 months.

If topical preparations do not work, more powerful antifungal agents such as fluconazole, itraconazole, terbinafine or griseofulvin taken in the form of tablets or capsules may be used.
When to see your pharmacist
Almost all antifungal preparations for the treatment of ringworm can be obtained from your local pharmacy without the need for a prescription. Describe the symptoms fully and your pharmacist will recommend a product that is best suited to the area of the body affected.

Although your pharmacist is able to supply amorolfine nail lacquer without a prescription, there are certain conditions that need to be met first, so your pharmacist will need to talk to you in detail to make sure that it is appropriate for you to use the product and that you know how to apply the lacquer properly.

If over the counter preparations do not work, or if you have a bacterial skin infection, your pharmacist will recommend that you see your doctor who may decide to prescribe more powerful antifungal agents or antibiotics.
When to see your doctor
Visit your doctor if over the counter remedies have not worked, if the problem is recurring or particularly severe. Ringworm affecting the scalp and nails may be particularly difficult to clear, so your doctor may prescribe antifungal agents in the form of tablets. If you have developed a skin infection, your doctor will probably prescribe an antibiotic in the form of a cream.
Living with ringworm
Some simple precautions can reduce the risk of catching ringworm. Wear light clothing that does not trap sweat. Change clothing, particularly socks regularly. Never share towels or hair brushes with someone you know that has ringworm. Always dry yourself thoroughly after washing. Wash your hands thoroughly after being in contact with animals.

In swimming baths, changing rooms or communal shower blocks do not walk around in bare feet, instead wear flip-flops or waterproof shoes.
Useful Tips
  • Try and keep the skin dry and open to the air if possible

  • Keep your towel and face cloth separate from the rest of the family, as ringworm is contagious

  • If you have athlete's foot, make sure that you dry between the toes thoroughly after bathing

  • If you have ringworm of the groin, avoid tight clothing and underwear made of synthetic fabrics like nylon

Reviewed on 27 May 2011