RINGWORM


DEFINITION

Ringworm is a common infection with a misleading name. The disease is actually caused by a fungus, not a worm. There are many types of ringworm and each is caused by a different type of fungus.

DESCRIPTION

Ringworm gets its name from its appearance, not from the agent that causes it. The characteristic feature of ringworm is patches of rough, reddened skin. The patches often contain circular lesions (pronounced LEE-zhuns), open wounds, that look as if they were caused by tiny worms under the skin.

Over time, the lesions grow outward from their center. The center heals up and becomes hard and crusty. But the outer edges of the lesions become inflamed and spread outwards.

Types of Ringworm

The most common types of ringworm are often named for the part of the body on which they occur.

Body ringworm is also known as tinea corporis (pronounced tin-EE-uh KORE-pur-iss). It can affect any part of the body except the scalp, feet, and facial area where a man's beard grows. These areas are infected with other types of ringworm. Tinea corporis causes well-defined flaky sores. The sores can be dry and scaly or moist and crusty.

Scalp ringworm is called tinea capitis (pronounced tin-EE-uh KAP-ih-tiss). This type of ringworm is seen most commonly in children. It causes scaly, swollen blisters or a rash that looks like black dots. Scalp ringworm sometimes becomes inflamed and filled with pus. These areas can cause crusty, flaky, round bald patches. Scalp ringworm can cause scarring and permanent hair loss.

Ringworm of the groin is also called tinea cruris (pronounced tin-EE-uh KROOR-iss) or "jock itch." It causes raised red sores with well-marked edges. This type of ringworm can spread to the buttocks, inner thighs, and external genitalia.

Ringworm of the nails is also known as tinea unguium (pronounced tin-EE-uh UN-gwee-um). It usually starts at the tip of a toenail. The nail gradually becomes thicker and discolored. It may begin to die off and pull away from the nail bed. Infections of the fingernails are much less common.

Tinea pedis is ringworm of the feet and is more commonly known as athlete's foot (see athlete's foot entry).

CAUSES

The fungus that causes ringworm is spread from one person to another. Sometimes this happens through direct contact. An infected person may touch someone who does not have the disease and directly transfer the fungus to the second person.

At other times, the fungus is transferred indirectly. For example, people with ringworm may leave the fungus on towels, hairbrushes, or other objects. A second person may then pick up the fungus while handling these objects.

Certain conditions increase the risk of spreading the fungi (more than one fungus) that cause ringworm. These include dampness, humidity, and dirty, crowded living conditions.

Ringworm: Words to Know

Fungus:
A large group of organisms that includes mold, mildew, rust fungi, yeast, and mushrooms, some of which may cause disease in humans and other animals.
Lesion:
A change in the structure or appearance of a part of the body as the result of an injury or infection.
Tinea corporis:
Scientific name for body ringworm, a fungal infection of the skin that it can affect any part of the body except the scalp, feet, and facial area.
Tinea capitis:
Scalp ringworm, a fungal infection of the scalp.
Tinea cruris;
An fungal infection that affects the groin and can spread to the buttocks, inner thighs, and external genitalia; also called "jock itch."
Tinea unguium:
Ringworm of the nails; a fungal infection that usually begins at the tip of a toenail.

SYMPTOMS

Symptoms of ringworm include inflammation and scaling of the infected area, along with itching.

Body ringworm is also known as tinea corporis. The sores from the infection can be dry and scaly or moist and crusty. (Reproduced by permission of Custom Medical Stock
Body ringworm is also known as tinea corporis. The sores from the infection can be dry and scaly or moist and crusty. (Reproduced by permission of
Custom Medical Stock

DIAGNOSIS

The various types of ringworm have distinctive appearances. A doctor or nurse will often suspect the disease simply from looking at a patient's skin. This preliminary diagnosis can be confirmed by taking scrapings of the infected skin. A small knife is used to scrape off a small amount of the infected material. The material can then be examined under a microscope where any fungi that may be present can be seen.

TREATMENT

Some cases of ringworm disappear without treatment. Other cases can be treated with various forms of medication. Some medications are applied directly to the infected skin in the form of powder or cream. Others must be taken orally (by mouth). Doctors recommend that medications be continued for two weeks after symptoms disappear. This precaution guarantees that all fungi are killed.

There are also specific treatments for each type of ringworm. These include:

  • Body ringworm: Wear loose clothing and check daily for open sores. Apply wet dressings to those sores two to three times a day.
  • Ringworm of the nails: Cut infected nails short and clear dead cells with an emery board.

Ringworm on a man's chin. Ringworm infections are most common on the feet, scalp, on the body, or in toenails, but they can infect any part of the skin. (© 1989. Reproduced by Custom Medical Stock Photo.)
Ringworm on a man's chin. Ringworm infections are most common on the feet, scalp, on the body, or in toenails, but they can infect any part of the skin. (© 1989. Reproduced by
Custom Medical Stock Photo
.)

  • Ringworm of the groin: Wear cotton underwear and change it more than once a day. Keep the infected area dry. Use antifungal powder and/or lotion.
  • Scalp ringworm: Use antifungal shampoo containing selenium sulfide or a prescription shampoo.

Alternative Treatment

Both homeopathic and herbal remedies are recommended for the treatment of ringworm. Some homeopathic products suggested include sepia, tellurium, graphite, and sulfur.

Herbs recommended for the treatment of ringworm include tea tree oil, thuja, and lavender. Practitioners may recommend other herbs to improve the body's immune system in general. Echinacea and astragalus are the two herbs most commonly recommended for this purpose. Alternative practitioners also suggest a well-balanced diet that includes protein, complex carbohydrates, fresh fruits and vegetables, and good quality fats to strengthen the immune system.

PROGNOSIS

Ringworm infections usually clear up with treatment. However, they tend to reoccur. About one in five patients experience a chronic infection that reappears time and time again.

Once scalp ringworm has cleared up, new hair starts to grow back. It usually takes six to twelve months for new hair to cover bald patches. New fingernails also grow out to replace those lost to ringworm of the nails. Complete recovery usually takes three to twelve months. Infections of the toenail are among the most difficult of all ringworm infections to cure.

PREVENTION

The best way to avoid getting ringworm is to avoid coming into contact with the fungi that cause the disease. That means staying away from people who have ringworm. It also means not handling objects that may have been used by an infected patient.

See also: Athlete's foot.

FOR MORE INFORMATION

Books

Cummings, Stephen, and Dana Ullman. Everyone's Guide to Homeopathic Medicine. Los Angeles: Jeremy P. Tarcher, 1984.

Shaw, Michael. Everything You Need to Know about Diseases. Springhouse, PA: Springhouse Corporation, 1996.

Web sites

Athlete's Foot, Jock Itch and Ringworm. [Online] http://www.2.ccf.org/ed/pated/kiosk/hinfo/docs/0039.htm (accessed on April 7, 1998).

"Ringworm." Thriveonline. [Online] http://www.thriveonline.com/health/Library/pedillsymp/pedillsymp361.html (accessed on April 5, 1998).

Ringworm. [Online] http://www.yourhealth.com/ohl/1282/html (accessed April 7, 1998).