Symptoms

The signs and symptoms of ringworm include:

• A circular rash on your skin that's red and inflamed around the edge and healthy looking in the middle
• Slightly raised expanding rings of red, scaly skin on your trunk or face
• A round, flat patch of itchy skin

More than one patch of ringworm may appear on your skin, and patches or red rings of rash may overlap. You can have tinea infection without having the common red ring of ringworm.

When to see a doctor
See your doctor if you have a rash on your skin that doesn't improve within two weeks. You may need prescription medication.

See your doctor immediately if you experience:

• Excessive redness
• Swelling
• Drainage
• Fever

Causes

Fungal infections, such as ringworm, are caused by microorganisms that become parasites on your body. These mold-like fungi (dermatophytes) live on the cells in the outer layer of your skin.

Ringworm is contagious and can be spread in the following ways:

• Human to human. Ringworm often spreads by direct, skin-to-skin contact with an infected person.
• Animal to human. You can contract ringworm by touching an animal with ringworm. Ringworm can spread while petting or grooming dogs or cats. You can also get ringworm from ferrets, rabbits, goats, pigs and horses.
• Object to human. Ringworm can spread by contact with objects or surfaces that an infected person or animal has recently touched or rubbed against, such as clothing, towels, bedding and linens, combs, and brushes.
• Soil to human. In rare cases, ringworm can be spread to humans by contact with infected soil. Infection would most likely occur only from prolonged contact with highly infected soil.

Risk factors

You're at higher risk of ringworm of the body if you:

• Live in damp, humid or crowded conditions
• Have close contact with an infected person or animal
• Share clothing, bedding or towels with someone who has a fungal infection
• Sweat excessively
• Participate in contact sports, such as wrestling, football or rugby
• Wear tight or restricted clothing
• Have a weakened immune system

Complications

A fungal infection rarely spreads below the surface of the skin to cause serious illness. However, people with weak immune systems, such as those with HIV/AIDS, may find it difficult to get rid of the infection.

Preparing for your appointment

Your family doctor or a skin specialist (dermatologist) can diagnose ringworm of the body. Because appointments can be brief and there's often a lot of ground to cover, it can help to be well prepared. Here are some tips to help you get ready for your appointment and what to expect from your doctor.

What you can do
Your time with your doctor is limited, so preparing a list of questions helps you make the most of your appointment. List your questions from most important to least important in case time runs out. For ringworm, some basic questions to ask your doctor include:

• What might be causing the signs and symptoms?
• Are tests needed to confirm the diagnosis?
• What is the best course of action?
• Is this condition temporary or chronic?
• Is there a generic alternative to the medicine you're prescribing?
• Can I wait to see if the condition goes away on its own?
• What can I do to prevent the infection from spreading?
• What skin care routines do you recommend while the condition heals?

What to expect from your doctor
Your doctor is likely to ask you a number of questions, such as:

• When did you first notice your symptoms?
• What did the rash look like when it first started?
• Have you had this type of rash in the past?
• Is the rash painful or itchy?
• What, if anything, makes it better?
• What, if anything, makes it worse?
• Does a pet or family member already have ringworm?

Tests and diagnosis

Your doctor will determine if you have ringworm or another skin disorder, such as psoriasis or atopic dermatitis. Your doctor may take skin scrapings or samples from the infected area and look at them under a microscope, a procedure known as a potassium hydroxide (KOH) test. If a sample shows fungus, treatment may include an antifungal medication. If the test is negative but your doctor still suspects that you have ringworm, a sample may be sent to the laboratory for testing. This test is known as a culture. Your doctor may also order a culture if your condition doesn't respond to treatment.

Treatment and drugs

If ringworm of the body covers a large area, is severe or doesn't respond to over-the-counter medicine, you may need a prescription-strength topical medication (lotion, cream or ointment) or an oral medication (pill, capsule or tablet). Many options are available, including:

Topical

• Butenafine (Mentax)
• Ciclopirox (Loprox)
• Econazole
• Clotrimazole (Mycelex)
• Terbinafine (Lamisil)

Oral

• Griseofulvin (Grifulvin V)
• Itraconazole (Sporanox)
• Fluconazole (Diflucan)
• Terbinafine (Lamisil)

Side effects from oral medications include gastrointestinal upset, rash and abnormal liver functioning. Certain oral medications for ringworm may alter the effectiveness of warfarin, an anticoagulant drug that decreases the clotting ability of your blood.

Lifestyle and home remedies

For a mild case of ringworm, you can apply an over-the-counter antifungal lotion, cream or ointment. Most fungal infections respond well to these topical agents, which include:

• Clotrimazole (Lotrimin AF)
• Miconazole (Micatin, Micaderm)
• Terbinafine (Lamisil AT)
• Tolnaftate (Tinactin)

Wash and dry the affected area. Then, apply a thin layer of the topical agent once or twice a day for at least two weeks, or according to package directions. Extend the application about an inch beyond the visible edge to ensure the best treatment. If you don't see an improvement after four weeks, see your doctor.

Prevention

Ringworm is difficult to prevent. The fungus that causes ringworm is common and contagious even before symptoms appear. However, you can help reduce your risk of ringworm by taking these steps:

• Educate yourself and others. Be aware of the risk of ringworm from infected persons or pets. Tell your children about ringworm, what to watch for and how to avoid the infection.
• Keep clean. Wash your hands often to avoid the spread of infection. Keep common or shared areas clean, especially in schools, child care centers, gyms and locker rooms.
• Stay cool and dry. Don't wear thick clothing for long periods of time in warm, humid weather. Avoid excessive sweating.
• Avoid infected animals. The infection often looks like a patch of skin where fur is missing. In some cases, though, you may not notice any signs of the disease. Ask your veterinarian to check your pets and domesticated animals for ringworm.
• Don't share personal items. Don't let others use your clothing, towels, hairbrushes or other personal items. Refrain from borrowing these items from others as well.