Ringworm, also known as tinea or dermatophytosis, is a common fungal infection of the skin. Despite its name, ringworm has nothing to do with worms. It is caused by various species of fungi that thrive in warm, moist environments. This infection can affect the skin, scalp, feet, and nails, and is highly contagious. Understanding its symptoms, types, and treatment options is essential for timely management.

Symptoms of Ringworm

The symptoms of ringworm vary depending on the area of the body affected, but they generally include:

1. Ring-shaped Rash: The most identifiable sign is a round, scaly rash with raised edges. The center of the rash may appear clear or normal, giving it a ring-like appearance.
2. Itching and Discomfort: The rash is often intensely itchy, causing discomfort.
3. Redness and Inflammation: The affected skin may become red and inflamed.
4. Blistering or Cracking: In severe cases, blisters may form, or the skin may crack and become painful.
5. Hair Loss: When ringworm affects the scalp, it can cause patches of hair to fall out, leaving bald spots.

Types of Ringworm

Different species of fungi cause various types of ringworm, classified based on the area of the body they affect:

1. Tinea Corporis (Body): This type of ringworm affects the skin on the body and is characterized by the classic ring-shaped rash.
2. Tinea Capitis (Scalp): Common in children, this type affects the scalp, leading to scaly, itchy patches and hair loss.
3. Tinea Pedis (Athlete’s Foot): This affects the feet, especially between the toes, causing itching, burning, and peeling skin.
4. Tinea Cruris (Jock Itch): Affects the groin area, causing itching, redness, and a rash, often seen in athletes.
5. Tinea Unguium (Nail Fungus): Affects the nails, causing them to become thick, discolored, and brittle.

Causes of Ringworm

Ringworm is caused by dermatophytes, a type of fungus that feeds on keratin (a protein found in skin, hair, and nails). The fungi thrive in warm, moist environments such as public showers, locker rooms, and swimming pools. It spreads through:

• Direct Skin Contact: Touching an infected person or animal.
• Indirect Contact: Coming into contact with contaminated objects like towels, bedding, or clothing.
• Soil: Rarely, ringworm can be contracted from soil that contains fungal spores.

Treatment of Ringworm

Treatment for ringworm usually involves antifungal medications. The type of medication depends on the severity of the infection and its location on the body.

1. Topical Antifungals: For mild cases, over-the-counter (OTC) antifungal creams, lotions, or powders can be effective. These include:
   • Clotrimazole
   • Miconazole
   • Terbinafine
   These should be applied directly to the affected area as per the instructions for 2 to 4 weeks, even if symptoms improve sooner.
2. Oral Antifungals: For more severe infections, particularly on the scalp or nails, oral antifungal medications may be prescribed. Common options include:
   • Griseofulvin
   • Terbinafine
   • Itraconazole
   Treatment can last several weeks to months, depending on the location of the infection.
3. Antifungal Shampoo: For scalp ringworm, antifungal shampoos containing ketoconazole or selenium sulfide can be used to reduce shedding of fungal spores.
4. Hygiene Practices: In addition to medication, maintaining proper hygiene is crucial:
   • Keep the affected area clean and dry.
   • Avoid sharing personal items like towels or clothing.
   • Wash bedding and clothing in hot water to prevent reinfection.

It is absolutely important to take the medicine as prescribed by dermatologist. This course of anti-fungals might last for 1-3 months. Interestingly the old medicine like Fluconazole, clotrimazole, or miconazole are not showing much response in India. More so if you have applied steroids.

Itraconazole is the only effective medication. It has side effects. Do not take it without consulting a doctor. In addition, you have to put 2 different anti-fungal creams like luliconazole and amorolfine for 3 months continuously.

Preventing Ringworm

Preventing ringworm involves good hygiene and taking steps to avoid contact with the fungi:

Keep Skin Dry and Clean: Fungi thrive in moist environments, so ensure that areas prone to sweating (such as the feet and groin) are kept dry.

Avoid Sharing Personal Items: Do not share towels, combs, clothing, or sports equipment with others.

Wear Footwear in Public Areas: Use sandals or flip-flops in public showers, locker rooms, and around swimming pools.

Treat Pets: Animals can carry ringworm without showing symptoms. If a pet is diagnosed, they should be treated promptly, and precautions should be taken to avoid spreading the infection.

Do not self medicate: The most important precaution is does not self medicate. Most tubes available at the chemist’s shop have steroids that reduce itching and redness, but fungus increases. Steroids reduce your immunity. Once there is no fight between fungus and immunity, redness and itching go. But fungus increases. This is the reason when you stop the steroid tube fungus comes back even more severely.

Do not itch: Avoid itching because this will lead to the spreading of fungal infection. Take anti-itching medicine like cetirizine to stop itching.

Avoid tight clothes: Wear loose cotton clothes that allow air circulation. Avoid tight cloths like jeans or leggings etc.

Wash cloth seperately: Wash clothes of infected person seperately that too inside out. If possible, iron them inside out before wearing them.

Do not miss dose: Fungus is getting more resistant day by day. if you miss medicines chances are that medicines prescribed by the doctor would stop working. Also, apply medicine 2 cm beyond the margins because fungus lives on the margin of the rash.

Watch this video for full list of precautions:

Why Fungal infection is getting resistant?

The main causes of the increase and resistance of fungal infections are:

• Application of steroid creams on ringworm.
• Overuse of antibiotics
• Use of insecticide and pesticides has increased the level of fungal spores in the environment.
• Fungal elements are not getting destroyed easily and are found to survive on toilets seats, bedding, shoes, clothes, nails etc.
• Incomplete treatment.

When to See a Doctor

In most cases, ringworm responds well to over-the-counter treatments, but if you experience any of the following, it’s time to consult a doctor:

• The rash doesn’t improve after two weeks of treatment.
• The infection is severe or widespread.
• You have a compromised immune system.
• The infection recurs frequently.
• You experience hair loss or have a rash on the scalp.

Home remedies of fungus

Fungus tends to recur even after treatment, You can put mustard oil twice a day because it has anti-fungal action.

You can also make this anti-fungal oil oil to prevent recurrences by mixing:

• Mustard oil- 100ml
• Tea tree oil- 5ml to 10 ml(reduce concentration if it irritates your skin)
• Garlic oil 1 ml
• Neem oil- 5 ml to 10 ml (reduce concentration if it irritates your skin)

Do not use this oil on active red lesions because it will irritate them. Start it once air skin gets normal to prevent recurrences.

Conclusion

Ringworm is a common but manageable fungal infection. By recognizing its symptoms early and using appropriate treatments, most cases can be effectively treated at home. However, for more persistent or severe cases, seeking medical advice is essential to prevent complications and stop the spread of infection.