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ASK THE DOC – RINGWORM: A FUNGUS AMONG US

Written by Jason Goldman M.D.

A very common skin ailment first thought to be the result of a worm infecting the skin is known as ringworm. This condition is not actually a worm at all, but a fungal skin infection that is contagious and can spread from person to person. It can be treated with medication but it is important to recognize the condition so prompt therapy can be initiated. In this article, I will discuss the causes, course of the disease and treatment.

Our skin has many organisms on it including bacteria and fungus. This symbiotic relationship is usually in balance and keeps our skin healthy. In some cases, fungi can infect various parts of the body and lead to unsightly lesions. The name for this skin infection is tinea and the usual species of fungus are trichophyton, microsporidia and epidermophyton. The condition is named for the location of the fungus. Since the disease was originally thought to be caused by a worm, it was named for the word tinea, which means worm in Latin. The location of the fungus would define the second name. For example, tinea pedis occurs on the foot, tinea capitis on the head, tinea corporis on the body and so forth. Regardless of the name, the same fungal species are the culprit.

The lesions of ringworm appear as red, scaly, itchy patches on the affected area. It will usually manifest 4-14 days after exposure and is very contagious. Fungi like warm, damp areas and can be found in both the environment as well as on people and animals. The disease can easily spread from person to person, animal to person or environment to person. While individuals with lowered immune systems can certainly get the disease, everyone is at risk. It is important to remember that the fungus does live in many places so a person can easily contract tinea from sharing clothing, towels, personal items, showers, locker rooms, as well as personal contact with infected people and animals. It is also fairly easy to diagnose ringworm as it has a very typical appearance and can be recognized by most healthcare providers. If necessary, a skin scraping can be done and the fungus can be identified under a microscope.

Treating ringworm can usually be accomplished by over the counter medications known as antifungals. Various topical medications such as terbinafine, clotrimazole, ketoconazole, miconazole and others are effective against most forms of tinea but some will require oral medications prescribed by a doctor. Tinea of the scalp almost always requires a prescription. If ringworm is suspected then over the counter treatment can be initiated, but if it worsens, does not improve or respond to treatment, then medical care should be sought with a physician to make sure it is tinea and that proper treatment is being used. While the disease is common and contagious, with proper treatment the person should recover completely without significant problems.

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