Ringworm: signs, symptoms and complications

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Despite its name, ringworm is not caused by a worm. This is a fungal infection that causes a red, scaly, raised rash that usually forms round or ring-shaped patches.

However, in some areas, ringworm may not appear on the classic ring. In places like the scalp, hands and feet, groin, or beard area, ringworm can simply cause an itchy, scaly rash with no round shape.

Knowing what ringworm signs and symptoms to look for can help you correctly diagnose and treat them .

© Get Information on Medicines, 2018

Frequent symptoms

Anyone can get ringworm , but it is especially common in children .

Ringworm symptoms can vary depending on the area of the body affected, extending from the head to the toes. Ringworm on the abdomen can look very different than, for example, ringworm on the scalp.

In all areas, the first sign of ringworm is usually a small, red, scaly patch of skin. Just before the rash appears, you may feel a slight burning or stinging sensation. Ringworm is usually red in color, but the rash can be brown or gray in color.

Body ringworm (Tinea Corporis)

DermNet / CC BY-NC-ND

He has the typical ringworm rash on his torso, arms, and legs. First , you find a small, scaly area on your skin that is itchy. The scaly area rapidly progresses to form a slightly raised, ring-shaped rash. As the eruption spreads, the rings increase in diameter. The skin inside the ring may look clean and normal, or have red, scaly patches. Sometimes the rash resembles a bullseye. As the rash progresses, small blisters may form, causing oozing and crusting.

Rings are not always round; they can also be irregular. You can only have one ring or several. They can be separate or overlapping.

Ringworm of the face (Tinea faciei)

Ringworm on the face can turn into a classic ring-shaped rash, but not always. Instead, you may notice raised, scaly, red spots that itch.

Ringworm in the beard area (Tinea Barbae)

In men, ringworm can also appear in the beard area. Ringworm in the beard area causes scabbing and flaking of the skin . Hair can break or fall out, causing receding of the beard hairline. Ringworm here often forms bumps and blisters that can be mistaken for acne or folliculitis.

Ringworm of the scalp (Tinera capitis)

On the scalp, you probably won't notice the rings. Instead, there will be scaly patches that itch. These spots can be red, silver gray, or hard yellow. Hair can become brittle, break, or fall out easily. Very often it causes receding of the hairline. Ringworm of the scalp is quite common in toddlers and school children.

Athlete's foot or ringworm of the foot (Tinea pedis)

DermNet / CC BY-NC-ND

Athletic foot is caused by the same group of fungi, dermatophytes , as ringworm. Instead of a ring rash, you will end up with dry, scaly and itchy skin, especially between the toes. Your feet may burn or itch. After a while, the sole of the foot may thicken like a corn. Athletic feet are common in teens and adults, but rarely before adolescence.

Ringworm in the groin area, also known as Jock Itch (Tinea Cruris)

Like a sports foot, an athlete's itch is caused by the same group of fungi that causes ringworm. Athlete's itch causes a red to brown rash in the skin folds around the groin. It can spread to the thighs, buttocks, and abdomen. The rash is scaly and raised. It stings often, but not always. It may be painful. Jock itch is more common in men than women and, like athletes, is rare in children .

Ringworm of the hands (Tinea manus)

Ringworm can also appear on the hands. If it appears on the back of your hands, you are more likely to develop the classic itchy, ring-shaped rash. However, on the palms and between the fingers, it can be mistaken for dry skin due to dryness, peeling, and cracking. Over time, you may also notice a thickening of the skin in the form of calluses.

Ringworm of the nails (Tinea Unguium)

This fungal infection, also called onychomycosis , can also affect the nails. It can happen on both fingernails and toenails, but is most common on the toes. The nails will become discolored, thicker and brittle. They can be detached from the nail bed.

Possible complications

Really serious complications of ringworm are extremely rare and, in the vast majority of cases, go away quickly with treatment.

Extension

The biggest complication to look for spreads to other areas of the body. Ringworm can be easily spread by touching infected spots and then touching other areas of the skin.

Dark markings

After the ringworm has healed, some people may have a dark mark at the site of the rash. This is called post-inflammatory hyperpigmentation . These spots can appear after an inflammatory wound such as ringworm has healed. Some people are more likely to develop post-inflammatory hyperpigmentation, and this is more common in people with a dark complexion.

Secondary infections

Secondary bacterial infections can also occur if bacteria enter damaged skin. They may be more common in children because they are more likely to scratch, damage the skin, and allow opportunistic bacteria to take root. Signs of a secondary bacterial infection include redness, pain, swelling, pimples, fever, and drainage. If the fungal infection is not treated for a long period of time, the nails can become deformed.

Abscess

You can also develop a type of abscess called kerion if you are hypersensitive to the fungus that causes ringworm or if it is not treated. Kerions most often develop on the scalp, but they can develop wherever there is ringworm. These are large, swollen lumps filled with pus. They appear smooth and generally cause receding of the hairline.

These bald patches can be temporary or permanent, depending on how much damage has been done to the skin. Some people also have a fever and generally do not feel well.

Deep or widespread infections

In rare cases, the fungus that causes ringworm can sometimes cause a deeper infection called Moyokka's granuloma. Ringworm usually affects only the surface of the skin called the epidermis. In a Mojocchi granuloma, the fungus spreads through the hair follicle and affects the deeper layers of the skin called the dermis . Local treatments can rarely reach these deeper areas, so oral medications are needed to treat Moyokka granulomas.

A generalized fungal infection, in which the fungus grows uncontrollably over large areas of the body, is extremely rare, but it can occur in people with weakened immune systems, for example if you have HIV / AIDS or are receiving chemotherapy . People with weakened immune systems and older people may have a harder time fighting a ringworm infection, even with treatment.

When to see a doctor

Ringworm is not a serious problem in most cases. But for certain symptoms, your doctor will be your best friend to treat ringworm as effectively as possible, especially to avoid future complications of the infection .

Doctor's Ringworm Discussion Guide

Get our printable guide to your next doctor's appointment to help you ask the right questions.

In most cases, ringworm is easy to treat, but you shouldn't ignore it. Your doctor can help you treat this.

Consult your doctor if …

  • You have been using over-the-counter antifungal medications for two weeks with no improvement.
  • You have ringworm on your scalp. Treat ringworm of the scalp as soon as possible to prevent hair loss.
  • You have ringworm over large areas of your body or it is spreading rapidly.
  • Ringworm spots become infected (swollen, juicy, hot, and painful).
  • You are not sure if you really have ringworm. Whenever you develop an unidentified rash, you should see your doctor.

Frequently asked questions

  • If you have ringworm, you can expect a rash after 4 to 10 days. Ringworm on the scalp develops a little more, in 10 to 14 days.

  • The first sign of ringworm is usually a rash. Depending on where the fungus has taken hold on the body, the rash may look different. For example, it does not always form a round shape on the skin. In the groin, the center of the rash may be reddish-brown. A rash on the palms of the hands and feet may resemble thickened patches of skin, and between the toes, the skin may be moist and form open sores.

  • Ringworm on the face is called tinea faciei. This is not the same as ringworm, which affects your hair or beard. The rash it causes is not round, but often has clear boundaries and tends to spread. Other symptoms include itching and burning, especially if the rash is in the sun. Facial ringworm can also form a fungal abscess called a kerion.

  • Ringworm on dark skin will be similar in size and shape to a rash on light skin. It will also cause itching and flaking. However, it is most likely not reddish, but brown or gray.

  • Ringworm does not go away on its own, so symptoms can get worse if left untreated. For example, areas of hair loss on the scalp or beard can become enlarged. If left untreated, ringworm can cause blisters and cracks on the skin, making it vulnerable to bacterial infections. And because ringworm is highly contagious, if left untreated, it can spread to other parts of the body.

  • Because ringworm does not always appear on flat areas of the skin and takes on the classic round shape, there are many conditions that can cause ringworm-like symptoms, including:

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