Ringworm treatment is usually simple. You may even be able to use over-the-counter medicines. It's always a good idea to check with a doctor, though, to make sure you do have ringworm and that you're using the correct treatment.
Ringworm isn't really a worm. It's probably called that because, classically, it looks like a raised circle, almost like a worm has burrowed into the skin. Actually, ringworm is a type of fungus. Doctors call the rash tinea coporis. The circle forms as the fungus spreads outward, with skin returning to normal at the center.
Ringworm can appear anywhere on the arms, legs, trunk, face, or scalp. Sometimes it looks like a red or scaly patch instead of a circle. It usually itches.
When it occurs on the scalp, ringworm looks a little different. The fungus and damaged skin tend to pile up, forming an ugly-looking bump. Hair generally breaks off, leaving bald patches. Skin may also be red and itchy. Ringworm of the scalp is called tinea capitis.
A doctor can usually diagnose ringworm without any special tests. He/she will probably examine the rash and ask you about exposures and symptoms. If there is any question, skin scrapings can be examined for the fungus.
Except for scalp infections, ringworm treatment begins with antifungal creams. Over-the counter creams might be sufficient. Your doctor may recommend any of the following:
- Miconazole (brand names Micatin, Monistat)
- Terbinafine (Lamisil)
- Clotrimazole (Lotrimin, Mycelex)
A steroid cream such as hydrocortisone, available either over-the-counter or by prescription, can help with the itching and redness. However, these creams won't cure the ringworm, and they shouldn't be used without anti-fungal medicine. Check with your doctor before using a steroid cream.
If the over-the-counter creams don't work, your doctor will probably choose a prescription medicine. That might include a prescription cream or a pill. For example:
- Fluconazole (Diflucan): This pill needs to be taken daily for two to four weeks.
- Itraconazole (Sporanox): Sporanox is taken orally for one to two weeks, depending on the dose.
- Ketoconazole (Nizoral): This daily pill will probably be prescribed for several weeks.
- Terbinafine (Lamisil, Daskil): This is the same medicine as in Lamisil cream, but the pill is stronger.
- Griseofulvin (Fulvicin): This is an older medicine, but is still an effective choice.
All the pills for ringworm treatment can have serious side effects. Most people are able to take them without any problems, but be sure to tell your doctor if you have any other medical conditions, take other medicines, or have any allergies. You may need to return for monitoring tests while you're on the medicine.
Most of the time, ringworm treatment is successful. If the rash has gone away completely, you usually won't even need to return to the doctor's office. However, it's important to finish all medicine as prescribed, so that the rash won't return.
If the rash doesn't improve, or if it gets better but doesn't completely clear up, you'll need to check in with your doctor. He/she might try a different or stronger medicine. Occasionally, a major ringworm infection is a signal that something else is wrong. If your ringworm can't be cured, your doctor may want to test your immune system to make sure it is working properly.
Ringworm is passed from person to person. It can also be carried by dogs, cats, and other animals. It's possible to get ringworm from objects, such as sheets or towels, that the infected person or animal has touched. Small children, who play together at daycare or school, are prone to infection. It's impossible to avoid the risk of ringworm entirely, but you can help prevent its spread by washing sheets and towels in hot water and teaching children not to share personal items like towels and hairbrushes. Infected individuals should avoid close contact with others until the infection has been treated.
The fungus that causes ringworm likes warm, damp places. It's seen more often in warm, humid climates. Frequent perspiration and damp workout clothes can raise the risk. People with damaged immune systems, such as AIDS patients and people being treated for cancer, are also at higher risk.