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How To Treat Ringworm

by Sue Hubbard, M.D.

The saying, “a picture is worth a thousand words”  is so true.  I saw a cute 4 year old little girl today with “ a rash” on her arm.  This is the first “good” case of ringworm I have seen in a while, so I snapped a shot with my trusty iPhone camera to be able to show you.   

ringwormRingworm is a skin infection that appears as a “ring like” rash.  Although many parents are concerned that is it caused by worms, it is actually due to a fungal infection of the skin. The medical term for ringworm on the skin is tinea corporis. The fungus can also affect the skin on the scalp, tinea capitis,or on the feet, athletes foot, or in the groin where is it commonly referred to as jock itch.

The fungus that causes ringworm is contagious and likes to live in warm and moist areas. It can easily occur after any minor break in the skin (not always visible to the naked eye), and it should not be thought of as due to being “dirty”.  It really has nothing to do with cleanliness as the fungus can be passed from person to person by direct contact, or may also develop after contact with contaminated clothes, or shower and pool surfaces.

It is also not uncommon for household pets like cats and dogs to have the fungus and pass it to a child who spends a great deal of time hugging, petting and loving their pet (which is really quite healthy).

The most common way ringworm is diagnosed is by clinical appearance alone. A scraping of the area may also be done to be examined beneath the microscope to confirm the diagnosis.

The treatment of most ringworm infections on the skin is with a topical antifungal cream, many of which can be bought over the counter.  The most common topical agents contain miconazole or clotrimazole.  The cream may be applied as directed and it may take up to 4 weeks to completely treat the infection.

There are cases, especially with ringworm involving the scalp or feet that a systemic prescription medication may be needed.  When using the cream it may take 4 – 6 weeks for the infection to be completely treated, if you stop too quickly it may re-occur. If the lesion is not improving after a week or so it may be resistant to over the counter creams and require a broader spectrum antifungal cream that is available by prescription only.

Nummular eczema is often mistaken with ringworm and using a steroid cream on eczema will treat the dry patches but will not treat ringworm at all.  If the  “ring like dry patch” is not improving with a steroid cream it I might try an antifungal and if neither seems to work time for a visit to the doctor!

That’s your daily dose. We’ll chat again tomorrow!

Send your question to Dr. Sue!

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