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All About Ringworm: Causes, Symptoms, Risk Factors, Diagnosis, Treatments And Prevention

Ringworm, also known as tinea corporis, is a type of fungal skin infection caused by dermatophytes (a type of fungi that need keratin of the skin for growth). This is why, ringworm is also known as dermatophytosis or dermatophyte infection.

Ringworm infection is often confused to have been caused by worms and not fungus. However, it is given the name due to its appearance as the infection that the fungus causes resembles a worm in a ring shape. [1]

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The infection can affect any part of the skin and named accordingly. For example, ringworm on the scalp is tinea capitis, the groin area is tinea cruris, hands is tinea manuum and ringworm on the face is tinea faciei.

In this article, we will discuss ringworm in detail. Take a look.

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Causes Of Ringworm

The dermatophytes or fungus which is responsible for causing ringworm mainly belong to the genera Epidermophyton, Trichophyton rubrum, T. tonsurans and Microsporum canis. T. rubrum is the most common cause of ringworm in many parts of the world.

Other fungi include T. tonsurans, T. interdigitale, T. concentricum, M. audouinii and Epidermophyton floccosum.

Ringworm is mainly caused by direct contact of the skin from the infected animals, soil, objects or skin as the ringworm-causative fungi have the ability to attach themselves to the keratin tissues of the skin. [2]

Whenever a person comes in direct skin-to-skin contact with infected soil, animals, objects or skin, the fungus passes to their body due to its contagious nature and starts growing.

Some of the objects responsible for causing ringworm are infected clothes, combs, bedsheets and brushes. Also, soil to human spread is rare as the person has to spend long hours in the infected soil to get the infection.

Symptoms Of Ringworm

Some of the signs and symptoms of ringworm include:

  • Oval or circular scaly patch on the skin with raised leading edges.
  • Red patches, redder mainly on the outside edges.
  • The centre of the infection is brown and less scaly.
  • Itchiness [3]
  • Multiple lesions are often formed together as polycyclic patterns.
  • Sometimes, pus-filled ringworm.
  • Hair loss if present on the scalp.
  • Abnormal colour and shape of the nails, if present in the nails.

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Risk Factors Of Ringworm

Studies say that ringworm can spread even when the symptoms are not fully developed. Some of the risk factors for ringworm include:

  • Staying in areas where there is excessive heat.
  • Wearing tight fitted clothes
  • Staying in high humidity areas.
  • Coming in direct contact with an infected person's skin.
  • Playing with pets like cats and dogs or coming in contact with their furs. [4]
  • Sharing towels, bed sheets, hairbrushes or clothes with an infected person. [5]
  • Having certain immunosuppressive conditions like diabetes or AIDS.
  • Skin or nail injuries.
  • Not maintaining feet hygiene in the locker room or pool.

Complications Of Ringworm

Untreated ringworm can lead to complications like:

  • Spread of the infection to larger body areas.
  • Hair loss
  • Deep infection in the area (Majocchi's granuloma). [6]
  • Permanent scarring of the skin.

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Diagnosis Of Ringworm

Ringworm can easily be diagnosable by its shape and appearance (ring-like). However, some of the other methods to confirm the diagnosis for ringworm may include:

  • Skin biopsy: To test and confirm the presence of fungus on the skin.
  • Fungal culture: It helps identify the exact fungus species. It is an expensive process and takes around one or two weeks for results.
  • Potassium hydroxide (KOH) preparation: This method is used to better analyse fungal infection and rule out other infections of the skin. [7]
  • Wood's light: This test is mainly carried out for scalp ringworm as it can only detect infection caused by Microsporum sp, those responsible for ringworm of the scalp.

Treatments Of Ringworm

Some of the treatment methods for ringworm may include:

  • Prescribed topical antifungals: It may include prescribed antifungal creams, lotions, ointments or shampoo to apply on the affected areas.
  • Medications: They are mainly prescribed in severe ringworm cases or when topical treatments fail. Some of the medications may include terbinafine, fluconazole and griseofulvin. [1]
  • Lifestyle management: It mainly includes maintaining good hygiene every day like washing bedsheets, using clean and unused towels, etc.

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Is Ringworm Preventive?

Yes, ringworm is preventive in many ways such as:

  • Keeping the hands clean.
  • Avoid sharing personal belongings such as towels, bedsheets, toothbrushes and hairbrushes.
  • Avoid wearing tight-fitting clothes or clothes that do not allow the absorption of sweat.
  • Avoid wearing thick clothes for longer.
  • Avoid touching random or infected animals such as cats, goats and dogs.
  • Washing bed sheets and cleaning the surroundings daily.
  • Washing underwear and socks daily.
  • Allowing shoes to dry off completely before using them again the next day. It is better to keep two pairs of shoes.
  • Bathing daily followed by drying the skin properly.
  • Treating the affected areas without any delay.
How do you get rid of ringworm fast?

Most of the cases of ringworm can be easily treated with prescribed topical antifungals such as creams and ointments, however, if the infected gets severe, medications like terbinafine, fluconazole and griseofulvin can help get rid of ringworm fast.

How does ringworm start?

Ringworm mainly starts with a sharp, oval or circular scaly patch with a raised edge. The area inside the lesion becomes hypopigmented or brown and is red at the borders. Later, the infection may get itchy or get filled with pus, depending on the severity and management of ringworm.

How long does ringworm last?

According to a study published in a journal Drugs In Context, the incubation period of ringworm is 1-3 weeks. If early diagnosed and treated, ringworm may not even last for a week, but if left untreated, it can last for three weeks as well as spread to other body areas, making the treatment delay.