Dealing with Ringworm
Ringworm can be a very frustrating condition for patients. Characterized by circular red patches on the skin, the condition may seem to come out of nowhere and can last for a very long time if left untreated. Here at California Skin Institute we deal with many types of skin conditions, and we see cases of ringworm on a regular basis.* In this educational installment, we sat down with Dr. Lauren Gebauer to help you better understand ringworm symptoms, and how to deal with this condition.
Q: What are ringworm symptoms?
Dr. Lauren Gebauer: Ringworm is a very common skin condition. It’s caused by fungal spores that latch onto the skin and take up residence there. When the infection occurs, it usually looks like a red, enlarged patch of skin that is sort of shaped like a circle. The redness occurs around the perimeter, but the skin in the center will usually be clear. The ring will be red and scaly, and the will tend to expand over time.
Q: How does a person become infected?
Dr. Lauren Gebauer: You can catch it from direct skin contact. So you might get it from other people, or animals, or any kind of surface. You can even get it if there are fungal spores on a table, chair, or a gym mat. There has to be physical contact for the transmission.
Q: So there are no actual worms involved?
Dr. Lauren Gebauer: Haha! No, it’s called ringworm in layman’s terms because of the way it looks; like a worm that’s curled up into a circle. The medical term for it is tinea corporis. So you don’t have to worry about worms crawling under your skin. It’s just a fungus.
Q: Where does ringworm typically appear on the body?
Dr. Lauren Gebauer: Ringworm can affect any location on the body, but mostly the trunk; think abdomen, chest, or shoulders. It can also appear on the extremities, in the same way athlete’s foot does – athlete’s foot is also caused by a fungus. It’s really just places that may come in contact with the fungus. You need direct skin contact to get it.
Q: How do you diagnose ringworm?
Dr. Lauren Gebauer: Ringworm is usually very easy to diagnose.* A clinical visual exam is typically enough, when performed by an experienced dermatologist.* If there is any question, we can do a scraping of the superficial scale – a painless procedure that allows us to sample the skin cells.* We look under microscope to see if there were any fungal elements.* In rare cases, we can do biopsies if a more uncommon type of fungus but typically not needed – but this is very rare.*
Q: How do you typically treat ringworm?
Dr. Lauren Gebauer: There are several methods we can use.* If the condition localized to one specific area on the body, then we can use a topical antifungal cream.* A typical course of treatment would be to apply the cream twice per day for two weeks, but this will vary from patient to patient.* Further, in some patients the condition can be more widespread – it typically happens with patients who have a compromised immune system.* In such cases we can administer oral anti-fungal medication.*
Q: Can you treat ringworm with over the counter creams?
Dr. Lauren Gebauer: This usually doesn’t work.* Over the counter creams may work for other fungal infections, like athlete’s foot.* But ringworm is harder to target with over the counter creams because the concentrations of anti-fungal medication are too low.* A prescription strength cream is needed in most cases.*
Q: Will ringworm go away on its own, without treatment?
Dr. Lauren Gebauer: The body can’t kill the ringworm spores on its own, so you have to treat it. If you don’t get treatment, then it will just continue to spread to other parts of the body.*
Q: And what are the health effects if you don’t treat it?
Dr. Lauren Gebauer: Fortunately, the fungus doesn’t grow deeper into the tissues. But it will spread to the surrounding healthy skin. The real big problems are: you’ll be more physically uncomfortable as it spreads, and some patients may develop feelings of insecurity and will avoid engaging in social activities if the ringworm patches are visible. Also, you’ve got to remember that you can spread it to other people. So your friends and family will be at risk of catching it. Lastly, the more ringworm spreads, the longer it will take to treat. There really isn’t any point in waiting. The sooner you start treatment the sooner it will be over.*
Q: Does ringworm come back after treatment?
Dr. Lauren Gebauer: Once you have a case, you might be more susceptible to future infections. But the fungus doesn’t stay in your body the way the chickenpox virus does, for example.* So with chickenpox you may need to worry about having shingles in the future because the virus remains dormant in the body.* But with ringworm, the only way to get it again is if you were infected with another source.*
Q: Can ringworm be confused with other skin conditions?
Dr. Lauren Gebauer: Yes! That’s a great question actually, because ringworm does get misdiagnosed quite often by family doctors, because they don’t see as many of these cases as a dermatologist does. One of the more common issues confused with ringworm is eczema, because of the way eczema redness can take on a circular appearance. Ringworm can also be confused with granuloma annulare, which typically shows up on the hands and feet, and looks like a pink or red circular lesion. Even psoriasis can sometimes look like ringworm. So if you’re being treated by your family doctor for ringworm and it doesn’t seem to get better, it might not be ringworm at all.* Definitely see a dermatologist for further investigation.*
Q: Are there any precautions patients can take to reduce chances of getting ringworm?
Dr. Lauren Gebauer: There are several. Definitely wash your hands when coming in from outside or coming home from the gym.* If you’re going to a public place, like a gym, bring hand sanitizer with you and use it.* Pets are also big carriers of ringworm because they come in direct contact with spores all the time. If you pet animals you don’t own, then wash your hands right after, because you don’t know how their owners take care of them.* If you have a cat or a dog, and notice a scaly patch in their fur, then get it checked out by a vet, because it could be ringworm and you and your family can easily catch it. Puppies and kittens are actually huge transporters or ringworm, because they look so cute and everyone wants to nuzzle up to them, which makes it very easy for spore transfer to occur. So, avoid nuzzling up to pets you don’t own, no matter how cute they may be.*
Q: What would you suggest to someone who thinks they may have ringworm?
Dr. Lauren Gebauer: Don’t wait to get treatment, because it won’t go away on its own.* Go see your dermatologist, because that’s who is trained specifically to work with skin conditions.* Here at CSI we see ringworm and other skin conditions all the time, so we have the expertise to accurately diagnose it and treat it.* Your family doctor is probably a great medical expert, but he or she won’t have the same expertise with skin conditions as a dermatologist will.*
(Dr. Lauren E. Gebauer is a board-certified, fellowship-trained dermatologic surgeon specializing in Mohs Micrographic Surgery. Additionally, she is skilled in multiple cosmetic procedures including neuromodulators, injectable fillers, and laser therapies.)
If you suspect you might have ringworm, please schedule an appointment by calling a California Skin Institute practice near you, or fill out the Contact Form!
*Individual results may vary and are not guaranteed.