Ringworm, also known as tinea and dermatophytosis, is a fungal infection that affects the skin. Patients with this condition will notice a red, circular rash on the skin. Typically, the rash begins as a flat, scaly area that is red and itchy, and as the rash progresses, it becomes slightly elevated above the skin's surface, and the edges take on an irregular, wavy shape. Ringworm can be spread through skin-to-skin contact with an individual who has the infection, and patients have also become infected after touching dogs, cats, or cows that have it.
Living in a warm climate, participating in wrestling, wearing tight clothing, and having a weakened immune system could all increase an individual's risk of contracting the infection. Doctors are often able to diagnose ringworm with a visual examination, and using a blacklight over the affected area can help in the diagnostic process. If the ringworm fungus is present, it will glow when the blacklight is applied. Rarely, a skin biopsy, fungal culture, or KOH test may be needed to confirm the diagnosis.
Wash Hands Often
One of the most effective methods for preventing ringworm is to wash hands often. This practice reduces the risk of contracting the infection after exposure. Doctors recommend washing hands before preparing food, after eating, and after going to the bathroom. Patients should also wash their hands after interacting with pets and when returning home after work or school. Washing hands under running water is beneficial, and patients should use antibacterial soap. After wetting the skin and applying soap, both hands should be rubbed together vigorously for at least twenty to thirty seconds. Special attention should be given to the areas between the fingers and underneath the fingernails. If water and soap aren't available, using an alcohol-based hand sanitizer is suggested.
Keep Cool And Dry
Patients who keep cool and dry may be able to reduce their risk of ringworm, and this is especially important for individuals who live in warm, humid climates. To keep cool and dry, it is important to wear clothing appropriate for the weather and particular activities. For example, wearing shorts and short sleeves in the summer can greatly increase an individual's ability to stay cool, and patients may also want to choose lightweight, breathable fabrics such as linen or cotton during the summer.
Polyester and other synthetic fabrics tend to trap heat, potentially increasing an individual's perspiration and creating an environment where fungus could easily multiply. Thick or tight clothing should be worn for only as long as necessary. In addition, it is crucial to dry the skin after exercise or prolonged periods spent in the outdoors. Patients should shower after exercising or sweating heavily, and they should change into clean clothing.
Don't Share Personal Items And Clothing
Since household items are easily contaminated by fungal infections, doctors suggest patients don't share personal items and clothing. For example, patients should never share clothing with a person known to have ringworm. Even items like jackets, hats, and socks should not be shared. Patients should also avoid sharing bed linens, towels, washcloths, and loofahs with others. Since ringworm can affect the scalp, hairbrushes should not be shared.
Patients should not borrow clothing, personal items, or hairbrushes from others. If a shared item has been accidentally used, patients should monitor their skin for signs of ringworm over the next two weeks. Shared items will need to be thrown away as they cannot be properly disinfected. Family members of a patient with ringworm may want to create a separate box for that individual's clothing and personal items, and these should be washed separately.
Wear Shoes Or Sandals In Lockers Rooms And Public Pools
Many cases of ringworm on the feet (athlete's foot) are contracted when patients walk barefoot through community gyms, shower spaces, locker rooms, or pools. For this reason, health experts suggest individuals wear shoes or sandals in lockers rooms and public pools. Open-toed shoes such as sandals or flip-flops offer valuable protection against this infection, and closed-toed shoes like sneakers are also beneficial. Patients should wear shoes even if the area in which they are walking appears clean; keeping an extra pair of shoes or flip-flops in a gym locker could be helpful. If the patient forgets their shoes or sandals, socks will provide at least some protection as long as they remain dry.
Waterproof shoes are available for use in the pool, and these should be allowed to air dry after each use. Pool shoes can typically be washed in the washing machine, and patients may want to wash their pool shoes at least once a month. For maximum protection against fungus, patients could consider leaving their locker room and pool shoes in a designated area at the front of their home so they don't track all of the germs from those environments into their carpet. Wiping the soles, sides, fronts, and backs of any gym or pool shoes with an antibacterial cleansing wipe is useful as well.
Antifungal creams are typically the first line of treatment in confirmed cases of ringworm. These creams are available over-the-counter and with a prescription. Patients may choose to start with over-the-counter creams, and prescription-strength creams can be prescribed for more severe cases. Clotrimazole, miconazole, and terbinafine are some of the most commonly used antifungals for ringworm, and patients who have ringworm that affects the scalp or that does not respond to creams may need to be given oral antifungals such as ketoconazole or griseofulvin.
Individuals using miconazole cream could notice itching or burning at the application site, and cases of contact dermatitis have been reported. Oral ketoconazole may cause serious liver damage, and doctors try to prescribe this medicine as a topical treatment when possible. Patients using prescription antifungal creams might be asked to return to their doctor for a follow-up appointment, and individuals who have not seen any improvement in their condition after using an over-the-counter antifungal cream for two weeks should also see a doctor. Prescription medications normally cure ringworm within two to four weeks.
Keep Fingernails And Toenails Short And Clean
One of the main ways to treat ringworm is for individuals to keep their fingernails and toenails short and clean. Ringworm infections typically occur underneath or around a fingernail or toenail that has become too long. When fingernails and toenails are long, it's harder to clean underneath them. If fungal spores get underneath, they're less likely to be washed away when individuals wash their hands. Even if individuals don't have long fingernails or toenails, failing to clean these areas properly can still lead to ringworm.
Individuals should be sure to clean underneath their nails when they wash their hands to get rid of dirt, bacteria, fungal spores, and potential viruses. When individuals shower, they should make sure to wash their feet and take special care to remove the dirt from underneath their toenails. Fake fingernails can be used if individuals prefer the fashion aesthetic of long nails.
Change Socks And Underwear Daily
One of the best ways individuals can prevent ringworm and other fungal infections is to change their socks and underwear daily. Many aren't aware these articles of clothing are meant to be changed daily. Individuals may think they can continue wearing them because they aren't visibly dirty, don't smell yet, or aren't significantly moist. Fungal infections can cause serious inflammatory processes to occur in the body, which can lead to significant discomfort. After individuals take off their socks, they should throw them in the laundry basket and put on a fresh pair.
The same is true of underwear. Continuing to wear the same underwear also puts individuals at a higher chance of getting multiple different kinds of infection in that area, not just ringworm. The reason these garments have an impact on ringworm is they tend to absorb sweat and become moist. This leads to a humid and warm environment that allows fungus to grow. It's important to air out clothes and put on fresh garments every day.
Shower After Playing Sports Or Intense Exercise
Another important aspect of preventing ringworm is to shower after playing sports or engaging in intense exercise. Basically, if individuals have been in a situation where they sweat a lot, they should shower afterward. The reasons behind this aren't just social. It's true that when individuals sweat, they're more likely to have body odor and look 'sticky.' They might feel sticky, hot, and overall not their best. Engaging in rigorous physical activity raises the temperature of the body, which causes the sweat glands to open. This is the body's natural cooling system. Sweat makes the skin and various areas of the body moist. This heated, moistened environment makes a perfect breeding ground for fungal infections. Individuals should shower immediately after practice or, at the very least, before they go to bed. In addition to preventing fungal infections, this will help individuals keep their bedsheets cleaner over time.
Use Antifungal Shampoo
If individuals have ringworm, one treatment option is to use an antifungal shampoo. Of course, this depends slightly on the area in which the infection is. There are different types of antifungal shampoos available, which may have different concentrations of a variety of active ingredients. Antifungal medication helps target and break down fungal spores so the infection goes away. It can also prevent or mitigate the spread of infection. The best time to use antifungal shampoo for ringworm is right after noticing the first patches. It may take a few treatments and days or weeks to see the results, but this is an important preventative measure to keep the spread contained.
Some of the most common antifungal shampoos are those with the active ingredient ketoconazole. There are ketoconazole shampoos available over-the-counter, or patients can get a prescription shampoo if their doctor deems it necessary. The shampoo can treat ringworm infections that appear on the scalp or areas of the body covered in hair. It's also commonly used to treat dandruff, since this condition is caused by a different type of fungal infection. Ketoconazole is also sometimes a first-line treatment for psoriasis.
Take Oral Antifungal Medication
Oral antifungal medications are used to treat fungal infections. They're often used in cases where the fungal infection appears in many different areas of the body, which makes it difficult to treat with topical medications. Some oral medications are available over-the-counter, but if a patient's infection is serious, they might need to see a doctor and get a prescription. Ringworm is one of the most common infections treated with oral antifungals. Other infections these medications treat include fungal nail infections, athlete's foot, and severe dandruff.
Oral antifungals are taken by mouth. They may be manufactured in liquid, tablet, or capsule form. Some oral medications kill the existing fungal cells, while others are optimized to prevent the infection from spreading. As with most oral medications, oral antifungals may have some side effects. These can include nausea, pain in the abdomen, and diarrhea. More rarely, patients might experience an allergic reaction to one of the ingredients. Patients should stop taking antifungals right away if they have allergic symptoms and seek emergency treatment if they have trouble breathing.