Ringworm (Tinea)

Ringworm is a fungal infection of the skin caused by dermatophytes — a group of fungi that feed on keratin, a protein found in skin, hair, and nails. Despite the name, NO actual worm is involved. The name comes from the ring-shaped rash it creates. **Key Facts:** - **Cause:** Dermatophyte fungi (Trichophyton, Microsporum, Epidermophyton species) - **Appearance:** Red, circular, ring-shaped rash with clearer skin in the center - **Contagious:** Yes — spreads through direct contact with infected people, animals, or contaminated surfaces - **Common names by location:** - Body: Tinea corporis (classic ringworm) - Scalp: Tinea capitis - Feet: Tinea pedis (athlete's foot) - Groin: Tinea cruris (jock itch) - Nails: Tinea unguium (onychomycosis) - Face: Tinea faciei **How It Spreads:** 1. Person-to-person skin contact 2. Touching infected animals (cats, dogs, cattle are common carriers) 3. Contaminated objects (towels, combs, gym equipment, shared clothing) 4. Contaminated soil (rare) **Important:** Ringworm is NOT a sign of poor hygiene. Anyone can get it, and it thrives in warm, moist environments.

**How Ringworm Develops:** **1. Fungal Exposure:** Dermatophyte fungi are everywhere — in soil, on animals, on other people, and on contaminated surfaces. You're exposed when the fungus contacts your skin through direct touch or shared items. **2. Skin Penetration:** The fungi feed on keratin, the protein in your outer skin layer, hair, and nails. They need a warm, moist environment to thrive. Tiny breaks in the skin, excess moisture, or prolonged contact allow the fungus to establish an infection. **3. Ring Formation:** The characteristic ring forms because the fungus grows outward from the center. As it expands, the center heals (the fungus has consumed the keratin there), leaving clearer skin in the middle and active infection at the expanding edges. **Risk Factors:** - Living in warm, humid climates - Excessive sweating and tight clothing - Contact sports (wrestling, martial arts) - Sharing personal items (towels, razors, clothing) - Using communal showers or locker rooms - Having pets (especially cats, dogs, or livestock) - Weakened immune system (HIV, diabetes, cancer treatment) - Children in daycare or school settings

**Topical Antifungals (First-line for body, groin, foot):** - **Clotrimazole (Lotrimin):** Apply twice daily for 2-4 weeks - **Terbinafine (Lamisil):** Apply once or twice daily for 1-2 weeks - **Miconazole (Monistat-Derm):** Apply twice daily for 2-4 weeks - **Ketoconazole (Nizoral):** Cream or shampoo for affected areas **Oral Antifungals (Required for scalp and nail ringworm):** - **Griseofulvin (Grifulvin V):** Standard for scalp ringworm in children, 6-12 weeks - **Terbinafine (Lamisil):** Oral tablets for widespread or resistant infections - **Itraconazole (Sporanox):** For resistant infections or nail fungus - **Fluconazole (Diflucan):** Alternative oral option **Important Treatment Notes:** - Continue topical treatment for the full recommended period even after rash looks better - Scalp ringworm ALWAYS requires oral antifungal medication (topical alone won't work) - Nail fungus requires months of oral treatment - Clean and disinfect bedding, clothing, and personal items during treatment