Ringworm: symptoms, causes & treatment

Ringworm is a common fungal skin infection that can be identified by its typical round shape with a red, scaly edge. The medical term for this is tinea corporis, which literally means fungus on the body. Fungal skin infections are also known as mycoses. The name ringworm can be confusing, because despite what the name suggests, it has nothing to do with worms. The ring shape occurs because the fungus spreads outwards from a central point, creating a characteristic circle with a compacted, red edge.

This skin infection is common, especially among children and young adults. Parents of children with a fungal infection on the hairy head can also develop ringworm. In fact, anyone can contract ringworm at any age, but some people are more susceptible to it than others. People with a weakened immune system, diabetes, or existing skin conditions such as eczema or psoriasis are at increased risk. Even if you regularly use anti-inflammatory creams or ointments on your skin, you may be more susceptible to fungal infections.

What distinguishes ringworm from other skin conditions is its distinctive ring-shaped growth. The spot starts small and gradually gets bigger as the fungus spreads further over your skin. Without treatment, these patches can expand significantly, but fortunately, ringworm generally responds well to treatment and disappears completely without leaving any permanent marks.

Ringworm occurs when specific fungi called dermatophytes invade your skin. These dermatophytes are highly adapted to survive on the outer layer of your skin, the stratum corneum. They can't grow deeper into your skin, but they can penetrate the hair follicles. Different types of fungi can cause ringworm, with certain types being more common than others. In addition to ringworm, these fungi can also cause other infections, such as foot fungus, nail fungus, or hairy head infections.

The spread of these fungi occurs via microscopic fungal spores that are present almost everywhere in our environment. These spores are extremely resilient and can survive for long periods of time under challenging conditions. They can even withstand a washing machine wash at 40 degrees, which explains why yeast infections can sometimes be persistent to remove completely from a household.

You usually contract a yeast infection through direct contact with someone or something that is infected. For example, children can contract it from classmates at school or daycare. Sometimes there is even a small outbreak of head fungus in schools, where the responsible fungi can also cause ringworm in the children themselves or their parents. Pets, especially dogs, can also be carriers of certain types of fungi and transmit them to humans. Even some fungi that live naturally in the soil can infect your skin.

Public spaces with humid, warm conditions are ideal breeding grounds for fungi. Walking around barefoot in gyms, swimming pools, changing rooms and saunas increases your risk significantly. This is because fungi thrive best in warm and humid conditions, where they can multiply rapidly. Family members can also become infected if one person in the household has ringworm, although fortunately this does not happen very often. Remarkably, people sometimes see entire families become infected after contact with young dogs that have ringworm, or after a visit to a petting zoo.

The most characteristic feature of ringworm is the typical round shape that the infection forms on your skin. The spot usually starts small and then slowly but steadily grows outwards. The edge of this circle is remarkably red and feels slightly raised. This edge often flakes, which means that small pieces of skin can peel off. The center of the ring may look relatively normal or be slightly lighter than the surrounding skin.

In addition to the visual aspect, ringworm is accompanied by unpleasant physical sensations. Itching is a common symptom that can range from mildly annoying to quite disturbing. Some people are more likely to experience a burning or stinging sensation at the affected area. These sensations may tempt you to scratch, but this is not recommended because it can spread the infection further and damage your skin.

As far as the size is concerned, ringworm can vary considerably. Some areas remain relatively small, about the size of a coin, while others can expand significantly if left untreated. In the worst case, untreated ringworm spots can grow to palm-sized or even larger. The growth rate varies from person to person and depends on various factors, such as your immune system and the specific type of fungus that causes the infection.

In people with darker skin, ringworm may look slightly different. The redness may be less noticeable and sometimes appear more as a darker or lighter discoloration of the skin. However, the scaling and the characteristic ring shape remain recognisable regardless of your skin tone. It's important to know that ringworm may look slightly different on different skin colors, but the typical circular shape and outward outgrowth remain constant features.

Ringworm can basically appear anywhere on your body where your skin is, but we see certain locations affected more often than others. The torso is a common area, with frequent infections in the chest, back and abdomen. The arms and legs are also frequently affected, with fungal areas appearing on both the inside and outside. The face may also be affected, although this is generally less common than infections on the torso or limbs.

It is remarkable that ringworm often occurs in areas that are susceptible to moisture and heat. Think of areas where clothing fits tightly or where you sweat a lot, such as under a belt, under your armpits, or in your groin. This is because the fungi that cause ringworm love these warm, humid conditions and can grow optimally there. Places that come into regular contact with infected surfaces or animals are also more at risk. For example, if you get a lot of infected animals with your hands, spots can develop there.

In children, we often see ringworm in areas that make a lot of contact with other children or with the ground, such as arms and legs. Parents who care for a child with head fungus sometimes develop ringworm spots on their arms or hands simply by taking care of their child. The spread across the body also depends on how the infection was contracted. Contact with an infected pet can cause patches on the arms or face when you pet the animal, while walking on contaminated floors can lead to infections on the feet that can then spread further.

As far as the distribution pattern is concerned, a single spot can stay where it started, but sometimes multiple spots are spread across the body. This mainly happens when the fungus is transferred via your hands to other parts of the body, for example by scratching the infected area and then touching your face or other parts of the body. It is therefore important to pay extra attention to your hand hygiene during an infection.

Ringworm treatment focuses on killing the fungi that cause the infection. This happens with antifungal drugs, which exist in various forms. For most cases of ringworm, a locally applied treatment, such as a cream, lotion or ointment applied directly to the affected skin, is sufficient. The big advantage of this is that you can tackle the fungus on the spot without exposing the rest of your body to medication.

When using an antifungal cream, it is important to treat not only the visible area, but also a spacious border around it. Therefore, always coat about two centimeters around the area. You do this because the fungus may have spread a little further than you can see with the naked eye. You apply the treatment at least twice a day for at least two weeks. Even if the area looks better after just one week, it is crucial to continue lubricating until the full treatment period has been completed. If you stop too early, residual fungi can start to grow again.

Some antifungal creams can be purchased directly from the pharmacy or pharmacy without a prescription, while others are prescribed by your doctor or dermatologist. However, it's important to remember that not every round, scaly spot is automatically a ringworm. Other skin conditions can be confusingly similar. When in doubt, it is wise to first visit your doctor or dermatologist to get a correct diagnosis before starting treatment yourself.

If the topical treatment does not work, or if you are dealing with an extensive or persistent yeast infection, your doctor may switch to tablets that you take. This systemic treatment works from your body and reaches the fungus via your bloodstream. This is often more effective for larger or difficult-to-treat infections. People with a weakened immune system are also prescribed these tablets more quickly, because their body has difficulty fighting the fungus itself. A treatment with tablets usually lasts between two and four weeks.

These tablets are generally well tolerated and cause few side effects in most people. If you have ever had liver problems in the past, it is wise to report this to your doctor. In that case, it may be necessary to have your blood checked occasionally during treatment. In addition to drug treatment, good skin care is supportive. Keep affected areas clean and dry because fungi love moisture. Wear light clothes and change them regularly, especially when you sweat.

There are quite a few misunderstandings about treating ringworm, and it's good to know what doesn't help prevent disappointment and loss of time. A common thought is that ringworm will go away on its own if you just let it sit for a while. Although your immune system is indeed trying to fight the fungus, ringworm rarely goes away on its own. In fact, without treatment, the spots usually become larger and can spread to other parts of your body or to people around you.

Home remedies like vinegar, tea tree oil, or garlic are sometimes touted as natural solutions. While some natural agents do indeed have mild antimicrobial properties, they are not powerful enough to effectively combat an established fungal infection. At best, they can temporarily alleviate the symptoms, but do not completely kill the fungus. This may cause you to think that things are going better, while the infection continues as usual.

Creams that are not specifically intended for fungal infections do not help either. Ordinary moisturizers or anti-inflammatory ointments that you may have at home for other skin problems don't address the cause. In fact, the use of anti-inflammatory creams can even worsen the situation by temporarily suppressing your local immune system, allowing the fungus to grow better.

Another misunderstanding is that good hygiene alone is enough to get rid of ringworm. While hygiene is absolutely important to prevent the spread, simply washing with soap and water won't kill the fungi that are already in your skin. You really need specific antifungal drugs to defeat the infection. Hygiene is crucial as a supportive measure, but not a substitute for the right medication.

Is ringworm contagious?

Yes, ringworm is certainly contagious and can spread to others. You can transmit it through direct skin contact with someone who has ringworm, but also indirectly through shared towels, clothing, or bed linen. Fortunately, family members do not always become infected, but vigilance is required. By maintaining good hand hygiene and avoiding direct contact with the affected areas, you can largely prevent the contamination of others.

How long does it take for ringworm to go away?

With the right treatment, you will usually see clear improvements within one to two weeks. However, the complete treatment takes at least two weeks with creams, and sometimes two to four weeks with tablets. Even if the area already looks better, it is important to complete the treatment. Without treatment, ringworm can persist for weeks to months and even grow larger.

Can I prevent ringworm?

Preventing ringworm completely is difficult because mold spores are everywhere in our environment, but you can reduce your risk. Wear slippers or bathing shoes in public areas such as swimming pools and gyms, don't share personal items such as towels or combs, and wash your hands regularly and thoroughly. If you have pets, have any suspicious areas on their skin checked by the vet. Dry, clean clothes and avoiding excessive sweating also help.

When should I see a doctor?

Visit your doctor if you suspect you have ringworm and aren't sure if it is, as other skin conditions can look confusingly similar. Go even if, despite treatment with over-the-counter creams, the spots do not improve after two weeks, if the infection spreads, or if the spots become very large. Medical advice is also important if you have a fever, increasing pain or if you have a weakened immune system.

Does ringworm come back after treatment?

After successful treatment, ringworm disappears completely without leaving scars or permanent marks. However, it is possible to become infected again later, especially if you come into contact with mold spores again. Unfortunately, a previous infection does not make you immune to future infections. By continuing to pay attention to preventive measures such as good hygiene, you can help prevent a new infection.

Can pets have and transmit ringworm?

Yes, pets can certainly have ringworm and transmit it to humans. Dogs are well-known carriers, especially young puppies. Cats can also get and spread it. It is remarkable that pets with ringworm sometimes show no obvious symptoms, so you don't immediately know they are infected. If you have ringworms and pets at home, it is wise to have them checked by the vet and treated if necessary to prevent back and forth contamination.

1. Huidziekten.nl - Information about ringworm and fungal skin infections