By Martha A. Simpson, D.O., M.B.A.

Assistant Professor of Family Medicine

Ohio University College of Osteopathic Medicine

RINGWORM IS NOT A WORM – BUT AN EASILY TREATED FUNGAL INFECTION

Question: My daughter was told she has ringworm on her arm. She is a very clean child and has not been around any worms. How did she get this and how is it taken care of? I have other children. Should I be worried about them getting this as well?

Answer: You share a common misconception that ringworm is caused by worms. It’s actually a fungal infection of the body surface by mold-like fungi called “dermatophytes,” a term that literally means "plants that live on the skin." This type of infection is called dermatophytosis, or more commonly tinea.

Tinea infections of the body, dubbed tinea corpus, typically produce round or oval rings of irritated, itchy skin that looks like a worm. That’s why this skin disorder was given the name ringworm many years ago, before the actual cause was known. As is often the case in medicine, the old name remained long after it was discovered this condition is caused by fungus, not parasites.

In addition to the body, tinea infections can appear on places like the scalp, the foot and nails. In each of these locations, it is usually caused by a different dermatophyte. When it occurs in these areas, the infection doesn’t have the characteristic “ringworm” look, so it’s usually called something else. For instance, ringworm of the foot (tinea pedis) is commonly known as athlete’s foot.

The dermatophyte that causes ringworm is found in contaminated soil, in humans and animals. It’s everywhere! It can be spread by direct contact with these primary carriers, and it is also often spread by indirect contact. In this case, the dermatophytes are spread first from a primary carrier to items such as clothing, stuffed toys, telephones or showers, and then from there to the victim.

Ringworm usually appears as a flat, round patch. As it expands, the center part begins to clear, leaving a red, slightly raised edge that appears to be a ring. Several plaques can merge together or appear separately. It is mildly itchy. It is easily diagnosed by a skilled practitioner. A scraping of one of the lesions can be taken for examination under a microscope, as well.

Ringworm is generally easy to cure, sometimes with over-the-counter antifungal medications. If it doesn’t clear up in a few days, you should ask your doctor for a professional diagnosis. Occasionally stronger, prescription-strength medication is required, and sometimes oral antifungal agents are needed if the rash is widespread.

An interesting note is that the incidence of ringworm appears to be increasing, especially among school-aged children. Prevention is better than treatment, but this can be difficult since dermatophytes are so common and widespread. Instruct your children not to share clothing, personal items or towels. Shared sleeping mats or gym mats can be a potential source of infection. If ringworm does crop up, get a prompt diagnosis and treat it completely. Also -- and this is the hard part -- try to identify and eliminate the source of the infection.

Family Medicine® is a weekly column. To submit questions, write to Martha A. Simpson, D.O., M.B.A., Ohio University College of Osteopathic Medicine, P.O. Box 110, Athens, Ohio 45701. Medical information in this column is provided as an educational service only. It does not replace the judgment of your personal physician, who should be relied on to diagnosis and recommend treatment for any medical conditions. Past columns are available online at http://www.FamilyMedicineNews.org.