Ringworm, also known as tinea or dermatophytosis, is a fungal infection of the skin and can appear on various parts of the body of humans and animals. It is highly contagious and should be treated immediately to avoid spreading it to others.
This common skin infection can affect anyone of any age, though children are more commonly infected. It spreads far easier among children due to the close contact activities they engage in. People with a weakened immune system are also at a higher risk for ‘catching’ ringworm.
Unless treated within 24-48 hours of the first symptoms of the infection, the ringworm can remain contagious until cured.
There are different types of ringworm, each based on its location on the body. Each is caused by a different type of fungus and, therefore, may require a specific type of antifungal treatment to cure it. Not all types of ringworm can be cured with OTC treatment.
Based on its characteristics, the term “ringworm” is a misnomer. It is neither caused by a ring or a worm. Ringworm is a reddish to brownish rash that appears on the skin in a circular formation. Ringworm symptoms vary depending on the part of the body infected. Common symptoms are:
In general, ringworm is caused by an infection with any of the three main types of fungi, Epidermophyton, Microsporum and Trichophyton. These fungi are spores that live in the soil and are transferred to humans or animals on contact. Thereafter, it can be spread through person-to-person or animal-to-person contact or contact with an infected object or item such as clothing, hairbrushes, combs or shoes.
Over-the-counter (OTC) or topical treatments are usually the first line of treatment, especially for mild to moderate forms of ringworm infection. There are several types of over the counter treatment available for ringworm and are made in different strengths. These may be creams, ointments, gels, lotions, powder, sprays or medicated shampoos. Each of them may be more suitable for a specific type of fungal infection.
Some common over-the-counter antifungal treatments contain antifungal drugs such as those in the allylamines class of drugs - terbinafine, butenafine and naftifine. Medications from the imidazole class (clotrimazole, miconazole) or the triazole class (itraconazole, fluconazole) or selenium sulfide may be used.
Patients tend to see improvement of the condition within two to four weeks of taking any of these types of medications one to two times a day, as directed by a doctor. During this time, the risk of infecting others is lower.
The following treatments discuss recommended doses as a guideline. Patients should use their medication as prescribed by your doctor by carefully following the instructions on the prescription label. For maximum effectiveness and to prevent the fungus from becoming resistant to the medication, avoid skipping doses.
Imidazoles such as clotrimazole and miconazole are among the most common treatment used for treating ringworm of the feet, body and jock itch. The triazoles, itraconazole and fluconazole are quite effective as well for topical treatment. These over-the-counter medications work by inhibiting the growth and spread of the organism and eventually kills it off. Depending on whether it is the cream or powder form, these medicines are applied directly to the infected skin one to two times daily for a period of one to four weeks.
Allylamines, mainly terbinafine, butenafine and naftifine, are topical antifungals commonly used to treat ringworm of the body and athlete’s foot. They work similar to clotrimazole and miconazole and are effective in preventing further growth of the fungus. Terbinafine may be applied to the affected area twice daily for a period of one to four weeks, as directed by your doctor.
Depending on whether it is the cream or gel form, naftifine can be applied once or twice daily for about four weeks. Butenafine cream can be used twice daily for about four weeks. In addition, the cream can effectively treat jock itch within one to four weeks depending on the dosage.
Selenium sulfide and ketoconazole are medicated compounds contained in some antifungal shampoos used to treat ringworm. Ringworm of the scalp and skin are most commonly treated with selenium sulfide shampoos. They can be used as an initial line of treatment, but do not kill the ringworm fungus in most cases. Ketoconazole is indicated for the treatment of ringworm of the body, athlete’s foot and jock itch.
If OTC treatment does not effectively clear away the infection, then a stronger dose of an OTC drug or prescription medicines will be needed to cure it. People with severe or recurrent ringworm will most likely need to be treated with oral antifungal medication or steroids.
Ringworm of the scalp is usually a more aggressive form of the infection and may need prescription antifungal, in addition to over-the-counter medicated shampoos. Griseofulvin is an oral antifungal commonly prescribed for treating severe and more aggressive forms of ringworm infections.