What Causes Ring Worm and How to Treat it

What do you know about the Ring worm?


Ring worm is a disease caused by a fungus in the skin. This not only infects humans but also can infect pets such as dogs, cats, sheep, cattle, etc.
In medical terminology, Ring worm is known as dermatophytosis.

Ring worm

Ring worm causes

The name is a little misleading though it is called ringworm, actually, it is not caused by any parasite or worm, but by a kind of fungus.


what does ring worm look like

The name is given to ringworm, because the skin lesion of the fungus usually produces a ring shape lesion. But this does not always look like a ring.


Ring worm rash


The ring worm produces a rash which is its main symptom. It may appear on any part of the body like on the scalp(called Tinea capitis) or Groin(Called jock itch).
The color of the rash may be red or silver. It may appear as a darker patch from the surrounding skin depending on skin color. It may be dry, scaly, and itchy.

Ringworm in humans

It is estimated that ring worm affects about 20-30% of the world population. So it is fairly common worldwide but luckily doesn’t cause serious infection.
Some people are pretty prone to ringworm infection like wrestlers and athletes. Even Wrestlers may be disqualified from the game if found to have ringworm. This is because of the chances of transferring the infection to the other wrestlers.

Is Ring worm contagious?


Yes, it is a contagious infection. These mold-like parasites survive on the outer layers of the skin. The fungus is found in warm and moist environments. This condition is favorable for their propagation. So warm and moist areas in humans that may be due to sweating, increase their growth.

How do you get Ring worm

You can get infections with your skin cuts, wounds, scalp, and nail injuries. children and athletes are also at risk.

It can spread as follows;

  • From Human to Human: this is the direct mode of spread from an infected person to others via close contact.
  • From Animal to human: if an animal is infected and you touch it, there are chances of getting this disease. So ring worm may spread by petting like cats and dogs.
  • From infected objects to humans: There is the possibility of contracting this disease if you directly come in contact with contaminated materials.
  • From Soil to Human or Animal: although this is rare if some remain in contact with highly contaminated soil for a longer time, there are chances.


The dermatophytes, which cause ringworm, feed on the keratin layer of the skin. Keratin is the proteinaceous material found in the outermost layer of skin. The dermatophytes survive and thrive on the skin, especially if the skin is moist and warm. Dermatophytes also thrive well in the hair (may be outside of the shaft or inside the hair shaft).


It is estimated that ringworm affects about 20-30% of the world population. So it is fairly common worldwide but luckily doesn’t cause a serious infection.
Some people are pretty prone to ringworm infection like wrestlers and athletes. Even Wrestlers may be disqualified from the game if found to have ringworm. This is because of the chances of transferring the infection to the other wrestlers.

What are the different types of ringworms?

There are several types of ringworms seen in humans, depending on the location mainly.

  • Tinea pedis, also commonly known as athlete’s foot, occurs in the feet.
  • Tinea capitis occurs on the scalp.
  • Tinea cruris, also known as itchy jokes occur in the groin.
  • Tinea unguium occurs in fingernails and toenails.
  • Tinea corporis occurs in the upper limbs, lower limbs, and body/trunk.
  • Tinea manuum occurs in palms.
  • Tinea faciei occurs in face.
  • Tinea barbae occurs in facial hair


There are also other clinically similar conditions. But not true ringworm as they are not caused by dermatophytes, such as Tinea versicolor (caused by Malassezia furfur) and Tinea nigra.

What are the risk factors for ringworm?

Ringworm is a contagious disease and may get transmitted from one person to another by close contact. Close contact sports also have the risk of ringworm transmission, especially if sports cause injury. Ringworm is also transmitted by sharing contaminated items such as combs, unwashed clothing, and shower or pool surfaces. It is more common during summer than in winter and symptoms are also less troubling during winter.

The disease can be transmitted from animals to humans (zoonotic disease). People handling or having pets such as dogs and cats are at higher risk of ringworm infection.

Symptoms of ringworm:

The symptoms of ringworm depend to large extent on the location of infection. Common symptoms of ringworm are itching, red, raised, scaly patches, from where there may be oozing. If nails are infected, they become thick, discolored, and may crumble and fall off. If the scalp or bearded area is infected, there may be bald or hairless patches.

The most common form of ringworm occurs on the skin, where it produces red, raised, scaly patches with itching, which may be intense at times. There may be more than one such skin patch in an individual. The skin patches have sharply defined edges. The borders are more well-demarcated (redder) than the center with comparatively normal-looking skin, which creates a ring-like appearance, hence the name ringworm.

Diagnosis of Ring worm

There are several diagnostic tests available for the accurate diagnosis of ringworm. In many cases, it is easy to diagnose ringworm by clinical examination alone, especially in skin and nails. There are typical symptoms of ringworm such as skin patches, which can help in accurate diagnosis, less complicated by the use of steroid ointment. But sometimes it is not possible to diagnose accurately by clinical examination alone and needs the help of diagnostic tests. The diagnostic tests available for ringworm are a microscopic examination of scrapings, culture, Woods test, etc.

Microscopic examination:

In case of any doubt about the diagnosis of skin patch as ringworm, skin scrapings from lesions can be examined under a microscope. In the hair shaft, there may be fungal spores present.

Woods test:

In this test, ultraviolet light (black light) is used with a magnifying lens, where fungus, if present will show as an apple-green fluorescence on hair shafts. But some fungi may not be seen with the Woods test as they are not fluorescent under ultraviolet light and microscopic examination can be used in such cases.

Culture:

The culture of samples is the best way to diagnose ringworm. But this method is time-consuming. Hairs from affected parts, skin scrapings from a skin lesion, or affected nails are cultured and examined under a microscope for definitive diagnosis. Culture can identify the species involved in the causation of skin infection (ringworm).

For most cases of ringworm infection, diagnosis is based on clinical examination and laboratory investigations such as are seldom required, unless there are some complications such as the use of steroid ointment without medical consultation, which may musk the typical symptoms of ringworm.


How common is ringworm?

Ringworm is a fairly common skin problem throughout the world. The true incidence or how common is ringworm is not known (as the incidence of ringworm is no longer registered by public health agencies), but it is a common disease that infects a large number of individuals throughout the world. The reported (although not confirmed by a reliable agency/organization) incidence of ringworm is estimated to be approximately 20% of the population, i.e. approximately 20% of individuals are infected with one form or other ringworm.

Variation from region to region

The causative fungus involved may vary from country to country and in different regions of the same country. In the United States, Tinea capitis (ringworm of the scalp) is most common among preadolescent school-age children. It accounts for more than 90% of dermatophytosis in children younger than 10 years of age. The disease is generally not seen among adults, but elderly people may be affected.

Tinea capitis is also common in urban areas in most countries of the world. In most parts of Europe, the disease is sporadic. Tinea capitis is common in North America, Central America, South America, Africa and India, and many countries. In Southeast Asia, the rate of infection with ringworm has decreased dramatically in the last 50 years. This is credited to improved general sanitary conditions and personal hygiene with improved economic conditions.

Worldwide the incidence of ringworm is underreported. Ringworm is also a disease, where many affected individuals may not seek medical attention. Especially in rural areas of underdeveloped and developing countries. Even in developed countries, many individuals with ringworm try home remedies. And may even ignore the disease as it is not a serious disease.

PREVENTION

Do not share clothing, sports equipment, towels, sheets, etc. that can transmit infection, especially with known individuals with ringworm.
Avoid handling and touching pets infected with ringworm, especially any bald area as the area may contain fungus. Treat pets immediately if you suspect your pet to have an infection.
Avoid walking barefoot and wear protective shoes/sandals while walking on beaches, on moist soil, or in showers.
Wash the cloths with hot water and use good quality detergent or fungicide soap. If you suspect any exposure to ringworm.
Keep your feet as well as your skin clean and dry. Maintain good personal hygiene.
If you get exposed to places where the risk of infection is very high, use antibacterial or antifungal soap.
It is possible to prevent the transmission of ringworm infection by maintaining good personal hygiene. Just follow the above-mentioned guidelines.


Treatment of ringworm:

There are several highly effective antifungal antibiotics (topical as well as systemic) available for the treatment of ringworm.

How to Prepare for Doctor’s Appointment for Ringworm?

Ringworm infection by what name it may be called, (dermatophytosis, tinea, or by any name).

There are many terminologies used. It depends on the location of the disease. As Ringworm is a common skin infection we all should be aware and know what to expect from the doctor. And what questions to ask or clarify doubts regarding the common skin infection. Before consulting your doctor or dermatologist, you should know what to ask. And what to expect from your doctor/dermatologist. Your appointment with your doctor or dermatologist may not be very long. You need to cover many aspects of the disease. It is wise to prepare for an appointment before going for it.

Your doctor or dermatologist will be able to diagnose ringworm easily by history and clinical examination. In most cases, the symptoms are typical.

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