Dermatophytosis or ringworm is a clinical condition caused by fungal infection of the skin in humans, pets such as cats and dogs, and domesticated animals such as sheep or cattle. Ringworm is a common fungal disease which Latin name is Tinea and doctors usually add another word to indicate where the fungus is located. If it’s on the scalp then its Tinea captitis, on the body it’s Tinea corporis, etc. Ringworm is not caused by a parasitic worm as its name suggests. It is caused by a fungal infection of the skin. The fungi responsible for the infection are known as dermatophytes.
Dermatophytes are a group of three types of fungus that usually causes skin infection in humans and animals. These fungi feed on keratin, the material found in the outer layer of the skin, hair, and nails. These fungi thrive on skin that is warm and moist, such as areas of frequent sweating, but may also survive directly on the outsides of hair shafts or in their interiors. In pets, the fungus survives on the skin and on the outer surface of hairs. Ringworm occurs in people of all ages, but it is particularly common in children.
Ringworm is highly contagious and can be passed from person to person by contact with infected skin areas or by sharing combs, brushes or other personal care items, or clothing. It is also possible to become infected with ringworm after coming in contact with locker room or pool surfaces. This condition can also affect cats and dogs, which may transmit the infection to humans. In animals, ringworm causes raised, circular areas that are often crusted over and associated with hair loss. In cats, the fungus can show no symptoms, but dogs almost always show the signs of the disease.
Ringworm Symptoms, Types And Diagnosis
The signs and symptoms on the body looks like its name suggest. It forms red, round rash which quickly grows on the skin with the healthy skin in the center. This condition is very common with up to 20% of population having one of these infections at any given moment. The causes for this condition are one of three types of fungus from which Trichophyton and Microsporum are the most common causative agents. These fungi can attack various parts of the body and sometimes can even appear on several locations at the same time. It can affect your scalp, feet, nails, arms, legs, the body, hands, palms, hair and facial hair and face. Only your doctor can determine if you have ringworm or other similar skin condition. The diagnosis of ringworm is often obvious from its location and appearance.
The different types of ringworm are:
- Tinea pedis (athlete’s foot) affects the feet
- Tinea unguium affects the fingernails and toenails
- Tinea corporis affects the arms, legs, and trunk
- Tinea cruris (jock itch) affects the groin area
- Tinea manuum affects the hands and palm area
- Tinea capitis affects the scalp
- Tinea barbae affects facial hair
- Tinea faciei (face fungus) affects the face
Your doctor may take skin scrapings or samples from the infected area and look at them under a microscope. This procedure is known as a potassium hydroxide (KOH) test. If a sample shows fungus, treatment may include antifungal medications. If the test is negative but your doctor still suspects that you have ringworm, a sample may be sent to the laboratory for testing. This test is known as a culture. Your doctor may also order a culture if your condition doesn’t respond to any treatment. If the condition is misdiagnosed and only treated with a topical steroid, it can result in tinea incognito, a condition where ringworm fungus will grow without typical features like a distinctive raised border and thus become harder to diagnose precisely and treat accordingly.
Ringworm in pets may often be asymptomatic, but circular bare patches on the skin can suggest the diagnosis. Veterinarians have several tests to identify ringworm infection and identify the fungal species that cause it: the woods test, microscopic test, and culture test. Identifying the species of fungi involved in pet infections can be helpful in controlling the source of infection particularly because the disease can be spread on to humans. These fungi may infect cats, dogs, horses, cattle, swine, pet rabbits.
How to Treat Ringworm
For a mild case of ringworm, you can apply an over-the-counter antifungal lotion, cream or ointment. Most fungal infections respond well to these topical agents, which include: Clotrimazole (Lotrimin AF), Ketoconazole (Nizoral), Miconazole (Micatin, Micaderm), Naftifine (Naftin), Oxiconazole (Oxistat), Sulconazole (Exelderm), Sertaconazole (Ertaczo), Tolnaftate (Tinactin). Wash and dry the affected area and then apply a thin layer of the topical agent once or twice a day for at least two weeks, or according to package directions. For the best treatment you should extend the application about an inch beyond the visible edges. In case you don’t see an improvement after four weeks, see your doctor because you may need a stronger medication.
When ringworm of the body covers a large area or doesn’t respond to over-the-counter medicine, you may need a prescription-strength topical medication (Butenafine (Mentax), Ciclopirox (Loprox), Econazole(Spectazole), Clotrimazole (Mycelex), Terbinafine (Lamisil)). Although a topical corticosteroid is sometimes used to help relieve the itching, this should be avoided as much as possible. In fact, steroids are never used as the only treatment in ringworm infections, as their use may worsen the infection and make the fungus more likely to spread into the hair follicles. Combination products may mix an antifungal medication with a steroid but these should also be avoided because they are expensive.
Antifungal medication may be given as a pill for extensive infections, infections that are not cleared with a topical medicine, infections in people with weakened immune systems or in severe cases of ringworm. Oral medications are Griseofulvin (Grifulvin V), Itraconazole (Sporanox), Fluconazole (Diflucan), Terbinafine (Lamisil)). Although griseofulvin is the least expensive oral medicine, it has more side effects and does not work on as many types of ringworm as the newer medications.You should also be aware that the side effects from oral medications include gastrointestinal upset, rash and abnormal liver functioning, while certain oral medications for ringworm may alter the effectiveness of warfarin, an anticoagulant drug that decreases the clotting ability of the blood.
Ringworm Prevention
Prevention is the key to how to treat ringworm. Common sense tells you that minimizing sweat and moisture can help prevent fungal infections. This means for men to wear boxer shorts, for women to avoid panty hose, etc. You can also take steps to prevent transmission of ringworm infections.
* Avoid sharing clothing, towels, hairbrushes, combs, hair accessories, or sports equipment.
* Wear sandals or shoes in gyms, locker rooms, and at pools. This can help you reduce your chances of contracting athlete’s foot.
* Wash the clothes in hot water with fungicidal soap after suspected exposure to ringworm.
* Avoid touching pets that have signs of ringworm (typically bald spots).
* After being exposed to places where the potential of being infected is great, you should wash with an antibacterial and anti-fungal soap or one that contains tea tree oil or terpinen-4-ol.
Although ringworm is a very common condition and in most cases easily treated, it’s important to follow the prevention guidelines, to complete a full course of therapy, and to follow proper hygiene.
