The phone rings, and it’s the school nurse. She tells you that your little Johnnie has an itchy, red patch of skin on his arm that she believes may be ringworm (tinea corporis). You hang up and start to wonder, “How in the world did my son get a worm infection?” You may even start to second guess your housecleaning skills.
Actually, ringworm is not a worm at all. Ringworm is a fungal infection in the skin or scalp that is common among children. It is usually in the shape of a ring and has the appearance of a worm on the raised outer border. Since anyone can get it, don’t get too distressed over this infection.
Sometimes there are several affected areas on a person. Ringworm usually is a ring-shaped, reddish rash that can be itchy. The area may appear dry and scaly or moist and crusty. There are different forms of ringworm. Some common ones include:
- ringworm of the body (tinea corporis)
- ringworm of the feet, commonly known as athlete’s foot (tinea pedis)
- ringworm of the groin, or jock itch, which is common among athletes (tinea cruris)
- ringworm of the scalp (tinea capitis)
Because ringworm is contagious, there are several ways to get it. The most common one is skin-to-skin contact with someone who has the infection. It can also be spread by contact with contaminated items such as a towel, comb or pool, as well as clothing and shower surfaces. Animals can also transmit a form of ringworm to humans, most commonly spread by kittens and puppies, but cows, sheep, pigs and horses can transmit it as well. Symptoms typically appear four to 14 days following exposure.
Ringworm usually responds well to a topical antifungal medication that can be purchased over the counter. Common ones contain clotrimazole, miconazole, ketoconazole or tolnaftate. Ask your local pharmacist for any assistance as needed. Remember to apply the medication one inch beyond the border of the ringworm and continue the medication for seven days after it has cleared. It usually takes about two to four weeks to clear. If you are not sure whether a condition is ringworm, contact your child’s pediatrician if the antifungal medication does not seem to be helping or if your child has ringworm of the scalp. Ringworm of the scalp does not respond to the antifungal medication. It requires the child to be on an oral prescription antifungal medication. Since the course of medication is a bit lengthy (four to six weeks), your child’s doctor may check to make sure it is a fungus.
If you notice increased redness or swelling, red streaks from the rash, pus, severe pain, warmth to touch, or fever, contact your doctor right away. Children can still attend daycare or school when they have ringworm, but try to cover the area with clothing to decrease the chance of skin-to-skin contact with another child. After 48 hours of antifungal medication, ringworm is not contagious.
If your child has ringworm and is in a contact sport such as wrestling, he should not participate until evaluated by a doctor. Here are some tips that may help prevent ringworm:
- Use proper handwashing techniques.
- Keep skin and feet dry and clean.
- Avoid sharing personal items such as clothing, linens, sports equipment and headgear.
- Shampoo on a regular basis, especially after haircuts.
- Wear shoes at pools or in locker rooms.
- Avoid petting animals with bald spots.
This article was written by Diane Rainbolt, RN, an Answer Line nurse at St. Louis Children’s Hospital.