Ringworm (Tinea Corporis)

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Images of Tinea Corporis (Ringworm of Body)

Overview

Tinea infections are fungal infections of the skin; they are often called ringworm, though there is no worm involved, because the infection can look like a ring-shaped rash on the skin. Ringworm infections are spread by contact with infected people, animals, or objects (eg, towels and locker room floors).

The most common kind of ringworm is called tinea corporis (ringworm of the body). It can be found on any area of skin on the body but usually appears on exposed regions, such as the face, hands, and arms. Athletes who have skin-to-skin contact with others are frequently affected by ringworm. There are special names for ringworm infections on other parts of the body. For example, if the rash affects the feet it is called athlete's foot (tinea pedis) and if it affects the groin it is called jock itch (tinea cruris). Write-ups for these specific areas are discussed separately.

Who's at risk?

Ringworm can occur in anyone, though people more likely to develop ringworm include children, people with other tinea infections, athletes involved in contact sports, people with immune deficiencies, and people in contact with animals such as cats, dogs, horses, and cattle.

Signs and Symptoms

The most common locations for ringworm include the following:

  • Neck
  • Arms
  • Legs
  • Trunk (chest, abdomen, back)
Ringworm appears as red ring-shaped patches with a raised scaly border ranging from 1 to 10 cm. The central area may be clear of any redness. The border of the affected skin may contain blisters, bumps, or scabs.

Ringworm may cause itching or burning, especially in people with weak immune systems.

Self-Care Guidelines

If you suspect that you have ringworm, you might try one of the following over-the-counter antifungal creams or lotions:

  • Terbinafine
  • Clotrimazole
  • Miconazole
Apply the cream to each lesion and to the normal-appearing skin 2 cm beyond the border of the affected skin for at least 2 weeks until the areas are completely clear of lesions. Because ringworm is very contagious, avoid contact sports until lesions have been treated for a minimum of 48 hours. Do not share towels, hats, or clothing with others until the lesions are healed.

Since people often have ringworm infections on more than one body part, examine yourself for other infections, such as on the face (tinea faciei), in the beard area (tinea barbae), in the groin area (tinea cruris, jock itch), or on the feet (tinea pedis, athlete's foot).

Make sure that any household pets are evaluated by a veterinarian to be certain that they do not have a dermatophyte infection. If the veterinarian discovers an infection, the animal should be treated.

When to Seek Medical Care

If large areas of the body are affected or if the lesions do not improve after 1–2 weeks of applying over-the-counter antifungal creams, see your doctor for an evaluation.

Treatments Your Physician May Prescribe

In order to confirm the diagnosis of ringworm, your physician might scrape some surface skin material (scales) onto a slide and examine it under a microscope. This procedure, called a KOH (potassium hydroxide) preparation, allows the doctor to look for tell-tale signs of fungal infection.

Once the diagnosis of ringworm has been confirmed, your physician will probably start treatment with an antifungal medication. Most ringworm infections can be treated with topical creams and lotions, including:

  • Terbinafine
  • Clotrimazole
  • Miconazole
  • Econazole
  • Oxiconazole
  • Ciclopirox
  • Ketoconazole
  • Sulconazole
  • Naftifine
  • Butenafine
Rarely, more extensive infections or those not improving with topical antifungal medications may require 3–4 weeks of treatment with oral antifungal pills, including:
  • Terbinafine
  • Itraconazole
  • Griseofulvin
  • Fluconazole
  • Ketoconazole
The infection should go away within 4–6 weeks after using effective treatment.

Trusted Links

Clinical Information and Differential Diagnosis of Tinea Corporis (Ringworm of Body)

References

Bolognia, Jean L., ed. Dermatology, pp.1174-1185. New York: Mosby, 2003.

Freedberg, Irwin M., ed. Fitzpatrick's Dermatology in General Medicine. 6th ed. pp.1997-1998, 2239-2243. New York: McGraw-Hill, 2003.