Suddenly you notice that your nails appear yellowish, peeling, or when you take off your shoes you feel a sharp pain under one of your toes and when you look, you see an injury. All this is the consequence of something quite common: fungi, the culprit behind ringworm. These little creatures, invisible to the naked eye, can be found in many places, such as swimming pools, pets, at the beach, or on other shared objects, and they multiply more easily in the summer, the hottest and most humid time of the year when people are more prone to ringworm.

What is Ringworm?

Ringworm is a common skin disease, also known as tinea or dermatophytosis. It is caused by more than 100 species of fungi that can live on the skin, on surfaces like locker rooms, and on household items like towels, bed linens, and clothes.

Causes of Ringworm

Although the world is full of microorganisms, only a few cause skin problems. The fungi responsible for ringworm are known as dermatophytes, microorganisms that feed on dead skin tissues, hair, and nails. Dermatophytes cause infections on the surface of the skin. Ringworm can be spread in the following ways:

  • Human to human – Ringworm usually spreads through direct skin contact with an infected person.
  • Animal to human – It is possible to catch ringworm by touching an animal with ringworm. Mainly dogs or cats, but it is also quite common in cattle.
  • Object to human – Ringworm can spread by contact with objects or surfaces recently touched or rubbed by an infected person or animal, such as clothes, towels, bed linens and sheets, combs and brushes.
  • Soil to human – In rare cases, ringworm can be transmitted to humans by contact with infected soil. Infection would likely only occur through prolonged contact with highly infected soil.

Symptoms of Ringworm

Ringworm usually begins as a red, flat, and scaly patch on the skin that can itch a lot. This area develops a slightly raised edge that expands outward as it grows, forming circular patches (known as impetigo). The borders of these patches can be quite irregular. The inside of the patch may be clear, scaly, or marked by scattered red dots. Some people develop several patches at the same time, and they may overlap.

Types of Ringworm

It is important to understand that the various types of ringworm do not refer to different species of fungi, but rather to species that cause different forms of ringworm. Although there are multiple forms, the most common ones affect:

  • Skin
  • Scalp
  • Feet
  • Groin
  • Nails
  • Face
  • Hands
  • Beard

Body Ringworm (Tinea Corporis)

This type refers to ringworm of the torso, legs, or arms. Although children are especially susceptible to developing ringworm, adults can be affected as well.

Acute and Chronic Body Ringworm

Body ringworm can be acute or chronic. When acute, the fungus suddenly causes red patches that may fill with pus and spread quickly. When chronic, ringworm spreads slowly and tends to appear in the folds of the body. Chronic ringworm is more difficult to treat and is more likely to recur over time. With treatment, it typically disappears within four weeks. It is best to avoid scratching, as this can lead to a skin infection.

Nail Ringworm (Tinea Unguium)

Nail ringworm is usually caused by either of two fungi: Trichophyton rubrum or T. interdigitale. Although it can refer to fungal infections of any nails, toenails are much more likely to contract this disease. Those most susceptible to nail ringworm include men, older adults, diabetics, people with peripheral vascular disease, or anyone with a compromised immune system. Some of the symptoms of nail ringworm include:

  • Yellow, brown, or otherwise discolored nails,
  • Hard nails
  • Brittle nails,
  • Thick nails

Without proper treatment, a nail infected by this fungus is at risk of falling off.

Scalp Ringworm (Tinea Capitis)

This type of ringworm is most common in children between the ages of 3 and 7 years, and less common in adults. The hair itself may be infected by several ringworm fungi, which can be spread by cattle, horses, pigs, dogs, and cats (especially cats). Some of the symptoms of scalp ringworm include:

  • Dandruff-like scaling accompanied by hair loss
  • Yellow crusts and matted hair
  • Swollen lymph nodes in the neck
  • Smooth patch where the hair has fallen out
  • Intensely inflamed mass resembling an abscess.

Athlete’s Foot (Tinea Pedis, Athlete’s Foot)

This is the most common form of ringworm in humans and also the hardest to treat. Athlete’s foot is more common in men and can present with several different symptoms, including:

  • Scaling on the soles of the feet,
  • Blisters on the sides of the feet,
  • Round dry patches on the top of the foot,
  • Dry soles that are not inflamed
  • Moisture and scaling of the skin between the toes (athlete’s foot)

Athlete’s foot can cause a painful crack in the skin (known as chilblain), and can produce an unpleasant odor. Athlete’s foot symptoms may not be caused by ringworm. They can also be caused by:

  • Bacterial infections,
  • Mold infections
  • Skin conditions such as psoriasis and eczema,
  • Injury
  • Friction due to toes pressing against each other.

Athletes are more likely to get this type of ringworm because they fall into several risk categories for this infection, including:

  • Shoes with poor ventilation,
  • Excessive sweating
  • Feet that stay wet for long periods
  • Walking through shared areas such as locker rooms and showers.

How is Ringworm Diagnosed?

Some forms of ringworm are easier to detect than others. The tell-tale sign is the raised red rings that can alert the doctor to the infection, making the diagnosis straightforward. At other times, however, ringworm may be difficult to diagnose. Certain types of ringworm are particularly resistant to diagnosis, such as ringworm of the face and hands. In these cases, the fungus can cause infections that resemble many other common skin conditions. If a dermatologist has trouble diagnosing ringworm, usually a small skin scraping is taken. This sample can then be analyzed in a laboratory to confirm the cause of the infection.

Treatment For Ringworm

Fungal diseases like ringworm are harder to treat than bacterial infections. This is because fungi have more complex cells, more similar to ours. This makes it more difficult to develop antifungal medicines that can kill the fungus without harming the patient’s health. As a result, topical and oral treatments are needed over a long period, and they may not be 100% effective. Even after the infection appears to have gone away, once ringworm appears, it is more likely to recur. To treat ringworm, creams, ointments, or topical lotions may be used, and in some cases, oral medications, when prescribed by a doctor. The treatment duration can range from 30 to 60 days (for the hands) and about 1 year for the feet. It is important that patients do not stop treatment without their doctor’s approval, since it is normal for symptoms to disappear before the disease is fully resolved.

How Can Ringworm Be Prevented?

Ringworm is very difficult to prevent because the causative fungus is common and contagious. You can reduce your risk by taking the following precautions:

  • Educate yourself – Be aware of the risk of catching ringworm from infected people or pets. Teach your children about ringworm, what to look for, and how to avoid infection.
  • Maintain hygiene – Wash your hands well to prevent spreading the infection. Keep shared or common areas clean, especially in schools, daycares, gyms, and locker rooms.
  • Keep cool and dry – Do not wear thick clothing for long periods in hot and humid weather. Avoid excessive sweating.
  • Avoid infected animals – In animals, the infection usually looks like a patch of skin where fur is missing. Sometimes, however, there may be no obvious sign of disease. Ask your veterinarian to check if your pets have ringworm.
  • Do not share personal items – Do not let others use your clothes, towels, hairbrushes, or other personal items. Also refrain from borrowing these and other products from other people.

See also: Black Skin Care Photos: PHIL_2938_lores, pepsyrock