Ringworm is a common skin infection in children. It is caused by several different fungal germs and is contagious. It is easily treated with antifungal medications and does not cause any serious complications.
What are the symptoms?
- It starts as a small round or oval pink or red patch or cluster of tiny bumps.
- It grows in size and forms a ring of small bumps or raised border, with clearing of the center of the patch.
- The border is often scaly.
- It may have mild itching or irritation but does not usually bother the child very much.
- The rash can be confused with eczema patches, contact dermatitis, or with a condition called granuloma annulare.
What causes ringworm?
Ringworm is a fungal infection of the skin. The germs can be spread from other children, pets, or the environment. The same fungal germs can cause infection in the scalp (tinea capitits), which requires different treatment. Similar germs also cause athlete’s foot and jock itch and nail infections.
What should I expect?
The patch will grow in size and usually form the typical ring. It is easier to recognize at this stage than at the very beginning. Usually the rash is about 1 inch in diameter. When treated with medication, it usually goes away in 1-2 weeks.
How is it treated?
- An antifungal cream is used. There are several available over-the-counter: clotrimazole (Lotrimin AF, Mycelex, store brands); ketoconazole (Nizoral, store brands); miconazole (Monistat, Micatin, store brands); terbinafine (Lamisil, store brands); tolnaftate (Tinactin, store brands).
- The cream should usually be used 2-3 times a day for up to 3-4 weeks. Use the cream for 1 week after the patch seems to be gone.
- Avoid scratching the area. You can cover the area with a bandage if this helps.
- Antifungal creams with a steroid (whether over-the-counter or prescription) should not be used; they can make it worse or cause complications.
What complications should I look for?
- If ringworm is in the scalp (tinea capitits), it needs to be treated with oral prescription medicine. Creams and shampoos will not work.
- If the rash continues to spread or is not responding to treatment, further evaluation is necessary.
How can I prevent my child from developing ringworm?
It is usually spread by close, skin-to-skin contact with other children, and occasionally from pets, who may not have any symptoms. There is not a lot you can do to prevent ringworm.
When can my child return to school or daycare?
Ringworm is mildly contagious. Your child can return once treatment is started. Some prefer to have the patches covered and if this is easily done then do it; however, it is not necessary once treatment is started.
When should I seek further care?
Call your doctor for an appointment if:
- The rash continues to spread after treatment for 5-7 days.
- The rash is not gone after 4 weeks of treatment.
