Ringworm: not a worm, but often a ring.
In humans, the fungal infection that causes ringworm usually starts as a small red or pink patch that expands outward. As the lesion expands the center often clears, giving the appearance of a ring. The outer border is often pinker than the inner border. The spot or ring of rash may be pink, red, or brownish, and often appears scaly. Because it is an infection, it can be transmitted to other parts of your own or another person’s body by direct contact with the rash.
Other conditions may mimic ringworm or vice versa. Conditions commonly mistaken for ringworm include eczema, psoriasis, pityriasis rosea, drug rashes, viral rashes, and secondary syphilis. To make a precise diagnosis your doctor may take a scraping from your rash for microscopic analysis, especially if your rash is not healing with standard treatment.
However, if you think you have ringworm, there’s a good change you are correct. If you feel fine otherwise, there’s little danger in treating yourself at home. You can always see your doctor if the rash is spreading or you develop additional symptoms.
The over-the-counter antifungal medications are excellent and most were prescription medications in the past. Lotrimin, Lamisil, and generics of the same are among the most effective treatments. Make sure you use the cream according to package directions. Be consistent in your treatment. If you use the medication off and on you may never get rid of the rash. The two most common reasons for ringworm that doesn’t heal are 1) insufficient use of the correct medication and 2) the wrong diagnosis to start with.
You must use the cream at least daily, depending on the antifungal you’ve chosen. Typically, the ringworm lesion will begin fading within several days. At this point patients often become lackadaisical in their treatment. You must continue using the cream for a good week after the rash appears to have resolved to make sure even microscopic infection has cleared. Otherwise, the rash may recur.
For patients who experience significant itching, over-the-counter hydrocortisone cream in addition to the antifungal cream may be useful. The benefits are a lessening of the itch and improvement of appearance. The biggest drawback is that the hydrocortisone will make the infection appear to be gone before it actually is, another reason to continue the antifungal cream for several days after the skin appears to be healed.
If these treatments are ineffective, a resistant fungus may be responsible, or more likely the diagnosis is incorrect. See your doctor for a definitive diagnosis and proper treatment.
