Ringworm, despite its name, is not caused by worms but by a fungal infection. The treatment approach for ringworm varies depending on the location and severity of the infection on the body, whether it affects the skin, scalp, or nails.
Antifungal medications are the cornerstone of ringworm treatment and come in various forms, including creams, ointments, lotions, powders, and oral pills. For some cases of ringworm, especially on the skin, over-the-counter (OTC) antifungal medications can be effective. However, more persistent or severe ringworm infections may require prescription-strength antifungals.
It’s crucial to avoid using over-the-counter creams that contain steroids, also known as corticosteroids, on ringworm or any undiagnosed rash. Steroids can worsen ringworm infections and hinder proper treatment.
Read more: About Ringworm & Fungal Nail Infections
Treatment Types for Ringworm
Ringworm on the Skin
Ringworm infections affecting the skin, such as athlete’s foot (tinea pedis) and jock itch (tinea cruris), are typically manageable with non-prescription antifungal medications. These medications are available as creams, ointments, lotions, or powders and are usually applied directly to the affected skin for a duration of 2 to 4 weeks. It’s important to adhere to the product instructions and continue applying the antifungal for the recommended period, even if symptoms begin to improve before then.
Several effective non-prescription products are available for treating skin ringworm, including:
- Clotrimazole (Lotrimin, Mycelex)
- Miconazole
- Terbinafine (Lamisil)
- Ketoconazole (Xolegel)
Ringworm on the Scalp
Ringworm infections of the scalp necessitate a different approach. They typically require prescription antifungal medication taken orally for a longer period, usually 1 to 3 months. Topical creams, lotions, or powders are not effective for treating scalp ringworm because they cannot penetrate the hair follicles to reach the infection. Prescription antifungal medications commonly used to treat scalp ringworm include:
- Griseofulvin (Grifulvin V, Gris-PEG)
- Terbinafine
- Itraconazole (Onmel, Sporanox)
- Fluconazole (Diflucan)
Fungal Nail Infections
Discoloration or changes in the shape of fingernails and toenails can arise from various factors, including injuries. Therefore, it’s essential to consult a healthcare provider for proper diagnosis and testing before initiating treatment for a suspected fungal nail infection.
Treatment for fungal nail infections is most effective when started in the early stages. Prescription antifungal medication taken by mouth is generally considered the most effective treatment option. In some cases, healthcare providers may opt to completely remove the infected nail. Eradicating fungal nail infections is a slow process, and it can take several months up to a year for the infection to fully resolve.
If left untreated, fungal nail infections can spread to the surrounding skin. Furthermore, even after successful treatment, nail infections can recur, particularly in individuals with diabetes who have an increased risk of recurrent infections.
When to Contact a Healthcare Provider for Ringworm
While over-the-counter treatments are available for certain types of ringworm, it is advisable to consult a healthcare provider for any suspected ringworm infection. A healthcare professional can accurately diagnose the condition, determine the underlying cause, and recommend the most appropriate and effective treatment plan for your specific situation.
Seeking professional medical advice and prescription treatment is particularly important in the following cases of ringworm:
- Suspected ringworm of the scalp.
- Suspected fungal nail infection.
Emerging and Severe Antifungal-Resistant Ringworm
A more aggressive and challenging type of ringworm infection has been emerging and spreading globally, with some cases reported in the United States. These infections may not respond to the standard antifungal medications typically used for ringworm treatment, posing a significant concern.
It is crucial to contact your doctor promptly if you experience ringworm symptoms that are:
- More severe or widespread than typical ringworm infections.
- Persistent and do not improve or resolve with over-the-counter treatments.
- Develop after contact with someone known to have a severe ringworm infection.
Additionally, inform your healthcare provider about your recent travel history, as this information can be relevant in diagnosing and treating potentially resistant strains of ringworm.
Things to Avoid When Treating Ringworm
It’s critical to avoid using creams containing steroids (or corticosteroids) to treat ringworm or any rash that could potentially be ringworm.
Many over-the-counter ointments and creams marketed for rashes contain corticosteroids. Using corticosteroids on ringworm infections can significantly worsen the condition. Steroids weaken the skin’s natural defenses against the fungus, allowing the infection to spread more extensively across the body. They can also exacerbate symptoms such as burning and redness. Furthermore, corticosteroids can alter the appearance of ringworm rashes, making it more challenging for healthcare providers to accurately diagnose the infection if medical care is sought later.
