Ringworm, despite its name, is not caused by worms but by a fungal infection. The treatment for ringworm varies depending on the severity of the infection and the location on the body, such as the skin, scalp, or nails. Effective treatments are available, ranging from over-the-counter medications for milder cases to prescription options for more stubborn infections.
Antifungal medications are the cornerstone of ringworm treatment and come in various forms including creams, ointments, lotions, powders, and oral pills. For many cases of ringworm, especially on the skin, non-prescription, over-the-counter antifungal medications can be highly effective. However, some ringworm infections, particularly those affecting the scalp or nails, often require prescription-strength antifungal medications to clear up completely.
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 actually worsen ringworm infections by suppressing the skin’s immune response and allowing the fungus to spread.
Types of Ringworm Treatments
Treating Ringworm on the Skin
Ringworm infections affecting the skin, such as athlete’s foot (tinea pedis) and jock itch (tinea cruris), are typically treated with over-the-counter antifungal medications. These medications are available as creams, ointments, lotions, or powders and are usually applied directly to the affected skin for a period of 2 to 4 weeks. It’s important to follow the product instructions carefully and continue applying the antifungal for the entire recommended duration, even if symptoms start to improve before then. Stopping treatment too early can lead to the infection returning.
Several effective non-prescription products are readily available for treating ringworm on the skin. Common active ingredients to look for include:
- Clotrimazole (found in brands like Lotrimin and Mycelex)
- Miconazole
- Terbinafine (Lamisil)
- Ketoconazole (Xolegel)
Treating Ringworm on the Scalp
Ringworm on the scalp (tinea capitis) is more challenging to treat than skin infections and generally requires prescription antifungal medication taken orally for 1 to 3 months. Topical creams, lotions, or powders are not effective for scalp ringworm because they cannot penetrate the hair follicles where the fungus resides.
Prescription antifungal medications commonly used to treat ringworm of the scalp include:
- Griseofulvin (Grifulvin V, Gris-PEG)
- Terbinafine
- Itraconazole (Onmel, Sporanox)
- Fluconazole (Diflucan)
Treating Fungal Nail Infections
Fungal nail infections, also known as onychomycosis, can cause nails to become discolored, thickened, or misshapen. While nail changes can occur for various reasons, including injury, it’s important to consult a healthcare provider for proper diagnosis before starting treatment for a suspected fungal infection.
Treatment for fungal nail infections is most effective when initiated early. Prescription antifungal medication taken orally is usually the most effective approach. In some cases, healthcare providers may recommend complete removal of the infected nail, especially in severe cases. Treating nail fungus is a lengthy process, and it can take several months to a year for the infection to fully resolve.
It’s crucial to use antifungal medications exactly as prescribed by your doctor or as directed in the over-the-counter product instructions.
When to Seek Medical Advice for Ringworm
While over-the-counter treatments are available for many types of ringworm, it’s advisable to contact a healthcare provider for any suspected ringworm infection. A healthcare provider can accurately diagnose the condition, rule out other potential causes, and recommend the most appropriate and effective treatment plan for your specific situation.
Medical consultation and prescription treatments are often necessary for certain types of ringworm infections. Always contact your healthcare provider if you suspect:
- Ringworm of the scalp.
- Fungal nail infection.
Be Aware of Emerging Antifungal-Resistant Ringworm
A more severe form of ringworm, which can be resistant to typical antifungal treatments, has been spreading globally, with some cases reported in the United States. These infections may not respond to the standard antifungal medications usually prescribed for ringworm.
Consult your doctor promptly if you experience ringworm symptoms that are:
- More severe or widespread than typical ringworm.
- Not improving or resolving after using over-the-counter treatments.
- Develop after contact with someone known to have a severe ringworm infection.
Inform your healthcare provider about your recent travel history, as this can be relevant in diagnosing and treating potentially resistant strains of ringworm.
What to Avoid When Treating Ringworm
It is 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 general rashes contain corticosteroids. Using these on a ringworm infection can significantly worsen the condition. Steroids weaken the skin’s natural defenses, allowing the fungal infection to spread more extensively. They can also intensify symptoms like burning and redness. Furthermore, corticosteroids can alter the appearance of ringworm rashes, making it more challenging for healthcare providers to accurately diagnose the condition if medical care is sought later.
