Ringworm is a fungal type of infection, which is caused by the fungal organisms known as dermatophytes. It can affect various parts of the body, especially the skin on the hands, feet, face, and neck. It can also affect the scalp or nails. Initially, it appears as a small dot. Gradually, as the infection develops, the redness increases and the inflammation worsens.
Ringworm is very contagious and the organisms causing the disease can be contracted directly or indirectly. If this skin condition is left untreated, the infection can intensify and can quickly spread. Blisters and pustules occur on the skin patches and the infected areas become itchy. The border becomes raised and crusty. Medications that contain antifungal components are the most effective treatment for ringworm.
Antifungal medications can be in the form of oral pills, creams, gels, sprays, and lotions. If left untreated, the infection spreads and the affected area becomes susceptible to bacterial infection. Treatment should start as soon as the signs of the fungal infection are observed.
Antifungal medications are necessary when it comes to treating ringworm since home remedies cannot completely cure the infection. Ringworm can be treated mainly by two ways: topical (external application) or systemic treatment (oral medications).
1. Topical Treatment
The aim of antifungal medications is to kill the fungi. By using topical medications, the infection can be cleared in 7-10 days if the condition is uncomplicated. The medication can continue for 10 days after the symptoms have gone to prevent its recurrence.
Ringworm treatment usually depends on where the infection is on the body and how severe it is. Generally, doctors recommend buying over-the-counter medications for ringworm. In some cases, a prescription is needed. If the skin is infected, then the doctor will most likely recommend an OTC antifungal cream, lotion, or powder. Miconazole is one of the most commonly used antifungal drug for the treatment of skin fungal infections. You can find miconazole is under the following trade names:
- Aloe Vesta
- Baza Antifungal
- Critic-Aid Clear
- Cruex Prescription Strength
- Fungoid Tincture
Other antifungal agents include:
- Mycelex, Lotrimin (clotrimazole)
- Remedy Antifungal with Olivamine
- Secura Antifungal
- Allylamines such as Naftin (naftifine) and Lamisil (terbinafine)
- Xolegel, Nizoral (ketoconazole)
- Spectazole (econazole)
- Oxistat (oxiconazole)
- Ertaczo (sertaconazole)
- Exelderm (sulconazole)
- Loprox (ciclopirox)
These medications can be used for 2-4 weeks on the skin. This makes sure that the causative agent of ringworm is killed. It also lowers the chances of recurrence.
The Food and Drug Administration (FDA) has approved luliconazole (Luzu) as an antifungal medication. It is the first topical azole antifungal agent approved. It needs to be applied once daily for one week. It is for the management of tinea cruris and tinea corporis in adults, who are over the age of 18.
Corticosteroids help relieve itching, but it should be avoided as much a possible. Steroids may worsen the infection and cause the fungus to most likely spread into the hair follicles. Combination products are available, but are more expensive. These products mix an antifungal medication with a steroid.
2. Systemic Treatment
Oral antifungal medications are given to people with widespread fungal infection, those who do not respond to topical antifungals, and those with a weakened immune system.
If ringworm is on the scalp and other parts of the body, using only OTC treatment may not be effective. The doctor will prescribe a specific antifungal medication for the infection. The doctor may also suggest an antifungal shampoo.
The oral antifungals prescribed by most doctors are griseofulvin (Grifulvin V, Gris-PEG), itraconazole, and terbinafine.
- Terbinafine - This antifungal medication needs to be taken for four weeks once a day. Usually, the side effects are mild and do not persist for long. Side effects include nausea, indigestion, diarrhea, and rashes. If you have liver disease or lupus, then your doctor will not prescribe this medicine.
- Griseofulvin - This medication is to be taken 8-10 weeks. It is available in the form of oral tablets as well as in the form of a spray. Side effects include nausea, mild diarrhea, vomiting, headache, and indigestion. If you are pregnant, planning to have a baby, or breastfeeding, then you cannot take this medicine since it may cause birth defects. This medication may affect the effectivity of birth control pills. Hence, condoms and other forms of contraception should be used. Also, do not drive or drink alcohol when you are taking this medication.
- Itraconazole - This drug is prescribed in the form of a pill for 7-15 days. It is not prescribed for children, the elderly, or people with severe liver problems. Side effects include nausea, vomiting, diarrhea, indigestion, and headaches. If the symptoms get worse or if there are no improvements after the treatment is over, then consult a doctor again for further assessment of your condition.
- Antibiotics - These medications are usually required in cases of bacterial superinfections of the skin with ringworm lesions.
- Surgical Drainage - This procedure is needed in cases of serious fungal infections or deep abscesses.
Other Antifungal Treatments
For scalp ringworm, antifungal shampoos containing selenium sulfide and ketoconazole are used. It can be used twice a week during the first two weeks of treatment. Over-the-counter antifungal creams, gels, and sprays are also available for fungal infections in the hand, face, groin, and feet. They should be applied over the rash and at 4-6 cm beyond the border of the healthy skin. The antifungal preparation should be applied for two weeks to the affected area.
Antifungal nail paint can be used for fungal nail infections. If the skin is inflamed, then the doctor may prescribe an antifungal cream combined with a steroid. However, it should not be used for more than seven days.
- Terbinafine Hydrochloride Cream (Lamisil) - It has been used to treat ringworm and has been found to be very effective. The cream should be applied to the affected areas of the skin. While applying this cream, the skin should be clean and dry.
- Ringworm Soap - It ensures that when the infection leaves the body it doesn’t cause much distress. The best antifungal soap is a defense soap for ringworm, which contains 2 percent of an essential oil. Defense Soap Body Wash Shower Gel is an antifungal body wash used for ringworm and other fungal infections. It is infused with eucalyptus and tea tree oil.
Home Treatment and Remedies
Most ringworm infections are treated with antifungal creams or ointments. Doctors may recommend over-the-counter medications. Use a nonprescription antifungal cream with miconazole or clotrimazole in it.
Apply the antifungal cream to the lesions one inch beyond their border. It should be applied daily for a minimum of two weeks. Yeast infections, diaper rash, and ringworm are all caused by fungi. However, the medications used for these conditions are ineffective for ringworm.
The rash should be washed with soap and water, and should be dried thoroughly. If the blister or sores are in larger areas of the body, then use compresses soaked with Burow’s solution to soothe and dry the blisters. Apply the antifungal cream beyond the edge or border of the rash.
Follow the package direction. You may need treatment for a period of 2-4 weeks. So don’t stop the medicine just because the symptoms have gone away. If there is no improvement in the symptoms after 2 weeks, then inform the doctor.
If the rash doesn’t clear even after applying various topical antifungals or if it is widespread, then you may need antifungal pills prescribed by the doctor.
If the ringworm is on the scalp, then it can be treated with the help of shampoos containing 1-2.5 percent selenium sulfide or ketoconazole such as Head & Shoulders Intensive Treatment, zinc pyrithione (1-2 percent), Selsun Blue, or Nizoral. The shampoo should be directly applied to the scalp and the entire body. It ensures complete eradication of the fungi. To achieve best results, nizoral should be used 2-3 times a week.
Because of natural antifungal properties, apple cider vinegar has been used as one of the most effective home remedies for fungal infections. However, it will take time to show its effect and it can be used in mild cases only. Also, when it is applied to the skin, it can sting. Thus, inform or contact your doctor before using it for your fungal infection.
If you have athletes foot and ringworm of the groin or legs, then both infections need to be treated.
Natural Home Remedies
There are plenty of natural home remedies available that are safe with fewer side effects. The following home remedies have proven to be effective for the treatment of fungal infections:
- Apple Cider Vinegar - Use a cotton ball in applying undiluted apple cider vinegar to the affected area of the skin. Repeat this process 3-5 times a day until the rashes go away. Apple cider vinegar is known for its antibacterial and antifungal properties.
- Garlic - It contains allicin and ajoene compounds, which are effective against fungal infections. Make a paste using crushed garlic cloves and olive oil, and apply the paste on the affected areas. Cover the areas with gauze for two hours and then rinse them with warm water. This process should be repeated three times a day for two weeks.
- Turmeric - It is used in traditional Indian medicine. Mix a teaspoon of turmeric powder with a few drops of water and create a paste. Apply this paste on the affected areas of the skin. Leave it for 10 minutes before rinsing.
- Papaya - The enzymes papain and chymopapain in papaya are known to be potent antifungals. Cut a papaya into pieces and rub them on the skin. You can also create a paste by crushing the papaya and then leave it on the rashes. After 20 minutes, wash the affected areas with warm water.
Antifungal oils are also known to be effective against ringworm. However, apply it with caution since some oils tend to irritate the skin. Test it first on a healthy patch of skin before you apply it to the affected area. If there is an irritation, then dilute the antifungal oil either with a carrier oil or warm water.
- Lavender Oil - Mix four drops of the oil and one teaspoon of carrier oil such as jojoba oil.
- Calendula Oil - It is another alternative when lavender oil cannot be acquired. Mix calendula oil with a carrier oil and apply it to the affected area.
- Tea Tree Oil - Pour some tea tree oil on a cotton swab and apply it to the affected skin areas. If needed, dilute the oil with warm water.
- Coconut Oil - Apply coconut oil using a cotton swab or cotton ball. Apply it liberally on the affected area.
Preventing a ringworm infection is easier than its treatment. The following are tips on how to avoid getting ringworm:
- Sharing of personal items such as combs, hairbrushes, shoes, socks, towels, bed linens, and clothing should be strictly avoided.
- Regularly wash bed sheets, pillow cases, and towels using hot water and detergent.
- Wash your hands regularly and frequently.
- Avoid scratching the infected lesions to prevent the spread of the infection to other body parts.
- Wear appropriate protective shoes in places like the beach, gyms, and locker rooms. Avoid walking barefoot.
- Avoid touching your face when you have facial ringworm.
- Wash your hands with antibacterial or antifungal soap or one that contains tea tree oil, if you are exposed to places where the chances of ringworm infection are high. Tea tree oil contains terpentine-4-ol, which has antimicrobial properties and has been found to be successful in treating fungal infections.
- Check pet animals for infections and get them treated immediately.
- Infected people should be isolated by avoiding school or work. This will prevent the spread to others.
- If you have contracted ringworm, then you can prevent it from spreading it further by covering the infected skin and keeping it dry and clean.
Once the lesion appears, then the person has a great potential of spreading the disease to others. This may vary from a few days to years depending on the treatment. According to doctors, children need not be isolated since the fungus is not contagious anymore after 24-48 hours of taking medication. Hygiene is very important in restricting ringworm. By being extra cautious around infected people, the chances of the infection spreading can be minimized.