This topic is about
ringworm of the skin, groin, or hands. For information about other fungal
infections, see the topics:
Ringworm of the skin
is an infection caused by a
Jock itch is a form
of ringworm that causes an itchy rash on the skin of your groin area. It is
much more common in men than in women. Jock itch may be caused by the spread of
athlete's foot fungus to the groin.
Ringworm is not caused by a worm. It is caused by a fungus. The kinds of
fungi (plural of fungus) that cause ringworm live and spread on the top layer
of the skin and on the hair. They grow best in warm, moist areas, such as
locker rooms and swimming pools, and in skin folds.
contagious. It spreads when you have skin-to-skin contact with a person or
animal that has it. It can also spread when you share things like towels,
clothing, or sports gear.
You can also get ringworm by touching an
infected dog or cat, although this form of ringworm is not common.
Ringworm of the skin
usually causes a very itchy rash. It often makes a pattern in the shape of a
ring, but not always. Sometimes it is just a red,
Jock itch is a rash in the skin folds of the groin.
It may also spread to the inner thighs or buttocks.
the hand looks like athlete's foot. The skin on the palm of the hand gets
thick, dry, and scaly. And skin between the fingers may be moist and have open
If you have
a ring-shaped rash, you very likely have ringworm. Your doctor will be able to
tell for sure. He or she will probably look at a scraping from the rash under a
microscope to check for the ringworm fungus.
Most ringworm of the skin can
be treated at home with creams you can buy without a prescription. Your rash
may clear up soon after you start treatment, but it's important to keep using
the cream for as long as the label or your doctor says. This will help keep the
infection from coming back. If the cream doesn't work, your doctor can
prescribe pills that will kill the fungus.
If ringworm is not
treated, your skin could blister, and the cracks could become infected with
bacteria. If this happens, you will need
If your child is being
treated for ringworm, you don't have to keep him or her out of school or day
If you or someone in your family has symptoms, it is
important to treat ringworm right away to keep other family members from
Learning about ringworm of the skin:
infection is caused by a
fungus. Fungi (plural of fungus) that cause ringworm
live and spread on the outer layer of skin. Ringworm is not caused by a worm or
Fungi are present everywhere in our environment,
including on the human body. They thrive in warm, moist areas, such as locker
rooms and swimming pools, and in skin folds. You can get ringworm of the skin
by sharing contaminated towels, clothing, and sports equipment, and by direct
contact with an infected person.
Ringworm of the skin (tinea corporis) is most commonly caused by the
fungus Trichophyton rubrum, which spreads from one
person to another. It can also be caused by Microsporum canis, which is spread by cats and dogs. This type is less common but
causes a more severe infection.
People often get ringworm of the
groin ("jock itch") by accidentally spreading
athlete's foot fungus to their own groin area. People
who have athlete's foot also commonly spread it to their hands (tinea
Some people are more likely to get fungal infections than others. The
tendency to get fungal skin infections or to have them return after treatment
seems to run in families.
ringworm infections cause a rash that may be peeling,
cracking, scaling, itching, and red. Sometimes the rash forms blisters,
especially on the feet.
Symptoms of ringworm of the body include a rash:
Symptoms of ringworm of the face
include a rash:
Symptoms of ringworm of the groin
(jock itch) include a rash:
Jock itch and
athlete's foot frequently occur at the same
Symptoms of ringworm on the hand
include a rash:
Fingernails can also be infected. For more information, see
Fungal Nail Infections.
Ringworm of the
skin may be confused with
other conditions with similar symptoms, such as
Ringworm of the skin can start as a small patch of itchy, red, or scaling skin. The rash
can spread and cover a large area.
Clothing that rubs the skin can
irritate the rash. Sweat, heat, or moisture in the air (humidity) can make the
itching and infection worse.
As the infection becomes worse, the
ring-shaped pattern and red-brown color may become
more visible. If not treated, the skin can become irritated and painful. Skin
blisters and cracks can become infected with bacteria and require
Ringworm can also spread to
other parts of the body, including the feet, nails, scalp, or beard.
After treatment, the rash will go away. But ringworm can return unless
you follow steps to prevent it. The tendency to get fungal skin infections or
to have them return after treatment seems to run in
Your risk of getting
ringworm is higher if:
If you suspect you have
ringworm of the skin, call your doctor if:
Watchful waiting is a wait-and-see approach. If
you get better on your own, you won't need treatment. If you get worse, you and
your doctor will decide what to do next.
You can treat ringworm
at home with medicines you can buy without a prescription. If symptoms do not
improve after 2 weeks of treatment with this medicine, call your doctor.
Any persistent, severe, or recurring infection should be checked by your
The following health professionals can diagnose and
ringworm of the skin:
To prepare for your appointment, see the topic Making the Most of Your Appointment.
Doctors often can easily recognize
ringworm by its
ring-shaped rash. Your doctor will probably also look
at a skin sample (KOH preparation) under a microscope to confirm that fungus is
Tests for ringworm of the skin include:
Most cases of
ringworm of the skin, including jock itch and ringworm
of the hand, can be treated with creams or ointments that you put on your skin
to kill fungi. These are called topical antifungals. You can get many topical
antifungals without a prescription. Brand names include Micatin, Tinactin,
Mycelex, and Lamisil.
You may need to take
antifungal pills (oral treatment) if the ringworm does not go away after you
have tried different topical antifungals or if the infection is widespread.
Oral treatments include
azoles such as fluconazole (Diflucan),
allylamines such as terbinafine (Lamisil), and
griseofulvin (Grifulvin V).
Your rash may start to clear up soon after you begin treatment, but it is
important to use the medicine exactly as the label or your doctor says. This
will help keep the infection from coming back. You will probably need to
continue treatment for 2 to 4 weeks.
If not treated, ringworm can
spread and the skin can become irritated and painful. Skin blisters and cracks
can become infected with bacteria. If this happens, you may need to take
You should treat a fungal
infection right away. Severe and widespread infections can be hard to
ringworm of the skin:
In most cases, you can treat
ringworm of the skin with antifungal creams or
ointments. Many are available without a prescription. Use a nonprescription
antifungal cream with miconazole or clotrimazole in it. Brand names include
Micatin, Mycelex, and Tinactin. Terbinafine cream (Lamisil) is also
available without a prescription.
If your rash does not clear after you have tried different
topical antifungals, or if the infection is widespread, you may need
prescription antifungal pills.
If you have both athlete's foot and
ringworm of your groin or legs, you should treat both infections. This will
prevent you from re-infecting your legs or groin with the athlete's foot
fungus, when you put on your underwear.
ringworm infections of the skin can be treated at home
with nonprescription antifungal creams. The rash will usually improve within 2
weeks. But most antifungals need to be used for 2 to 4 weeks to get rid of the
If the rash does not improve
after you have used an antifungal cream and it is severe and widespread or
returns frequently, you may need antifungal pills that your doctor prescribes.
When you are treating ringworm, it is important to finish the full course of
medicine prescribed, even if the symptoms have gone away, so that the infection
does not return.
The most common antifungals used to treat
ringworm of the skin are:
Clotrimazole/betamethasone (Lotrisone), a combination
corticosteroid, is sometimes used to treat ringworm
that is burning, itchy, and inflamed. This prescription medicine should be used
with caution and for no longer than 2 weeks, because complications can occur
with long-term use of corticosteroids.
People who are taking antifungal pills should have a doctor
monitor their blood counts and liver and kidney function during treatment to
watch for any harmful side effects.
The American Academy of Dermatology (AAD) provides information
about the care of skin. You can locate a dermatologist in your
area by using their "Find a Dermatologist" tool. Or you can read the latest news in dermatology. "SPOT Skin Cancer" is the AAD's program to reduce deaths from melanoma. There is also a link called "Skin Conditions" that has information about many common skin problems.
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CitationsHirschmann JV (2009). Fungal, bacterial, and viral infections of the skin. In EG Nabel, ed., ACP Medicine, section 2, chap. 7. Hamilton, ON: BC Decker.Other Works ConsultedAmerican Academy of Pediatrics (2009). Tinea corporis (ringworm of the body). In LK Pickering, ed., Red Book: 2009 Report of the Committee on Infectious Diseases, 28th ed., p. 663. Elk Grove Village, IL: American Academy of Pediatrics.Grossberg R (2011). Fungal diseases of the skin. In ET Bope et al., eds., Conn's Current Therapy 2011, pp. 869–871. Philadelphia: Saunders.Habif TP, et al. (2011). Tinea of the body (tinea corporis) and face (tinea faciei). In Skin Disease: Diagnosis and Treatment, 3rd ed., pp. 275–279. Edinburgh: Saunders.Hall JC (2010). Dermatologic mycology. In JC Hall, ed., Sauer’s Manual of Skin Diseases, 10th ed., pp. 246–266. Philadelphia: Lippincott Williams and Wilkins.
December 21, 2012
Kathleen Romito, MD - Family Medicine & John Pope, MD - Pediatrics
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