Ringworm

What is Ringworm?

Ringworm is a fungal infection with a misleading name. Ringworm actually has nothing to do with worms at all; it is so named for leaving a distinctive ring-shaped red mark. While it is frequently mistaken for a parasite, it is actually just a fungus. The confusion comes because it is so frequently listed among common ailments in animals, frequently spoken of in the same breath as many other actual parasites, and because of its name. The origin of the name is the distinctive look of the fungal infection, which very easily can resemble a ring of infesting worms just under the skin—these are actually just lesions and discoloration caused by the presence of a fungal infection.

Ringworm is a relatively minor infection in most circumstances, and far from uncommon. However, there is a little more to ringworm than might initially be apparent. Ringworm can lead to secondary infections if its symptoms are left unchecked, and can be quite uncomfortable. It can spread to others if it is not properly treated and hygiene is not maintained. It is similar in many ways to athlete’s foot, which is perhaps somewhat better known and more widely treated.

Ringworm is among the most common fungal infections, alongside athlete’s foot. Most of the treatments for ringworm are available over the counter, and it is rare that it grows serious enough to require full medical intervention. Over the counter treatment is usually sufficient to suppress the symptoms and cure individuals of ringworm.

Who gets Ringworm?

Ringworm is a fungal infection; it does not originate from any genetic condition. Most of the circumstances that lead to the development of ringworm are purely environmental. Ringworm does not discriminate based on ethnicity or sex, nor are there pre-existing conditions that might make one more vulnerable to ringworm in the future. There are no genes that play any relevant role. Hormone levels and body chemistry are relatively irrelevant, though they may play a very, very indirect roll in how they alter how much an individual sweats and what their body temperature levels out at. This does very little to determine who gets ringworm, however.

Contrary to what seems to be a popular belief, ringworm is not a parasite that animals get exclusively. Humans are just as likely to suffer from ringworm, if not more likely under some circumstances. The confusion stems from ringworm frequently being mentioned alongside other common ailments in pets, including and especially heartworm. Heartworm IS a parasite that is frequently found in domestic animals. Ringworm is a fungus that is frequently found in humans and domestic animals. They are very different.

Individuals taking antibiotics are more susceptible to fungal infections in general, and ringworm is no exception to this. Antibiotics kill bacteria but also suppress certain functions of the immune system, which can allow new pathogens to invade. Antibiotics do not directly cause ringworm, but can still play a considerable role that shouldn’t be ignored with respect to whether or not ringworm will be able to take hold of a person’s skin. Antbiotics can also make it more difficult to eradicate a case of ringworm that does take up, although again, they are not a primary cause by any stretch.

Those that live in certain geographical regions are more likely to suffer from ringworm than others. Some geographical areas contain ideal conditions for the infestation of ringworm, including and especially humidity. Humidity and warmth allow ringworm to thrive, and makes it much easier for ringworm to take hold. Tropical areas are far and away the worst for this, and it wasn’t until Western powers colonized certain parts of Asia that some forms of fungal infection were even well known. Ringworm did occur prior to this, but it was mistaken for an ailment common to the East before it became apparent that the reason for the increase in outbreaks was actually do to the change of climate and weather. Ringworm exposure, in truth, wasn’t any more common in the Eastern colonies, but the climate made it possible for the disease to take hold.

What causes Ringworm?

Ringworm infection is caused by exposure to ringworm. As a fungus, ringworm can take up residence in any number of locations, and can be spread from them. This includes various surfaces indoors and out, and skin. There are a number of possible vectors for ringworm, and as is common with most fungal infections, exposure is the only defined central ’cause’. All the rest is circumstantial support that enables the fungus to take a strong hold. There are no causes for ringworm that do not involve ringworm infection, however; ringworm cannot spontaneously come into being in a body. It is, like all other pathogens, a separate organism that has to come into contact with the body to infect it.

The first thing that makes a difference in ringworm infestation is moisture. Moisture allows fungi to thrive in surprising ways, and can make them spread very, very quickly. Ringworm is no exception to this generality, and it thrives well in moist locations. While it is not by any means restricted to these locations, it will find it much easier to grow under the arms, on the joints, between the legs and elsewhere. Moisture can come from many different sources; the easiest of these is purely environmental. Very humid areas foster ringworm most easily, as they have a tendency to keep a very large percentage of the skin damp—most skin that isn’t exposed to open are will become quite damp, if not wet.

The second thing that makes a difference is warmth. Much like bacteria, fungi can thrive on warmth up to a point. They can be in some cases more resilient than bacteria; ringworm can survive temperatures that might kill some bacteria. Warmth additionally encourages sweating, which increases dampness where it might not previously have been to begin with. This can result in warmth feeding the previous factor of dampness. Body heat gives most covered, insulated skin a chance to incubate ringworm, but warmer temperatures (especially warm temperatures in humid areas) pose greater and greater risks.

Immunocompromised individuals are more vulnerable to ringworm, as are individuals on antibiotics. Antibiotics cannot fight fungi, but they do depress the parts of the immune system that can. This can make it easier for ringworm to take hold and spread. Antibiotics will not cause outbreaks of ringworm, nor are they likely to be a defining trait that determines whether or not ringworm is contracted, but it can play a very big role in the spread of ringworm on a body and determining how long ringworm takes to treat.

What does Ringworm cause?

Ringworm, first and foremost, causes the discoloration of the skin. Ringworm’s appearance is distinctive in the form of a number of small red lesions that tend to form a ring, or otherwise appear covering a circular area. This is frequently mistaken for the presence of a wormlike parasite, but it is not; ringworm is a fungus, not a parasite. The confusion is understandable, but should not be perpetuated: despite appearances and despite the misleading name, ringworm is not a parasite.

Ringworm causes a number of tangible symptoms that can be the first indication of its presence. The first of these is almost always itching. Ringworm causes intense pruritis (the clinical term for ‘itching’) in almost all cases, which in turn can make it much easier to spread by inclining people to scratch. In addition to the itching, pain and swelling are very common. This itching is caused by the body’s immune response to the fungus, and can be quite uncomfortable and distracting, making it difficult to work, sleep, or engage in any other activities.

The itching of the skin can lead individuals to excoriate (scratch) and otherwise damage the skin. This leaves the body significantly more vulnerable to other infections, especially bacterial infections. Secondary bacterial infections add an additional dimension to ringworm. The antibiotics required to treat bad bacterial infections can interfere with the body’s ability to clear out fungal infections on its own, which can make the fungal infection last considerably longer.

Even without excoriation, ringworm can cause skin to dry out severely in various patches, which can combined with persistent wetness (as is common in the conditions ringworm thrives in) lead the skin to rupture, blister and crack. This additionally makes secondary bacterial infections much more likely, as it causes open sores that defeat the skin’s ability to defend against pathogens.

How serious is Ringworm?

Ringworm is not particularly serious in that it does not risk any long-term damage to the skin aside from the worst circumstances. However, it can be very, very uncomfortable. More relevantly, because it is a fungal infection, ringworm can be very resilient. Even with proper treatment, ringworm may persist to four or five weeks, if not even longer. This assumes ringworm is not given a chance to spread throughout more of the skin, effectively renewing its infection.

Secondary infections caused by ruptures in the skin can make ringworm more serious. Secondary bacterial infections are ailments unto themselves that will require separate treatment. Treatment options for these bacterial infections may be complicated by the treatment for ringworm.

What does Ringworm treatment look like?

There are a number of options available for ringworm treatment. One of the first of these, and most obvious, is an antifungal cream. Antifungal creams directly attack the fungal infection where it resides, killing it off and preventing its spread. Antifungals are also available in general form; these are used when it would be difficult or impossible to apply the cream to the full infected area, or the full infected area is simply too large (making it much more efficient to deliver antifungal medication to all of the body’s system’s equally). Antifungal treatments can be somewhat problematic, however, as they may provoke was is called an ‘id response’. An id response is a reaction between the antifungal treatment and the fungus itself. This results in a simple rash that usually is raised from the skin, but otherwise close to asymptomatic. The id reaction usually dissipates when the bacterial infection is ousted.

The actual first line of treatment, however, is prevention. Fungal infections are much easier to avoid than they are to treat. Fungi are very resilient and fungal infections can persist for a very long time. Fungi thrive when given a damp, dark, warm area. Feet are a primary locale that is vulnerable to this (athlete’s foot). The first preventative step is the prevention of exposure. This is frequently not possible, as the most common means by which ringworm is spread is the use of a common area, which generally means a mandatory task or a shared activity (such as a school gym’s locker room). When this fails, proper hygiene is the next step. Properly scrubbing skin expose to shared surfaces is a good idea for a number of reasons, and ringworm is not the least of these. Following that, skin should be kept dry. Humans are land mammals; keeping the skin wet or damp for prolonged periods can cause a number of issues, and it has a tendency to let ringworm that the skin has been exposed to absolutely thrive. If the skin is also warm, and there isn’t very much light to interfere, it can grow very quickly—faster than the body’s immune system can deal with it. Keeping the skin dry is a simple matter of allowing it to breathe; if liquids can evaporate, the skin will not remain damp for very long. If this is not possible, and one expects to sweat quite a lot, wicking clothes that sap away moisture should be used if possible. In any case, talcum powder serves just as well, if requiring a little bit of fuss and some mess to be useful. Talc in almost any set of shoes can help prevent athlete’s foot.

Symptomatic treatment for ringworm is also available. This is frequently very simple, taking the form of various over-the-counter anti-itch and pain relieving medications in the form of creams and oral supplements, including basic analgesics. Should the skin become excessively dry or scaly as a result of ringworm, a simple moisturizing lotion may serve to easily resolve this dryness. This will frequently prove ineffective if the ringworm should be stuck somewhere already damp (such as on a booted foot—this is athlete’s foot). These are fairly common in conjunction with direct anti-fungal treatments, as it may be quite some time before the fungus should resolve itself and the symptoms will cease on their own as a result.

Secondary bacterial infections are another matter entirely. These may require antibiotics to fully resolve, although this is something of a difficult move, as antibiotics can make it much easier for a fungus to spread healthily.

How do I know if I have Ringworm?

Ringworm can be easily identified by its distinctive ring shape. The red lesions are possible to mistake for dry skin, scrapes or, most commonly, the bites of insects or a very small animal. However, the intense itching and the inability of what should be a very basic injury to heal usually give it away, and individuals aware of ringworm can fairly reliably identify it should they contract a ringworm infection. A medical professional can identify ringworm visually. Some ultraviolet methods of fungus detection may not work on ringworm, should visual identification fail, but there are other methods of identifying ringworm, including a basic skin biopsy.

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