Ringworm Treatment

Although ringworm is really common and not a dangerous infection in most cases, it can be uncomfortable. Looking for ringworm treatment? Read on to find easy other-the-counter solutions that are quite effective.

Question

Dr. Greene, my little sister has a ring worm, whatever that is, on her leg right underneath her buttocks. We took her to the doctors and they said to use Tinactin cream. Does this sound right?? I've never heard of using a cream for ring worms -- friend of mine said they were put on antibiotics -- plus if it's not inconvenient, may I get a little information on what exactly a ring worm is, and how you pick them up??? They said she probably picked one up in the grass at one of our BBQ's, is that possible??? Thank you very much for reading my question, I'm just a very protective and concerned big sister. God Bless!
P.S. Thank you very much for having this (Dr.Greene's HouseCalls). I've gone through about what seems like a thousand topics and I've learned a lot, hopefully someday I too will become a pediatrician. (In about 10 years, not too bad eh??) Once again, Thanx a million!!!!!!!
Sincerely, Pearl C. - 14 years old - O.C., California

Dr. Greene`s Answer:

Pearl, you sound like an awesome big sister! Your little sister is really lucky to have someone like you watching out for her and helping her to learn about her own health. Taking her to the doctor AND making sure you understand the truth yourself is a winning combination. It sounds to me that you really are on the road to becoming a great pediatrician.

Ringworm is NOT a Worm

Infections by worms have been recognized since antiquity. Treating some of these infections was among the few notable successes of early doctors. Physicians adopted as their professional symbol a staff encircled by two worms. This symbol, the caduceus, is used to this day.

One of the more obvious worm infections was one which we today call cutaneous larva migrans. As the worms travel through the body just under the skin, scaly red lines mark their paths. These lines are actually inflammatory reactions to the worms.

A very similar skin finding, with raised scaly rings instead of straight lines, was also noted in antiquity.

This infection came to be called ringworm, since the worms apparently traveled in laps around a short circle, rather than in a wandering line. Ringworm typically lasted several months and then, thankfully, resolved on its own. The infection was known to be mildly contagious, but the worm itself was never seen. It was a great mystery.

Some people thought that the ringworm skin lesions looked rather like the holes made in garments by moths — flat in the center, with a raised border. During the Middle Ages physicians began calling this infection tinea, the name of a common family of moths. Physicians added a descriptive word to the name to specify where on the body the infection was located: ringworm infections on the head were called tinea capitis, on the body tinea corporis, on the feet tinea pedis. They also had specific names for the same infection found in the groin, armpit, facial hair, or nails.

Ringworm is a Fungus

It was not until 1837 that the true cause of ringworm was found. A Polish physician looking at scrapings from the skin of people with ringworm identified a fungus (that he then massaged into his own arm!). Over the next several years, a number of investigators proved that what we call ringworm is always a fungal infection. This was the first time that any microscopic organism was ever proven to cause human disease. It has no connection at all with worms, other than the similar appearance of the skin lesions.

Fungi are tiny living organisms that survive by eating plant or animal material. The ringworm fungi feed on keratin — the material found in the outer layer of skin, hair, and nails. These fungi thrive best on skin that is moist, hot, and hidden from the light. When this infection is found on the feet, it is commonly called athlete’s foot; when it is found in the groin it is commonly called jock itch; and when it is found on the body it is still called ringworm. Up to 20 percent of the population has one of these infections at any given moment.

Ringworm is Mildly Contagious

Ringworm is very mildly contagious. It can be caught from domestic animals (especially dogs and cats) as well as most farm animals. The infection can be caught from the animal directly, or from anything, the animal rubs against (yes, Pearl, your sister could have gotten it from playing on the ground at the BBQ). Ringworm can also be caught from other humans, both by direct contact and by prolonged contact with flakes of shed skin (by using shared locker rooms and showers, from sharing clothes or from house dust, for instance). Wrestlers commonly spread it back and forth with their sweaty contact (tinea gladiatorum!).

To catch ringworm, you have to be exposed to it, and you have to be susceptible. Some people are much more susceptible than others. Those with eczema or other skin problems get ringworm more easily because the protective barrier of the skin’s outer layer is less intact. People with weakened immune systems are also more likely to get infected.  Children are more susceptible before puberty. Boys get it more easily than girls. Some people are genetically predisposed and can get it easily throughout life (like me!). 

Ringworm Treatment

Ringworm treatment is one of the many effective topical antifungal creams, such as miconazole (Tinactin), clotrimazole (Lotrimin) or terbinafine (Lamisil). Several of these antifungal creams are now available without a prescription and come in lotions, creams and powders. Treatment may require several weeks. Only by treating for at least one week after the resolution of symptoms (and for a total of at least 4 weeks) can one guarantee eradication. (Pets can be treated with the same medicines, but this is difficult since they often don’t get a rash with their infections. Contact your pet’s veterinarian to get up-to-date information on the best treatment for animals). As soon as treatment has begun, it’s fine for her to play with others, but it’s best not to share clothing or to let other children rub the patch of ringworm.

Rarely, when ringworm of the body is resistant to topical therapy, we use oral antifungal medications for about one month.

When ringworm is found in the nails or on the scalp, the infection is much more difficult to eliminate. Prolonged treatment with a prescription oral anti-fungal medicine (as well as other topical medicines) is usually necessary. Scalp ringworm is a major cause of hair loss, and should be treated aggressively. Creams, lotions and powders do not work; oral medication for one to three months is needed in this case.

Prevention 

Although ringworm is really common and not a dangerous infection in most cases, it can be uncomfortable– so it is good to try to prevent the infection from starting!  There are a couple easy measures to decrease your risk of contracting ringworm. Keep your skin clean and dry (no wearing sweaty socks around!).  Try not to share clothes, brushes, or other personal items.  When using public locker rooms, wear sandals. Always wash your hands with soap and water after playing with pets. And if you are involved in sports, change out of your wet work out clothes. Wipe down gear such as your helmet, gloves, and shin guards; and allow these items to dry completely before wearing them again.

Pearl, I expect that your sister’s patch of ringworm on her leg will clear up with the Tinactin. In the meantime, thanks for watching out for her!

References and Resources

Hainer BL. Dermatophyte infections. American Family Physician. 2003;67(1):101-8.

Noble SL et al. Diagnosis and management of common tinea infections. American Family Physician. 1998;58(1):163-74,77-8.

Last medical review on: July 01, 2020
About the Author
Photo of Alan Greene MD
Dr. Greene is a practicing physician, author, national and international TEDx speaker, and global health advocate. He is a graduate of Princeton University and University of California San Francisco.
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Recent Comments

Sir…I am so badly infected in ringworm… please help me sir…I can’t move anywhere…it’s itching like anything…I cry in every night.because I can’t able to sleep. I am suffering from ringworm from about 3 years and more may be…it is spreading every where even in my face.. underarms.stomach.legs..and in my private areas..😭😭help me sir. I m taking medicine from 3 years may be because of that my facial hair are growing like a monkey..what should I do .I feel so Shay front of people. Help me

Oh Evaa, I’m so sorry!

Dr. Greene says, “… effective topical antifungal creams, such as miconazole (Tinactin) or clotrimazole (Lotrimin). Several of these antifungal creams are now available WITHOUT a prescription.” That means you can get it at a pharmacy. You can ask the pharmacist to help you make sure you are getting the correct cream. The pharmacist will not be at all embarrassed by your questions. Since ringworm can be in the hair or on the body, they may ask where it is. You can just answer “on my body” without saying where.

Additionally, Dr. Greene says, “Treatment may require several weeks. Only by treating for at least one week after the resolution of symptoms (and for a total of at least 4 weeks) can one guarantee eradication. Be sure and follow these instructions.

Dr. Greene also says, “Rarely, when ringworm of the body is resistant to topical therapy, we use oral antifungal medications for about one month.” This is all the more reason to be sure to use the cream long enough to wipe it out, but just knock it back. You would to be sure you get the most out of the cream.

I hope that helps.
Best, @MsGreene
Note: I am the co-founder of DrGreene.com, but I am not Dr. Greene and I am not a doctor. Please keep that in mind when reading my comments and replies.

I am suffering from ringworm from about a year and It is spreading day by day. I don’t go to clinic or any treatment because I am too shy. Plz help me for this.what medicine should I use.it have been all dark under my buttocks and it is too itchy. Plz help me 😭😭😭

Oh Evaa, I’m so sorry!

Dr. Greene says, “… effective topical antifungal creams, such as miconazole (Tinactin) or clotrimazole (Lotrimin). Several of these antifungal creams are now available WITHOUT a prescription.” That means you can get it at a pharmacy. You can ask the pharmacist to help you make sure you are getting the correct cream. The pharmacist will not be at all embarrassed by your questions. Since ringworm can be in the hair or on the body, they may ask where it is. You can just answer “on my body” without saying where.

Additionally, Dr. Greene says, “Treatment may require several weeks. Only by treating for at least one week after the resolution of symptoms (and for a total of at least 4 weeks) can one guarantee eradication. Be sure and follow these instructions.

Dr. Greene also says, “Rarely, when ringworm of the body is resistant to topical therapy, we use oral antifungal medications for about one month.” This is all the more reason to be sure to use the cream long enough to wipe it out, but just knock it back. You would to be sure you get the most out of the cream.

I hope that helps.
Best, @MsGreene
Note: I am the co-founder of DrGreene.com, but I am not Dr. Greene and I am not a doctor. Please keep that in mind when reading my comments and replies.

Am Ahmed from Nigeria Kogi Nigeria. I was diagnosed to have Candace Skil infection (ringworm), I ask take fluconale 200mg for a month which I did after taking the drugs I was ok but after a month I noticed the same problem is back. Please help me what will I do to solve the problem. I also noticed that the some worm move round by skin.

Hi! I can’t remember the comment or what I wrote, but I had a terrible case of ringworm a few years ago when pregnant with my son. I didn’t want to take medications. I cured it completely in a couple of months using Epsom salt as a body scrub, washing with Zymox enzymatic shampoo and applying a layer of zymox enzymatic cream rinse like a body lotion over my entire body. I used the cream rinse as lotion twice a day. I also washed my hair with the shampoo and used the cream rinse as conditioner to prevent it from spreading to my scalp. Zymox is marketed for pets but I decided to try it since it worked really well on my pets. I had no bad reactions to it whatsoever. You can buy it online – I get it on Amazon..It might help you! Alicia

I just saw this email…my doctor won’t give me any more meds..so I’m still fighting it…going laundry with bleach, cleaning..but I’ve been putting  compound W Gel on the spots…it burns, then dries and seems to get rid of the overall itch…I take an array of vitamins and herbs to help with immune function…I took Pau D Arca until it made me sick to my stomach…switched to Coconut oil and put Aloe on spots as well as took caps..Good Luck my friend..don’t stop trying!Steph

Hi! I can’t remember the comment or what I wrote, but I had a terrible case of ringworm a few years ago when pregnant with my son. I didn’t want to take medications. I cured it completely in a couple of months using Epsom salt as a body scrub, washing with Zymox enzymatic shampoo and applying a layer of zymox enzymatic cream rinse like a body lotion over my entire body. I used the cream rinse as lotion twice a day. I also washed my hair with the shampoo and used the cream rinse as conditioner to prevent it from spreading to my scalp. Zymox is marketed for pets but I decided to try it since it worked really well on my pets. I had no bad reactions to it whatsoever. You can buy it online – I get it on Amazon..It might help you! Alicia

Thank you so much this is extremely helpful, ringworm is so frustrating.

Aung,

Vinegar is an acid. You are likely “burning” the skin on your arm. This is a natural reaction, but it signals that you should not continue this line of treatment.

I hope that helps.
Best, @MsGreene
Note: I am the co-founder of DrGreene.com, but I am not Dr. Greene and I am not a doctor. Please keep that in mind when reading my comments and replies.

Hello,
I have ringworm and now trying to cure with a natural way into apple cider vinegar. I was used for the last four days now these infected areas getting red and inflamed. Why? and is it harmful?
With respect

Aung,

Vinegar is an acid. You are likely “burning” the skin on your arm. This is a natural reaction, but it signals that you should not continue this line of treatment.

I hope that helps.
Best, @MsGreene
Note: I am the co-founder of DrGreene.com, but I am not Dr. Greene and I am not a doctor. Please keep that in mind when reading my comments and replies.

Thank you so much for your response. I am getting better now, I didn’t use much vinegar, I believe the fact that I started taking vitamin C (600%) helped cure ringworm with my own immune system
Cheers