Ringworm is not caused by a worm but, rather, is a fungal (yeast) infection.  It may occur anywhere on the body surface or on the scalp.  

Ringworm of the skin is known as Tinea corpus.  It occurs from the neck down and on the face.  Classic ringworm begins as a flat scaly spot that then develops a raised border.  The border extends out at variable rates in all directions.  The advancing edge may have a red, raised border while the central area clears. 

This type of ringworm usually responds to anti-fungal creams. The spots become non-contagious after several days of treatment.  It takes 2 – 3 weeks to clear the rash, but occasionally the rash may persist for up to 6 weeks.  Medication should be continued for one week after rash is gone to insure the very tiny organisms you cannot see are all killed.

Lotrimin is available over-the-counter.  Lotrimin comes under several names: Lotrimin, Lotrimin AF, or Clortrimazole.  

Please see your pediatrician if over-the –counter Medications do not resolve the rash.  Oxistat , Nystatin, and Spectazole are examples of prescription medications which may be prescribed by your provider.

Ringworm of the scalp is known as Tinea capitis.  It is a fungal infection of the hair and scalp.  It attacks the hair at its root.

The main symptom is loss of hair with patchy baldness.  There may appear to be black dots representing broken hair shafts within the area of baldness.  It may be complicated by an inflammatory reaction that exudes pus called a kerion.  This represents an allergic reaction to the fungus.  The kerion will heal, but some scarring and hair loss can occasionally occur. 

The diagnosis of tinea of the scalp is confirmed with a fungal culture of the scalp sent to the laboratory.  However, because the fungus is slow growing, it takes two to three weeks for the cultures to turn positive.  Tinea capitis must be distinguished from a bacterial infection of the scalp, as the treatment is very different.

Because tinea capitis is a deeper infection, topical anti-fungal agents or shampoos are not effective alone for treating tinea capitis.  The treatment for tinea of the scalp is prescription medication, either Griseofulvin or Ketoconazole. 

Griseofulvin is used most often.  It requires a daily dose for a period of 6 or 8 weeks.   Give the Griseofulvin with fatty foods as milk or ice cream.   

If kerions are present, then oral steroids such as

Prednisone may also be necessary to hasten healing and reduce scarring.  In addition, the use of Selsun Blue shampoo is recommended twice weekly to prevent the spread of the spores to others.  Alternatively, your healthcare provider may prescribe Nizoral,  a prescription shampoo.

Tinea capitis is contagious.  Combs, brushes, and some hair products such as gels and mousse spread it.   The tinea spores remain alive on furniture too.  Meticulous cleaning of all possibly contaminated objects may help prevent re-infection.  Pay special attention to cleaning combs and brushes.  

In addition, all family members should be examined carefully for evidence of ringworm.  Cutting the hair, shaving the head or wearing a cap is not necessary when the patient is treated as outlined above.  The patient may return to school several days after treatment has begun.

Call your pediatrician during regular office hours if:

The ringworm becomes infected with pus or yellow crust or the ringworm continues to spread after two weeks of treatment.