The last patient of the day last week was a mother with her 3 adorable little girls…who were actually en route to the local high school football game but swung by my office first. While the mother had been dressing her daughters’ in their “mini-cheerleader” outfits, she noticed a rash on her oldest daughter’s trunk and kind of “freaked out” that she had ringworm.
Ringworm is a common fungal skin infection and the medical term is tinea corporis (fungus of body). You can also get tinea on your feet ( athlete’s foot) in the groin area and on the scalp. Fungal infections are easy to acquire and they are nothing to be “too” alarmed about as they are typically fairly easy to treat. As I remind many a parent….this is not life threatening.
This sweet mother had not noticed the rash until that day and she assured me that she bathed her daughter every night. Having ringworm has nothing to do with cleanliness as it is easily acquired by direct contact with other people and clothes, as well as from contaminated surfaces (locker rooms, pool decks) and for many kids from a family pet. A new kitten or puppy may often be the source of the infection. Trying to track down the “source” is typically not necessary….it is just one of those common childhood issues.
The typical lesion of ringworm is easy to diagnose and rarely requires a trip to the dermatologist. It is described as a circular lesion with a raised red rim and will often have decreased pigmentation in the central area of the skin lesion. It may be itchy and scaly. At times the edge of the lesion may form an “irregular” circular that looks like the wavy outline of a worm - and so the name. If your doctor has a Wood’s lamp they may shine the light on the lesion as it will “glow” in the black light. If the lesion is “atypical” a scraping may be obtained and prepared and can be looked at under the microscope.
Most infections of the skin may be treated with a topical over the counter anti-fungal cream or ointment. It may take several weeks to a month or more to treat the infection and I usually recommend longer rather than shorter topical treatment. In some cases an over the counter cream may not work as the fungus may be resistant and you may need a broader spectrum anti- fungal that will be prescribed by your pediatrician.
During elementary school one of my sons had gotten a new watch that he wore day and night. When he finally took it off I noticed what I thought to be a LARGE ringworm beneath the watch face….oh well. A few weeks of an anti-fungal cream on his wrist and he had that watch back on!!