Before Alice addresses ringworm treatment options, let her first briefly describe ringworm.

Ringworm is a skin disease that is not caused by worms, but by fungus. You can have ringworm of the scalp (tinea capitis) and of the body's hairless skin (tinea corporis). Fungus can also infect toenails and feet (also known as athlete's foot -- read Athlete's Foot and More on athlete's foot in Alice's General Health archives for more information).

Ringworm is contagious. Basically, ringworm is transmitted via fungal agents by direct skin-to-skin contact with infected individuals and pets (your cat, for instance), and by indirect contact with personal items used by infected individuals, such as hai r, combs, brushes, hats, bedsheets, hairpins, floors, and bathtubs.

Considering the contagious and infectious nature of ringworm, anyone is susceptible. It does not discriminate, although children and adults seem to be more prone to infection by differing kinds of ringworm. In addition, athletes participating in contact sports, such as wrestling and football, are at higher risk. Appropriate precautions must be taken to avoid infection, spread, and reinfection, such as showering after each sports play, regularly washing contacted surfaces, laundering clothes after every sports activity, avoiding clothes- and towel-sharing, and being aware of who is infected on the team.

Symptoms of fungal infections differ by variety. The first symptoms of scalp ringworm are usually redness, and small, pimple-like bumps and/or skin flakes that enlarge and become scaly. These ringworm patches appear hairless, or have broken hair shafts, because infected hairs are easily broken off. These affected areas of the scalp are bald only temporarily if treated before infection becomes severe. For body ringworm, look for a growing, ring-shaped patch, with a flat and clear healing center and a r aised red border that can appear either dry and scaly, or moist and crusty. More than one patch can develop, and there could also be some overlap. For a fungal infection of the nails, look for changes in nail color, thickness, and strength. Infected na ils discolor, thicken, and break easily. For a fungal infection of the feet, look for dry, scaly, and/or cracked skin, particularly between the toes. All varieties of fungal infections could involve itching, which can be extreme in some cases.

Early recognition and treatment of a fungal infection is ideal. It is also important for you to know that in order for treatment to be successful in combating a fungal infection, you must complete the full treatment regimen, regardless of early signs of improvement. If you are uncertain that what you have is a fungal infection, then see a dermatologist or primary care provider for a proper diagnosis. For example, what may look like ringworm could actually be something else, such as pityriasis rosea, eczema, or dandruff, which would require different treatments.

If you do have a fungal infection, appropriate antifungal treatment depends on the particular kind of fungal infection you have. There are some new medications, oral and now locally applied, which seem to be effective, well-tolerated, and considered safe . These include Sporanox, which is taken orally, and Lamisil, which is effective locally (especially good for nail fungus). For body ringworm, and fungal infections of the nails, feet, and toes, topical antifungal medications, in the forms of creams and powders, are recommended. Ask your doctor if you need a prescription or over-the-counter (OTC) treatment for your particular condition. If you can use an OTC treatment, look for one that contains miconazoles or clotrimazoles that does not have c ortisone. Adhere to the directions for use that are indicated on the package. In addition, for scalp ringworm in particular, you may be prescribed a lotion shampoo containing selenium sulfide, which helps destroy fungal spores and may speed up the treat ment process. Follow your doctor's directions for use. Selenium sulfide lotion may also be used as a preventive measure by exposed individuals.

In the meantime, to reduce the spread of ringworm to others, and potentially to other parts of your body, wear something over the infected areas. Also make sure that the source of the infection, such as your cat, gets treated as well (your cat would need to see a veterinarian); and, that others who may have been exposed to ringworm, such as family members, get examined by a doctor.

Alice

Related Q&As

Pityriasis Rosea

Sleeping with the animals