All about ring­worms

Chronicle (Zimbabwe) - - National News - Health Mat­ters Dr Anitha An­chan

RING­WORM in­fec­tion is caused by a fun­gus. Fungi that cause ring­worm live and spread on the outer layer of the skin. Ring­worm is not caused by a worm or other par­a­site.

Fungi are present ev­ery­where in our en­vi­ron­ment, in­clud­ing on the hu­man body. They thrive in warm, moist ar­eas such as locker rooms and swim­ming pools and in skin folds. You can get ring­worm of the skin by shar­ing con­tam­i­nated tow­els, cloth­ing and sports equip­ment as well as di­rect con­tact with an in­fected per­son.

Ring­worm of the skin (tinea cor­poris) is most com­monly caused by the fun­gus Tri­chophy­ton rubrum, which spreads from one per­son to an­other. It can also be caused by Mi­crospo­rum ca­nis, which is spread by cats and dogs. This type is less com­mon but causes a more se­vere in­fec­tion.

Peo­ple of­ten get ring­worm of the groin by ac­ci­den­tally spread­ing ath­lete’s foot fun­gus to their own groin area. Peo­ple who have ath­lete’s foot also com­monly spread it to their hands (tinea manuum).

Some peo­ple are more likely to get fun­gal in­fec­tions than oth­ers. The ten­dency to get fun­gal skin in­fec­tions or to have them re­turn af­ter treat­ment seems to run in fam­i­lies.

Most ring­worm in­fec­tions cause a rash that may be peel­ing, crack­ing, scal­ing, itch­ing, and red. Some­times the rash forms blis­ters, es­pe­cially on the feet.

Symp­toms of ring­worm of the body in­clude a rash on the ch­est, stom­ach, arms, legs, face or back with edges that are red and scaly or moist and crusted. The rash also may have small bumps that look like blis­ters. The cen­tre of the rash may be clear, giv­ing it a ring­shaped ap­pear­ance, or there may be a clus­ter of red bumps.

The rash may ap­pear on the groin, skin folds, in­ner thighs or but­tocks. It usu­ally does not oc­cur on the scro­tum or pe­nis. On the palm, ring­worm may be mis­taken for eczema. The palm is thick­ened, dry, and scaly, sim­i­lar to ath­lete’s foot while skin be­tween the fin­gers may be moist and have open sores. Finger­nails can also be in­fected. Ring­worm of the skin may be con­fused with other con­di­tions with sim­i­lar symp­toms such as eczema or pso­ri­a­sis.

It can start as a small patch of itchy, red or scal­ing skin. The rash can spread and cover a large area.

Cloth­ing that rubs the skin can ir­ri­tate the rash. Sweat, heat or mois­ture in the air (hu­mid­ity) can make the itch­ing and in­fec­tion worse.

As the in­fec­tion be­comes worse, the ring-shaped pat­tern and red-brown colour may be­come more vis­i­ble. If not treated, the skin can be­come ir­ri­tated and painful. Skin blis­ters and cracks can be­come in­fected with bac­te­ria and re­quire an­tibi­otics.

Af­ter treat­ment, the rash will go away. But ring­worm can re­turn un­less you fol­low steps to pre­vent it.

Your risk of get­ting ring­worm is higher if you come into con­tact with a per­son who has a fun­gal in­fec­tion or with a car­rier, a per­son who has the fungi but does not have symp­toms.

You are also at risk if you are sus­cep­ti­ble to fun­gal in­fec­tions or have had a pre­vi­ous fun­gal in­fec­tion, you have an im­paired im­mune sys­tem due to a dis­ease such as di­a­betes or can­cer, you live in a warm, damp cli­mate or you wear tight-fit­ting clothes or you let your skin stay damp for long pe­ri­ods, such as by stay­ing in a wet bathing suit or sweaty work­out clothes.

If you sus­pect you have ring­worm of the skin, call your doc­tor if you have patches of skin that are itchy, red, or scaly with bumps that look like blis­ters, and they have not im­proved af­ter two weeks of treat­ment with a non-pre­scrip­tion an­ti­fun­gal prod­uct.

Signs of bac­te­rial in­fec­tion de­velop in­clud­ing in­creased pain, swelling, redness, ten­der­ness, or heat, red streaks ex­tend­ing from the area and dis­charge of pus.

Watch­ful wait­ing is a wait-and-see ap­proach. If you get bet­ter on your own, you won’t need treat­ment. If you get worse, you and your doc­tor will de­cide what to do next.

Any per­sis­tent, se­vere, or re­cur­ring in­fec­tion should be checked by your doc­tor.

Most cases of ring­worm of the skin, in­clud­ing jock itch and ring­worm of the hand, can be treated with creams or oint­ments that you ap­ply on your skin to kill fungi. These are called top­i­cal an­ti­fun­gals. You can get many top­i­cal anti-fun­gals with­out a pre­scrip­tion.

You may need to take an­ti­fun­gal pills (oral treat­ment) if the ring­worm does not go away af­ter you have tried dif­fer­ent top­i­cal an­ti­fun­gals or if the in­fec­tion is wide­spread. Oral treat­ments in­clude azoles such as flu­cona­zole (Di­flu­can), al­ly­lamines such as terbinafine (Lamisil), and grise­o­ful­vin (Gri­ful­vin V).

Your rash may start to clear up soon af­ter you be­gin treat­ment, but it is im­por­tant to use the medicine ex­actly as the la­bel or your doc­tor says. This will help keep the in­fec­tion from com­ing back. You will prob­a­bly need to con­tinue treat­ment for two to four weeks.

You should treat a fun­gal in­fec­tion right away. Se­vere and wide­spread in­fec­tions can be hard to treat.

Keep your skin clean and dry. Change your socks and un­der­wear at least once a day.

Wear loose-fit­ting cot­ton cloth­ing. Avoid tight un­der­wear, pants, and panty hose.

Al­ways dry your­self com­pletely af­ter show­ers or baths. Af­ter dry­ing your skin with a towel, al­low your skin to air-dry be­fore putting your clothes on. You can also use a hair dryer, set on a cool set­ting, to dry your skin.

Do not share cloth­ing, sports equip­ment, tow­els, or sheets. If you think you have been ex­posed to ring­worm, wash your clothes in hot wa­ter with fun­guskilling (fungi­ci­dal) soap.

Wear slip­pers or san­dals in locker rooms, show­ers, and pub­lic bathing ar­eas.

Shower and sham­poo thor­oughly af­ter any sport that re­quires skin-to-skin con­tact.

If you have ath­lete’s foot, put your socks on be­fore your un­der­wear so that fungi do not spread from your feet to your groin. Also, when tow­elling off af­ter a shower or bath, dry your feet last.

Take your pet to a ve­teri­nar­ian if it has patches of miss­ing hair, which may be a sign of a fun­gal in­fec­tion. House­hold pets can spread fungi that cause ring­worm in peo­ple. —

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