Ringworm

Pediatric HouseCalls Online

DEFINITION

• Fungal skin infection causing 1 or more ring-shaped spots

Symptoms

• Round pink patch
• Clearing of the center as the patch grows
• Raised, rough, scaly border
• Usually ½ to 1 inch (12 - 25 mm) in size
• Ring slowly increases in size
• Mildly itchy 

Cause

• A fungus infection of the skin often transmitted from puppies or kittens who have it.
• Less commonly transmitted human-to-human because it required direct contact. An exception is that an epidemic from ringworm can occur among wrestlers because of close body contact during matches.
• Occasionally transmitted from fungus in the soil.

Return to School

• Your child doesn't have to miss any day care or school for ringworm.

See More Appropriate Topic (instead of this one) If

• Doesn't look like ringworm, see RASH - LOCALIZED AND CAUSE UNKNOWN

WHEN TO CALL YOUR DOCTOR

Call Your Doctor Within 24 Hours (between 9am and 4pm) If

• Pus is draining from the rash.

Call Your Doctor During Weekday Office Hours If

• You think your child needs to be seen.
• Scalp is involved.
• More than 3 spots are present.
• Teen is a wrestler.
• Rash continues to spread after 1 week on treatment.
• Rash lasts longer than 4 weeks. 
• You have other questions or concerns.

Parent Care at Home If

• Mild ringworm and you don't think your child needs to be seen.

HOME CARE ADVICE FOR RINGWORM

1. Antifungal Cream:
   • Use Lamisil, Micatin or Lotrimin cream (no prescription needed) 2 times per day.
   • Apply it to the rash and 1 inch beyond its borders.
   • Continue the cream for at least 7 days after the rash is cleared.
2. Contagiousness:
   • Your child doesn't have to miss any day care or school for ringworm.
   • Ringworm of the skin is mildly contagious. It requires direct skin-to-skin contact.
   • The type acquired from pets is not transmitted from human to human, only from animal to human.
   • After 48 hours of treatment, ringworm is not contagious at all.
   • Wrestlers, however, should avoid all wrestling until evaluated by your child's doctor.
3. Expected Course: It clears completely in 3 to 4 weeks. For any recurrences, suspect the household puppy or kitten and take it to the vet for diagnosis and treatment.
4. Call Your Doctor If:
   • Rash continues to spread after 1 week on treatment
   • Rash is not cleared by 4 weeks
   • Your child becomes worse

And remember, contact your doctor if your child develops any of the "Call Your Doctor" symptoms.