Ringworm in Children

What is ringworm in children?

Ringworm is a type of skin infection cause by a fungus. It looks like a red skin rash that forms a ring around normal-looking skin. Ringworm can be of several types.

What causes ringworm in a child?

A ringworm infection is not caused by an actual worm. It is caused by fungi on the skin, hair, and nailbeds called dermatophytes. Different types of dermatophytes affect different parts of the body. They cause different types of symptoms.

Which children are at risk for ringworm?

Children may be at risk for ringworm if they:

• Are malnourished
• Have poor hygiene
• Live in a warm climate
• Have contact with other children or pets that have ringworm
• Have weak immune systems because of illness or medicines
• Play contact sports, such as wrestling 
• Use shared bathrooms or locker rooms 

What are the symptoms of ringworm in a child?

The symptoms of ringworm vary depending on which part of the body is affected. The most common types of ringworm are listed below.

Athlete’s foot

This problem mostly affects teenage boys and men. It usually doesn’t affect children before puberty. Things such as sweating, not drying the feet well after swimming or bathing, wearing tight socks and shoes, and warm weather can play a part in this problem. Symptoms may include:

• Whitening of the skin between the toes
• Scaling of the feet
• Itchy rash on the feet
• Blisters on the feet

Jock itch

This problem is also more common in males. It happens more often during warm weather. It is very rare in females. Symptoms of jock itch may include:

• Red, ring-like patches in the groin area
• Itching in the groin area
• Pain in the groin area

It does not usually involve the scrotum.

Scalp ringworm

Scalp ringworm is highly contagious, especially among children. It happens mainly in children between ages 2 and 10. It rarely happens in adults. Symptoms may include:

• Red, scaly rash on the scalp
• Itchy scalp
• Hair loss on the scalp
• Rash elsewhere on the body

Bad cases of ringworm of the scalp can also develop into a kerion. A kerion is a thick, pus-filled area on the scalp. It can also cause a fever. This can be caused by an overly active response of the immune system or an allergic reaction to the fungus. It may cause a rash elsewhere on the body and tender lymph nodes in the neck.

Nail infection

This type of ringworm causes the nails to become thickened and deformed. This problem affects the toenails more often than the fingernails. It happens more often in adolescents and adults rather than young children. Symptoms may include thickening of the ends of the nails and yellowing of the nails.

Body ringworm

This skin infection is a ring-like rash that appears anywhere on the body or face. It happens in all ages, but is more common in children. It is also more common in warmer climates. The symptoms may include:

• Red, ring-like rash with raised edges
• The middle of the rash may become less red as the lesion grows
• Itching of the affected area

Ringworm may look like many skin problems. Make sure your child sees his or her healthcare provider for a diagnosis.

How is ringworm diagnosed in a child?

Ringworm is usually diagnosed based on a health history and physical exam of your child. The ringworm rash is unique. This makes it easy to diagnose with a physical exam. In addition, your child's healthcare provider may order a culture or skin scraping of the rash to confirm the diagnosis.

How is ringworm treated in a child?

Fungi can live indefinitely on the skin, so ringworm is likely to come back. Treatment may need to be repeated. Treatment will depend on your child’s symptoms, age, and general health. It will also depend on how severe the condition is. Treatment for scalp ringworm may include:

• Antifungal medicine taken by mouth for 4 to 8 weeks. Some children may need longer treatment.
• Special shampoo to help get rid of the fungus. Shampoos can't replace the oral medicine, but you can use shampoo in addition to them.

If your child has a kerion or a secondary sore (abscess) or bacterial infection, the healthcare provider may order additional medicines to help reduce the swelling. These may include steroids.

Treatment for ringworm of the body, groin, and foot is usually an antifungal cream or pill to take by mouth. The length of the treatment depends on the location of the ringworm.

Ringworm of the nails can be difficult to cure. It is usually treated with antifungal medicine taken by mouth.

What are the possible complications of ringworm in a child?

Ringworm rarely has serious complications. 

What can I do to prevent ringworm in my child?

Ringworm can be prevented by:

• Having good hygiene
• Avoiding wearing other people's hats or clothing
• Keeping feet dry
• Avoiding close contact with someone who has ringworm

When should I call my child's healthcare provider?

Most types of ringworm can be treated with over-the-counter medicines. But ringworm of the scalp and nails require taking an antifungal medicine by mouth. This medicine must be prescribed by your healthcare provider. If you are unsure if your child has ringworm or if your child has a weakened immune system, call your child's healthcare provider.

Key points about ringworm in children

• Ringworm is a type of skin infection. It looks like a red skin rash that forms a ring around normal-looking skin.
• Ringworm infection is not caused by an actual worm but by fungi on the skin, hair, and nailbeds.
• The symptoms of ringworm vary, depending on which part of the body is affected. Most cause itching.
• Ringworm is usually diagnosed based on a health history and physical exam of your child.
• Most ringworm infections are treated with medicines that you apply to the skin. But ringworm of the scalp and nails require a prescribed antifungal medicine that your child takes by mouth.

Next steps

Tips to help you get the most from a visit to your child’s healthcare provider:

• Know the reason for the visit and what you want to happen.
• Before your visit, write down questions you want answered.
• At the visit, write down the name of a new diagnosis, and any new medicines, treatments, or tests. Also write down any new instructions your provider gives you for your child.
• Know why a new medicine or treatment is prescribed and how it will help your child. Also know what the side effects are.
• Ask if your child’s condition can be treated in other ways.
• Know why a test or procedure is recommended and what the results could mean.
• Know what to expect if your child does not take the medicine or have the test or procedure.
• If your child has a follow-up appointment, write down the date, time, and purpose for that visit.
• Know how you can contact your child’s provider after office hours. This is important if your child becomes ill and you have questions or need advice.