Ringworm consultation

Ringworm (tinea corporis) is a fungal infection that has no connection to worms. Its main symptom is a rash that looks like rings.

A ringworm rash can be:

• itchy, scaly and dry
• swollen
• red, silver or darker than your usual skin colour
• found all over the body but often on arms and legs

It is common to get ringworm. A 2020 medical review estimates that ringworm affects between 1 in 10 and 1 in 5 people in their lifetime.

Fungal infections like ringworm can also be referred to by different names when they occur in other areas. These include:

• tinea capitis (scalp)
• tinea pedis (feet, also known as athlete’s foot)
• tinea cruris (groin or inner thighs, also known as jock itch)

What causes ringworm?

Ringworm is caused by fungi called dermatophytes. Once the fungi spores are on your body, they can live off your skin which causes the rash. The fungi spores can survive in soil, skin, and household objects such as towels and bed linen.

You can get the spores on your body from:

• person-to-person contact
• animal-to-person contact
• objects such as towels, bed linen and combs
• prolonged contact with infected soil

Ringworm treatment is an antifungal medication that kills the fungi spores causing the rash on your skin.

Treatment depends on where the rash is on the body and how serious it is.

• Ringworm on the body: antifungal creams, ointments, gels or powders available over-the-counter
• Ringworm on the scalp: prescription antifungal medication taken orally

How effective is ringworm treatment?

A medical review in 2014 found that topical antifungal treatments were extremely effective for treating ringworm, with some treatments up to 93.5% effective in clearing up the infection within 2 to 4 weeks.

How long does it take for ringworm treatment to work?

Ringworm treatment can take between 2 and 4 weeks to work. The rash may clear up quickly, but you should follow instructions and finish the course of treatment to make sure the treatment has worked properly.

Ringworm on the scalp can take longer to treat, with treatment usually taken orally for between 1 and 3 months.

Can ringworm come back after treatment?

Yes, ringworm can return after you have finished treatment.

There are creams, gels, ointments and powders available to treat ringworm. These are applied to the rash (called topical treatments), but there is also medication that you take orally. Some treatments are available over the counter from a pharmacist, whereas others require a prescription from a doctor. This will depend on where you have ringworm and its severity.

Over-the-counter treatments

At Superdrug Online Doctor, we recommend an antifungal cream called clotrimazole 2% to treat ringworm. It is sold as a generic medication orunder the brand Canesten.

Other topical anti-fungal creams that you can buy over the counter include:

• terbinafine (brand name Lamisil 1%)
• miconazole nitrate (brand name Daktarin 2%)
• ketoconazole (brand name Nizoral 2%)
• econazole nitrate (brand name Pevaryl 1%)

These creams are similar in how you apply them, how effective they are and what the side effects are. As they have different active ingredients, a pharmacist may recommend a specific cream depending on your circumstances.

Studies have shown clotrimazole is effective at clearing up ringworm within 4 weeks in 73.1% of cases, and terbinafine is effective in 93.5% of cases.

Fluconazole (brand name Diflucan) is an oral antifungal medication available over the counter that is usually used to treat thrush but can also be used to treat ringworm, though these require different doses.

Prescription treatments

Treatments for ringworm on the body that need either a prescription from a doctor or to be administered in the hospital include:

• nystatin (brand name Nystan)
• amphotericin

Doctors will prescribe an oral antifungal medication if you have ringworm on the scalp or nails. These include:

• griseofulvin
• terbinafine
• fluconazole
• itraconazole

Some of these medications have the same active ingredient as topical antifungal medications, but they are taken orally.

What’s the best treatment for ringworm?

There is no single best treatment for ringworm. Which medication is best for you depends on how your body reacts to the different ingredients, how severe the case of ringworm is and your lifestyle.

You can help ensure the treatment you are using is effective by:

• finishing the course of treatment as instructed
• treat all outbreaks of ringworm on your body at the same time
• washing your hands after touching the infected area
• changing your clothes daily
• not sharing towels, bed linen and other personal items with anyone
• disinfecting or throwing away any infected things

Like all medications, it is possible to get side effects from ringworm treatment. Whether or not you get side effects and how they impact you varies from person to person.

If you are using a topical antifungal medication to treat ringworm on the body, you may experience the following after applying the cream, ointment, gel or powder:

• itching
• blisters
• burning sensation
• swelling
• redness
• discomfort
• peeling of skin

In rare cases, you may experience an allergic reaction. Seek medical attention urgently if you have the following symptoms after applying the treatment:

• swallowing or breathing problems
• swelling of tongue, throat, lips and race
• rash (not the ringworm rash)
• dizziness or feeling faint
• nausea

There are many treatments for ringworm, so it is essential to check the patient information leaflet that comes with each one to be sure it is safe for you to use it. A pharmacist or doctor can recommend the most effective treatment based on your circumstances.

Antifungal creams used to treat ringworm are suitable for most people over 18. If you are pregnant or breastfeeding, talk to your doctor to be sure it is safe for you to use the cream.

The stronger prescription medications used to treat ringworm on the scalp or more severe cases of ringworm on the body are unsuitable if you are pregnant, breastfeeding, trying for a baby, or having specific conditions.

If you are allergic to any of the ingredients in the ringworm treatment, you cannot use it.

To know if you need ringworm treatment, you need to be sure you have ringworm and not a different type of skin condition. As ringworm can look like other rashes (such as psoriasis, eczema and pityriasis rosea), you cannot diagnose it yourself.

The most obvious way to tell if you have ringworm is by a doctor or pharmacist looking at the rash:

• A ringworm rash looks like a ring with paler skin in the middle that grows outwards.
• It can be red, silver or darker than your usual skin colour.
• The rash can be itchy, dry and swollen.

If the doctor or pharmacist is unsure if you have ringworm, they may take a sample from the rash for testing by gently scraping the skin. The test can confirm if there are fungi on your skin or if something else is causing the rash.

If you know you have been in a situation with a risk of getting ringworm, getting any rashes checked out is a good idea.

Superdrug Online Doctor can diagnose ringworm using our Skin Diagnosis service.

1. Take a photo of the affected area.
2. Upload it to your patient account.
3. Our doctors will review your photos and make a diagnosis and treatment recommendations in 24 hours.

Home remedies

Many people use home remedies to treat ringworm, such as:

• essential oil such as oregano, lemongrass, tea tree
• turmeric
• coconut oil
• apple cider vinegar

It’s important to note that these remedies are not scientifically proven to work.

How can I stop ringworm spreading?

If you think you have ringworm:

• do not scratch the rash
• get treatment as soon as possible

The following can help you avoid getting a ringworm infection in the first place:

• keeping alert to situations where you might get an infection, such as through pets and soil
• checking your pets for signs of ringworm
• making sure your skin is clean and dry
• regularly washing bedsheets and towels
• carefully washing your hands after handling soil