Ringworm

Not all fungi cause skin disease. Developing on the top layer of the skin, ringworm is caused by a type of skin fungi called dermathophytes.^4a,5a Skin fungi feed on surface keratin found in skin, nails and hair. ^5b Breeding in warm, moist environments ringworm is more likely to occur in tropical climates, gyms, locker rooms, public showers and swimming pools.^6a

Signs and symptoms vary from person to person. Typically, ringworm begins as a scaly, sometimes slightly raised, red patch of skin, which can become itchy and, in some cases, may burn. The patch develops a border that expands outward forming a roughly circular ring. It may form blisters or begin to ooze.^1b
Scalp ringworm may begin as a small pimple-like sore that becomes patchy, scaly or has dandruff-like flakes. It can cause hair to fall out or break into a stubble, resulting in a tender, sometimes red, bald patch.^7a

Ringworm is a common skin condition that occurs in people of all ages but most common in children and adolescents and some people are more at risk than others.^{5c, 8a}
You are at higher risk if you:

• Have health issues such as diabetes, obesity or a weakened immune system from a serious illness or long-term use of medication
• Live in a warm climate
• Live in close contact with other people (military barracks, boarding school)
  Sweat heavily
• Take part in contact sports such as rugby, American football or wrestling ^{4b, 6b, 7b, 8b}

• Direct human to human skin-to-skin contact with an infected person or if an infected person touches the infected area and then touches another part of their body
• Direct animal to human skin-to-skin contact by touching an infected animal
• Object / surface to human contact by touching a surface or object that an infected person or animal has touched or rubbed against recently (bedding, clothing, towels, razors, hair brushes)
• Soil to human contact from touching infected soil (although this is rare and may occur if you have prolonged contact with infected soil)^{4d, 7c, 8d}

While usually not serious, without treatment, the fungal infection can develop a more serious bacterial infection or spread to other parts of your body.⁹
Your doctor may diagnose ringworm simply by looking at it, making a diagnose based on location and appearance, particularly if it presents with the telltale circular markings typical of the condition. ^{5d, 10} However, other skin conditions such as psoriasis and certain types of eczema may look like ringworm so, your doctor may perform other tests such as taking a skin scraping for microscopic examination.
In most cases, over-the-counter antifungal creams will usually clear up the infection although scalp ringworm may require an antifungal shampoo.^8e If your condition does not clear up within 2 weeks or worsens, see a doctor or dermatologist for a thorough diagnosis and prescription-strength anti-fungal medication. ^{4e, 11}

There are steps you can take to reduce your risk or and if you have it already, to stop it from spreading. This includes:

• Washing your hands regularly with soap and water, especially after playing with pets
• Keep common or shared areas clean (gyms, locker rooms, public showers and swimming pools)
• Drying your skin thoroughly with a clean towel after swimming or showering
• Showering as soon as possible after exercising or playing sport
• Keeping cool and dry and reducing your chances of sweating heavily – for example, avoid thick clothing in warm weather
• Change your clothes, particularly underwear and socks every day
• Do not touch infected animals and regularly check for patches of skin with missing fur or patches with brittle or broken hairs – if you suspect your pet may have ringworm, take them to the vet
  ⦁ Do not share personal items (clothing, sports gear, towels, bed linen, razors, hair brushes)
  ⦁ Wash your clothes, linen and towels in hot water at 140F (60C) ^{1c, 4f, 8f}