What is ringworm and how is it treated?

From the Guidelines

Ringworm is a common fungal infection of the skin caused by dermatophyte fungi, and its treatment typically involves oral antifungal medications, such as griseofulvin or terbinafine, for 6-8 weeks or 2-4 weeks, respectively, depending on the causative dermatophyte and patient's weight. The infection creates circular, red, itchy patches with raised, scaly borders that resemble a worm in a ring shape. According to the British Association of Dermatologists' guidelines for the management of tinea capitis 2014 1, topical therapy alone is not recommended for the treatment of tinea capitis, and oral therapy is generally indicated to achieve both clinical and mycological cure.

Key Points to Consider

• The choice of systemic therapy should be directed by the causative dermatophyte and/or local epidemiology, with griseofulvin being more effective against Microsporum species and terbinafine being more efficacious against Trichophyton species 1.
• The dosage of griseofulvin and terbinafine varies by body weight, with griseofulvin dosed at 15-20 mg/kg/day for 6-8 weeks for patients under 50 kg, and terbinafine dosed at 625 mg/day for 2-4 weeks for patients under 20 kg 1.
• Treatment failure should be initially considered due to lack of compliance, suboptimal absorption of the drug, relative insensitivity of the organism, and reinfection, and second-line therapy with itraconazole may be necessary 1.
• Children receiving appropriate therapy should be allowed to attend school or nursery, and index cases due to T. tonsurans warrant screening of all family members and close contacts and treatment for those positive cases 1.

Additional Measures

• Keep the affected area clean and dry, avoid sharing personal items, and wash bedding and clothing in hot water to prevent reinfection or spreading to others.
• Complete treatment is essential even after symptoms improve to fully eliminate the fungus and prevent recurrence.
• The end point of treatment is mycological rather than clinical cure, and repeat mycology sampling is recommended until mycological clearance is achieved 1.

From the FDA Drug Label

Accurate diagnosis of the infecting organism is essential. Representative treatment periods are tinea capitis, 4 to 6 weeks; tinea corporis, 2 to 4 weeks; tinea pedis, 4 to 8 weeks; General measures in regard to hygiene should be observed to control sources of infection or reinfection.

Ringworm is a fungal infection, also known as tinea, that can affect different parts of the body, such as the skin (tinea corporis), scalp (tinea capitis), and feet (tinea pedis).

• The treatment of ringworm typically involves the use of antifungal medications, such as griseofulvin (2) or ketoconazole (3).
• The duration of treatment varies depending on the location and severity of the infection, but it is usually continued until the infecting organism is completely eradicated.
• Good hygiene practices are also essential to control the sources of infection and prevent reinfection.

From the Research

What is Ringworm

• Ringworm, also known as dermatophytosis, is a common fungal infection of the skin, hair, and nails 4.
• It is caused by a group of closely related fungi that have the capacity to invade keratinized tissue 4.
• The infection is not dangerous but can be difficult to treat and may cause physical discomfort for patients 5.

Symptoms of Ringworm

• The symptoms of ringworm vary depending on the region of the body affected 4.
• Common symptoms include a ring-shaped lesion on the skin, itching, and redness 6.
• In some cases, ringworm can cause more severe symptoms such as blisters, pustules, and eczematous eruptions 6.

Treatment of Ringworm

• The treatment of ringworm typically involves the use of antifungal medications [(5,7,8)].
• Topical antifungal creams such as terbinafine and clotrimazole can be effective in treating mild cases of ringworm 7.
• Oral antifungal medications such as griseofulvin, itraconazole, and fluconazole may be necessary for more severe cases or for infections that do not respond to topical treatment 8.
• The choice of treatment will depend on the severity of the infection, the location of the infection, and the patient's overall health [(5,8)].