Detailed information on the most common types of ringworm, including diagnosis and treatment
The Medical Dermatology Program at Massachusetts General Hospital is a full-service dermatology practice that provides care for all skin, hair and nail conditions.
What is tinea infection?
Tinea is a fungal infection of the skin. Tinea on the body or scalp is sometimes known as ringworm. This is because it can cause red patches on the skin in the shape of rings. But it’s not caused by worms. It’s caused by different types of fungi. Tinea infection can affect any part of the body. Tinea infections of the feet, nails, and genital area. But it most often occurs in moist areas of the body and around hair. The fungus can be spread from person to person.
Different types of fungal (tinea) infections are named for where they occur on the body. The most common types are:
Athlete's foot (tinea pedis). This common type occurs on the feet and between the toes. It may be caused by sweating, not drying the feet after swimming or bathing, wearing tight socks and shoes, and warm weather.
Jock itch (tinea cruris). This rash occurs in the groin. Jock itch may be hard to cure. This condition is more common in men and rare in women. It happens more often in warm weather.
Scalp ringworm (tinea capitis). Scalp ringworm occurs on the head. It's very contagious but rare in adults.
Nail infection (tinea unguium or onychomycosis). This is an infection of the toenails, and sometimes fingernails. It causes thickened, deformed, and discolored nails instead of a rash.
Body ringworm (tinea corporis). This occurs anywhere on the body. But it's more common in skin folds. It is also more common in warmer climates.
What causes tinea infection?
The fungus that causes tinea is very common all over the world, including the U.S. It’s very contagious. The fungus is spread through direct contact with:
An infected person
Infected objects such as towels, clothing, and combs
An infected animal
It can take days or up to 2 weeks before you develop the infection after being in contact with the fungus. The fungi that cause ringworm can live for a long time on objects. Because of this, you may not know the exact source.
Who is at risk for tinea infection?
You are more at risk for tinea infection if you:
Live in a warm climate
Have contact with people or pets that have tinea
Play contact sports, such as wrestling
Use communal baths or locker rooms
Share towels, clothing, combs, or brushes
Have poor hygiene
Have a depressed immune system because of disease or medicine
Don’t have good nutrition
What are the symptoms of tinea infection?
Symptoms can occur a bit differently in each person.
Symptoms of athlete's foot (tinea pedis) may include:
Itchy, burning rash on the feet
Whitening and breakdown of the skin between the toes
Scaling of the feet
Blisters on the feet
Symptoms of jock itch (tinea cruris) may include:
Red, ring-like patches in the groin area and inner thighs, but not scrotum
Itching in the groin area
Pain in the groin area
Symptoms of scalp ringworm (tinea capitis) may include:
Red, scaly rash on the scalp
Itching of the scalp
Hair loss on the scalp
Enlarged lymph nodes
Symptoms of nail infection (tinea unguium, onychomycosis) may include:
Thickening of the ends of the nails
Yellow color to the nails
Symptoms of body ringworm (tinea corporis) may include:
Red, ring-shaped patches with raised, scaly edges
The symptoms of tinea infection can be like other health conditions. Psoriasis, pityriasis rosea, and atopic dermatitis all look similar. Make sure to see your healthcare provider for a diagnosis.
How is tinea infection diagnosed?
Your healthcare provider will ask about your symptoms and health history. They will give you a physical exam. The physical exam will include looking closely at your skin or nails. You may also have tests, such as:
Skin scraping. The healthcare provider may scrape the top of your skin with a small tool. This does not hurt. The scraped tissue is looked at with a microscope. This test can confirm the diagnosis.
Biopsy. If the infection is on the scalp or in the nails, the provider will take samples of hair or nail clippings to look at with a microscope to identify the fungus.
Skin culture. A sample of skin may be sent to a lab to see what kind of fungus is growing. This is called a culture.
How is tinea infection treated?
Tinea may be hard to cure. Scalp ringworm and nail infection are hardest to treat. The length of the treatment depends on the location of the tinea. Fungi can live for a long time on the skin. Because of this, tinea infection is hard to cure and can come back easily. Treatment may need to be repeated.
Treatment of athlete's foot (tinea pedis) may include:
Antifungal medicine by mouth
Treatment of jock itch (tinea cruris) may include:
Antifungal medicine by mouth
Treatment of scalp ringworm (tinea capitis) may include:
Antifungal medicine by mouth for weeks or months
A special shampoo to help kill the fungus. Shampoos are used along with oral medicine. They won’t get rid of the fungus by themselves.
Treatment of nail infection (tinea unguium) may include:
Antifungal medicine by mouth for weeks or months. This is the most effective treatment.
Medicated nail lacquers. These are occasionally helpful.
Treatment of body ringworm (tinea corporis) may include:
Antifungal medicine by mouth
Don't scratch at the rash or pick at the rash. This can cause infection and scarring, or spread the rash to other areas.
Take medicine as prescribed. If you were prescribed a cream, apply it exactly as directed. Put the cream on the rash and also on the skin 1 or 2 inches around the rash.
Scrub your hands with warm water and soap for at least 20 seconds before and after you use the medicine on the rash. This will keep from spreading the fungus.
Take medicine by mouth as directed until your healthcare provider says to stop.
Keep tinea from spreading to others. It can be spread by skin-to-skin contact and sharing personal items, such as brushes, shoes, or towels.
When you wash the area of your body that has ringworm, wash your hands before touching any other part of your body. Use a different towel to dry the rest of your body to prevent spreading the ringworm. Wash towels in hot, soapy water.
Keep the part of your body that has ringworm clean and dry.
Wear shower shoes in public pools, gyms, locker rooms, and public showers. Ringworm can live on gym equipment for a long time.
Talk with your healthcare providers about the risks, benefits, and possible side effects of all treatments.
What are possible complications of tinea infection?
Tinea of the scalp can also develop into a kerion. This is a large, painful, swollen sore over the area of the tinea infection. This is caused by a hypersensitivity to the tinea. The lymph nodes in your neck may be swollen and sore. You may also have a rash on another part of your body. A kerion may be treated with steroid medicine to help reduce inflammation and swelling.
In some cases, a tinea infection can lead to an infection by bacteria. This may be treated with antibiotics.
Can tinea infection be prevented?
Some types of tinea infection can be prevented if you:
Wash after you get dirty or sweaty, or after using a locker room.
Don’t go barefoot. Wear shower shoes in public showers, gyms, locker rooms, and pools.
Don’t share towels, combs, brushes, clothing, or shoes.
Keep your skin and feet dry.
Wear clean, loose-fitting underwear.
Make sure your pet does not have ringworm. People can get ringworm from animals. If you think your pet has ringworm, take the pet to a veterinarian for treatment. The vet can advise you on how to disinfect your home.
When should I call my healthcare provider?
Call the healthcare provider if:
The rash does not get better after 10 days of treatment
The rash spreads to other areas of the body
Redness around the rash gets worse
Fluid leaks from the rash
You have a fever of 100.4º (38ºC) or higher, or as directed by your healthcare provider
Key points about tinea infection
Tinea is a fungal infection of the skin. It's also known as ringworm. But it's not caused by worms.
The fungus is very contagious and can be spread from person to person.
Tinea infection can affect any part of the body. But it most often occurs on the feet, groin, nails, body, and scalp.
Treatment depends on what part of the body is infected. It may include antifungal cream, shampoo, or medicine by mouth.
Some types of tinea infection can be prevented if you don't share personal hygiene products, clothing, or shoes and keep your skin dry.
Tips to help you get the most from a visit to your healthcare provider:
Know the reason for your visit and what you want to happen.
Before your visit, write down questions you want answered.
Bring someone with you to help you ask questions and remember what your provider tells you.
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.
Know why a new medicine or treatment is prescribed and how it will help you. Also know what the side effects are.
Ask if your 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 you do not take the medicine or have the test or procedure.
If you have a follow-up appointment, write down the date, time, and purpose for that visit.
Know how you can contact your provider if you have questions.
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