Ringworm is a skin infection caused by a fungus, not a worm. It can be spread from infected animals (such as pet cats and dogs) or people infected with the fungus. The infection starts as a small, red, itchy sore. It grows larger, in the shape of a round, 1- to 2-inch ring with clear skin in the center. When the fungus infects the scalp, it causes round bald patches that are itchy and flaky. In severe cases, these areas may scar, and the hair may not grow back.
Your health care provider can often tell that you have ringworm by looking at the infected area. To know for sure, a small scraping of skin on the scalp is taken. The sample is then sent to a lab and examined under a microscope.
Ringworm of the scalp can be hard to treat. You'll need to take oral antifungal medicines for 2 to 12 weeks. Follow special instructions for taking the medicine. Antifungal creams and shampoos may also be prescribed to help prevent the spread of infection. Steroid creams to treat ringworm are not recommended by the CDC, since they aren't effective and may make the condition worse.
Home care
Follow these guidelines when caring for yourself at home:
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It may take up to 12 weeks for the infection to fully clear. To stop it from coming back, keep taking the medicine until the rash is gone and your health care provider has told you to stop. Throw out any combs, hairbrushes, barrettes, hats, or other products that have touched your head. Or you can disinfect these items by soaking them in diluted chlorine bleach. (Use 1/4 cup bleach per gallon of water.)
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Clean towels, pillowcases, sheets, and other linens or clothing each time they may have touched the infected area. Wash them in hot water with a strong detergent. Dry them on high heat.
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Use two towels to dry after your bath. Use one towel on your body and a different towel to dry your head. Don’t use this towel on the rest of your body. Before reusing these towels, wash them in hot water and detergent.
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Ringworm of the scalp is very contagious. This means it spreads easily to other people. Other family members may need to be treated. Don't share hats, combs, hairbrushes, towels, pillowcases, or helmets while infected.
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Any child with ringworm of the scalp should stay out of school or day care until prescription medicine is started, or until the health care provider says it's okay to return. Your child shouldn't play contact sports or use public swimming pools, lockers, or showers until the provider says it's safe to do so.
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Shampooing with an antifungal shampoo will help to clear the scalp ringworm, but it won't cure the condition. It is recommended that other family members also use the antifungal shampoo to reduce the chances of spreading.
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You don't need to cut or shave the hair. This won't help.
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Have your veterinarian check your pets for signs of ringworm.
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After you touch any area with ringworm, wash your hands with warm water and soap before touching another area of your body.
Follow-up care
Follow up with your health care provider, or as advised.
When to get medical care
Contact your health care provider or get medical care right away if:
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Ringworm comes back.
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Scalp swelling or pain gets worse.
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Fluid or pus drains from the rash.
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An adult with ringworm has a fever of 100.4°F (38°C) or above, lasting for 24 to 48 hours.
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A child with ringworm has a fever. (See "Fever and children" below.)
Fever and children
Use a digital thermometer to check your child’s temperature. Don’t use a mercury thermometer. There are different kinds and uses of digital thermometers. They include:
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Rectal. For children younger than 3 years old, a rectal temperature is the most accurate.
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Forehead (temporal). This works for children age 3 months and older. If a child under 3 months old has signs of illness, this can be used for a first pass. The health care provider may want to confirm with a rectal temperature.
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Ear (tympanic). Ear temperatures are accurate after 6 months of age, but not before.
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Armpit (axillary). This is the least reliable, but it may be used for a first pass to check a child of any age with signs of illness. The provider may want to confirm with a rectal temperature.
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Mouth (oral). Don’t use a thermometer in your child’s mouth until they are at least 4 years old.
Use the rectal thermometer with care. Follow the product maker’s directions for correct use. Insert it gently. Label it, and make sure it’s not used in the mouth. It may pass on germs from the stool. If you don’t feel okay using a rectal thermometer, ask the provider what type to use instead. When you talk with any health care provider about your child’s fever, tell them which type you used.
Below are guidelines to know if your young child has a fever. Your child’s provider may give you different numbers for your child. Follow your provider’s specific instructions.
Fever readings for a baby under 3 months old:
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First, ask your child’s health care provider how you should take the temperature.
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Rectal or forehead: 100.4°F (38°C) or higher
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Armpit: 99°F (37.2°C) or higher
Fever readings for a child age 3 months to 36 months (3 years):
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Rectal, forehead, or ear: 102°F (38.9°C) or higher
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Armpit: 101°F (38.3°C) or higher
Call the provider in these cases:
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Repeated temperature of 104°F (40°C) or higher in a child of any age
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Fever of 100.4° (38°C) or higher in baby younger than 3 months
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Fever that lasts more than 24 hours in a child under age 2
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Fever that lasts for 3 days in a child age 2 or older
