Ringworm is a disease of the skin, nails and hair of a person that is triggered by pathogenic fungi and is highly contagious. This type of fungal infection is well studied in medicine, it can be called trichophytia or microsporia, as it is caused by two types of mycotic organisms: Microsporum and Trichophyton. Another synonym for ringworm are terms such as: dermatophytosis, dermatophytosis, ringworm.
Microsporia is a highly contagious infection, children are in an increased risk zone. Moreover, boys are five times more often infected with ringworm than girls. It is customary to distinguish microsporia of smooth skin and scalp. Nails are involved with the pathological process much less often.
Zooanthroponous microsporia, the pathogen of which affects dogs, cats and humans;
Anthroponotic microsporia, the pathogen of which affects only man;
Geophiles – pathogens of this type of microsporia live exclusively in the soil, infection can occur only upon contact with it.
According to available statistics, microsporia affects from 50 to 70 people out of 100,000. The disease is seasonal in nature, has a wider distribution in the warm season. In those regions where a hot climate prevails, the infection is diagnosed much more often.
Trichophytosis can be transmitted either from animals to humans, or from humans to humans. Only people suffer from anthroponotic trichophytosis, most often these are children. Zooanthroponic trichophytosis can be transmitted from domestic animals or from mice to humans.
Symptoms of ringworm
The symptoms of ringworm can vary somewhat, depending on the location of the infection, on impaired immunity and on its ability to cope with the disease.
In this regard, it is customary to distinguish:
Deprive the surface with localization on the scalp. Most often, infection occurs through contact with a sick person, or when interacting with an infected animal. If the superficial deprivation of the scalp does not get rid of in childhood, then there is the danger of its transition to a chronic form after puberty of a female child. In boys aged 13–15, untreated superficial versicolor of the scalp often passes on its own.
Symptoms of this type of ringworm are:
A single area, or multiple zones of damage with thinning hair. Such foci have a rounded shape.
On the face may appear patches of flaky skin, the scales of which are grayish or white. They are very similar in appearance to dandruff.
The more actively the microorganisms causing lichen begin to multiply, the more the hair begins to break. Over time, the area looks as if the hair on it was cut at a level of 1–2 mm from the skin.
The edges of the affected area are surrounded by small bubbles. After they burst, a yellow crust forms in their place. The skin itself may be slightly hyperemic.
The affected areas have a large diameter and can reach 10 cm, and sometimes exceed this figure.
Itching with a superficial form of ringworm is most often not observed. If it occurs, it has a rather weak degree of severity and does not cause discomfort to the person.
A patient with superficial deprive is more experiencing psychological discomfort, since his appearance is seriously affected.
Deprive the surface, affecting smooth skin. Often this type of ringworm can be confused with rosy lichen, but between them there is one significant difference – rosy versicolor never affects the hands, feet and face. Ringworm, in turn, can occur anywhere on the body. In addition, pink lichen will not last more than 8 weeks, and ringworm can disturb a person for many years, often changing the stage of remission to the acute stage.
Symptoms of the surface form of ringworm affecting smooth skin are:
Bright spot with clear borders. The boundaries themselves will be raised above the skin, forming a small roller. It consists of bubbles and pinkish papules. The middle of the spot is lighter, covered with skin scales.
If the disease is not treated, then the spots can grow.
The patient will be chased by itchy skin.
Most often, the facial versicolor occurs on the smooth skin of the neck and face, and often appears on the lower extremities and on the body.
Chronic ringworm. The chronic form of ringworm in adulthood can only be found in females. The disease develops against the background of an infection that was not cured in childhood and becomes aggravated when the ovaries and thyroid gland are disturbed. A general decrease in immune forces and hypovitaminosis can also be a push.
Symptoms of chronic ringworm are as follows:
The affected area is the scalp (mostly temples and the back of the head), smooth skin (mostly elbows, buttocks, thighs, palms), nail plates.
When a hairline is affected, the rods themselves break at the root. The focus does not grow by more than 10 mm, there is no inflammation, and a scaly scar develops over time.
When smooth skin is involved in the process, the spot has no clearly defined boundaries, it can reach large sizes. The color of the spot can be any shade, ranging from pink and ending with a bluish. Chronic eruptions are always itchy and flaky.
If the nail plate is involved in the pathological process, then its color changes first. From light pink it transforms to gray. The nail grows turbid, grows dull, starts to crumble. There are two options for changing the nail plate: it becomes either thinner or thicker.
Infiltrative-suppurative form of deep ringworm. This type of disease affects only the human hair follicles. This form of the disease can only be infected by an animal.
Deep ringworm symptoms are as follows:
The rise in body temperature.
Swollen and sore lymph nodes.
Concomitant skin rash of an allergic nature.
General weakness and malaise.
Large red plaques appear on the head, their diameter can reach 10 cm or more. They have an uneven surface with hillocks rising above it. Externally, deep ringworm resembles a tumor. The similar look is caused by the fact that suppuration of hair follicles occurs. This inflammatory process is accompanied by swelling of the skin, which elevates the plaque above the surface.
A person experiences pain at the site of inflammation. If the follicle is opened, then purulent contents will be released from it.
As the inflammation subsides, loose brown crusts appear in the middle of the plaque. If a man is exposed to a disease, then his plaques may form on his mustache and beard.
The abortive form of the disease is characterized by the appearance of pale spots that do not have clearly defined boundaries. Symptoms of the disease are mild, itching is not pronounced.
Erythematous and edematous type of ringworm can occur in childhood or in women. This form of the disease is characterized by the presence of pronounced inflammation and allergic skin reactions. The surface of the spot is covered with small scales.
Papular squamous form of the disease affects the chest and face. At the same time, the formed plaque rises above the surface of the skin, has pronounced hillocks, and is covered with dense skin scales. Itchy skin is pronounced to a great extent.
Causes of ringworm
The reason for the appearance of ringworm can be only one – it is infection from the carrier of the fungus. Carriers can act both people and animals (most often it is stray dogs or cats).
On the skin of a healthy person gets the element of wool, a particle of the dermis, soil or hair shaft, which contains a pathogenic fungus. It penetrates deep into healthy skin or nail and begins to multiply. If hair follicles are located nearby, then the fungi gradually grow into them, occupying the entire space of the bulb. After that, they begin to climb up the hair, accumulating in high concentrations between the hair scales. As the disease progresses, the mushrooms destroy the core. As a result, the hair breaks due to the increased weight. Around the rest of the hair shaft, the fungus continues to multiply, forming a white sheath. It can be seen without special magnifying equipment. This is the mechanism of infection with ringworm.
The ways of infection can be identified as follows:
Transfer is flexible from animal to human. In this regard, children are most at risk. After all, they are often in contact with homeless animals. Moreover, parents should know that puppies and kittens of homeless animals often suffer from ringworm, and the symptoms of affection may not be visible on their fur until a certain time. In addition to homeless cats and dogs, pets, such as pigs, goats, sheep, etc., also act as a natural source of infection. Rodents can be carriers of the infection.
Transfer of the fungus from a sick person to a healthy person through contact-household way. Household items, hairbrushes, underwear, and clothes used by the patient are dangerous. For a long time, spores of the fungus continue to support their vital activity on car seats, on sofas, on soft toys, carpets, etc. They can live without a human or other living organism for several months.
Contact with the diseased skin of an infected person can be dangerous in terms of the transmission of the fungus.
Infection with ringworm can occur in a barbershop where the rules for disinfection of instruments are not followed.
However, experts point out that infection with a fungus after its brief contact with healthy skin does not always occur. For mycotic organisms to multiply on the skin, in the hair follicles, on the nails, they need favorable conditions. If the human immune system is strong, then it will not allow the pathological activity of the fungus. In this regard, the integrity of the skin is also important.
The factors that create favorable conditions for ringworm infection include the following:
Maceration of the skin. This process is characterized by softening of the dermis as a result of its prolonged contact with water. This can also be attributed to hyperhidrosis of the palms and feet, violations of the chemical composition of the secretions secreted by the sebaceous and sweat glands.
Frequent contact with the land or animals associated with professional activities.
Any injuries, scratches, abrasions, cracks, burns, abrasions, callosity of the skin, that is, all that leads to a violation of its integrity.
The crowding of people, which is especially important for children’s groups, increases the risk of infection with ringworm.
Neglect of personal hygiene. It is known that the spores of the fungus are easily washed off with water when it comes into contact with the skin of a healthy person.
Skin infections and reduced immune defense of the body as a whole. In this regard, depressions, stressful situations, chronic diseases, acute infections, etc., have a negative effect.
What is dangerous ringworm? Consequences and complications
Ringworm does not pose a serious threat to human health or life. Most often, after getting rid of the disease, the scalp is fully restored.
However, if the disease provokes suppuration and inflammation on the scalp, it can lead to hair loss without the possibility of their subsequent recovery.
Children who have had ringworm in infiltrative-suppurative form may have one or several bald spots on their heads in the future. In addition, there is a risk of attaching a secondary infection.
Diagnosis of ringworm
Diagnosis is to examine the patient, to clarify the features of his life activity (contact with animals, the presence of an outbreak of the disease in kindergarten conditions).
For the detection of mycotic cells and mycelium of the fungus, a microscopic examination of skin scraping is performed. To clarify the diagnosis, a culture study is conducted to determine the type of pathogen of inflammation.
Luminescent examination with the Wood’s lamp makes it possible to examine not only the patient himself, but also contact persons. If there is a fact of infection, the fungal mycelium will be highlighted in green.
These diagnostic measures will be sufficient for diagnosis.
Answers to popular questions:
Is ringworm contagious? Yes, ringworm is an infectious and highly contagious disease.
Can the ringworm pass without treatment? The possibility of self-rid the body of ringworm exists, but it is negligible. Science knows of several cases when the disease has passed without any medical intervention, however these are isolated phenomena. Most often, the infection, causing inflammation once, begins to spread further. If the disease has developed in childhood and has not been subjected to therapy, then it will persist until adult years.
Can ringworm develop again? The disease may develop again if a new infection has occurred, or the treatment has not been completed. The body is not able to form immunity against ringworm fungi.
Ringworm itches or not? The disease causes itching, and in some cases it can give the patient expressed anxiety.
Is it possible to wash with ringworm? The disease is not a contraindication to the implementation of hygiene procedures. During the illness, it is best to take not a bath, but a shower.
What if I get sick with ringworm during pregnancy? Do not panic if the infection has developed during gestation, as these mycotic organisms are not capable of having a pronounced effect on the child or woman. If infected, you should consult a doctor and receive the recommended treatment. During pregnancy, oral medications are not prescribed to get rid of the infection, it will be enough to use the ointments prescribed by the doctor.
Which doctor to contact?
If symptoms of ringworm are found in an adult or in a child, you should immediately consult a doctor. This may be a specialist dermatologist or infectious diseases.
The doctor with the help of his available diagnostic methods will confirm or deny the fact of infection and prescribe appropriate treatment. It is worth remembering that without treatment, ringworm is able to provoke very unpleasant consequences in the form of baldness or suppuration, and can also be spread to other people.
In addition, there is a possibility that under the symptoms of ringworm hiding such diseases as: atopic dermatitis, psoriasis, lichen planus, focal alopecia, etc.
Treatment for ringworm
Treatment for ringworm can not be very fast. As a rule, therapy takes from one month to 6 weeks. To prevent the disease from becoming chronic, all recommendations prescribed by a doctor must be strictly followed.
The treatment must be carried out by a specialist, as attempts to get rid of the infection on their own can also lead to a chronic process. In this case, the disease will periodically remind of itself, capturing all new patches of skin and scalp.
If during the diagnosis on the skin a single focus is found depriving, and the patient feels well, then only local treatment can be prescribed. However, it is practiced only when the location of the rash on the skin without vellum or hard hair. The patient is recommended in the morning to treat the affected surface with iodine in 5% concentration, and then apply anti-mycotic ointment. The evening before applying the ointment, the skin is treated with salicylic acid.
If there are several plaques on the body, the disease is treated in a hospital. At the same time, local therapy is mandatory supplemented with intake of drugs.
Ointments for treating ringworm have a thick consistency, remain on the skin for a long time, do not drain and do not spread much. In addition, they are not able to penetrate deep into the cells of the epidermis, which means that the risk of side effects is minimal. Their composition may include clotrimazole, ketoconazole terbinafine, mycoconazole.
The application of ointments is recommended to be combined with pretreatment of the skin with iodine, as this contributes to the drying of depriving, providing antiseptic effect.
Doctors prescribe the following ointment for the treatment of ringworm:
Salicylic ointment. It can not be applied to the skin. The ointment has an antimycotic and anti-inflammatory effect; after its application, the treated surface should be covered with a sterile cloth.
Sulfuric ointment in 10% or in 10% concentration. It helps to get rid of mycotic organisms and bacteria, has a positive effect on the process of skin regeneration.
Sulfur tar ointment. It is applied to the surface of lichen and the surrounding tissue. If the skin is swollen around, then a sterile dressing should be applied over the ointment.
Mikospor. This ointment contributes to the destruction of the cells of mycotic organisms, it must be applied in a thin layer.
Lamisil. It has a damaging effect on fungi, prevents their further reproduction.
Prescription antimycotic agents for the local treatment of ringworm is Vidal milk and Lassar paste. They are made in a pharmacy to order.
If the skin around the treatment area is dirty, it should be washed. They do this not with ordinary water, but with disinfectant compounds, for example, with furatsilina solution, potassium permanganate, Miramistin.
Gels with an antimycotic effect are also often prescribed by dermatologists for the local treatment of ringworm. They are quickly absorbed and do not stain clothes, so they are easy to use.
In addition, gels contain high concentrations of drugs:
Exifin gel in 1% terbinafine-based concentration.
Mikogel KMP, in addition to the antimycotic effect, has an antibacterial effect. The main active ingredient is miconazole.
For the treatment of the scalp it is more convenient to use antifungal drugs in the form of solutions. They have good permeability and do not stain hair. They can be used for the treatment of depriving smooth skin as a preparation before applying an ointment or gel.
The following solutions are considered the most effective:
Vokadin based on iodine.
Yoditsirin on the basis of iodine and glycerin.
Nitrofungin based on 1-chloro-4-nitrophenol. A modern and effective remedy that has an antimycotic and antibacterial effect.
In addition to local treatment, it is possible to prescribe drugs with antifungal effect in tablet form. They contribute to the destruction of the fungus from the inside. However, it is worth remembering that such a remedy may be recommended only by a doctor. Although they have a pronounced therapeutic effect, antimycotics can cause side effects.
Popular oral medicines are:
Griseofulvin. It is a natural antimycotic with a narrow spectrum of action against fungi that cause ringworm. The full course of therapy is up to 15 days.
Orungal. The course of taking this drug on the basis of itraconazole lasts up to 15 days.
Lamisil with the active ingredient terbinafine can be recommended to receive for 6 weeks.
Fluconazole. The course of treatment with this drug is up to 8 weeks.
The effectiveness of the therapy is assessed using a fluorescent lamp. At the end of the therapeutic course, a repeated scraping of the skin will be performed. If the fungi continue to be present on the integuments of a person, then the treatment is either continued or replaced with a different drug.
Do not refuse the recommendation of the doctor to shave off hair at the site of injury. This will not only economically apply the tool, but also increase the effectiveness of treatment.
It is important to take precautions within the family if there is someone with ringworm in it. To prevent its spread, you can use shampoos with antimycotic ingredients as a preventive measure: ketoconazole (1%), zinc pyrithione (up to 1%), selenium sulfide (1.5%), povidone-iodine.
Children with uncomplicated ringworm are treated at home. They should not attend educational institutions for 14 days from the start of therapy or more.
Article author: Kuzmina Vera Valerievna | Dietitian, endocrinologist
Education: Diploma RSMU them. N. I. Pirogov, specialty General Medicine (2004). Residency at Moscow State University of Medicine and Dentistry, diploma in Endocrinology (2006).