Tinea Infections (Ringworm) in Children
What are tinea infections?
Different fungi, depending on their location on the child's body, cause ringworm. It is caused by a fungal infection — not an actual worm. Fungi on the skin, hair, and nail bed are called dermatophytes. Also referred to by health care providers as tinea infections, ringworm is characterized by ring-shaped, red, scaly patches with clearing centers. There is an increased risk of contracting ringworm if your child:
Has poor hygiene
Lives in a warm climate
Has contact with other children or pets that have ringworm
Is immunocompromised by disease or medicine
Plays contact sports, like wrestling
Uses communal baths or locker rooms
What are the most common types of tinea infections?
The most common types of ringworm include the following:
Athlete's foot (tinea pedis). This common condition mostly affects teen and adult males. It less often affects children before puberty. Contributing causes include sweating, not drying the feet well after swimming or bathing, wearing tight socks and shoes, and warm weather conditions. Symptoms of athlete's foot may include:
Whitening of the skin between the toes
Scaling of the feet
Itchy rash on the feet
Blisters on the feet
Jock itch (tinea cruris). This condition is also more common in males and happens more often during warm weather conditions. It is very rare in females. Symptoms of jock itch may include:
Red, ring-like patches in the groin area
Itching in the groin area
Pain in the groin area
Does not usually involve the scrotum, but rather the inner thighs
Scalp ringworm (tinea capitis). Scalp ringworm is highly contagious, especially among children. It happens mainly in children between the ages of 2 and 10. It rarely happens in adults. Symptoms of scalp ringworm may include:
Red, scaly rash on the scalp
Itching of the scalp
Hair loss on the scalp
Rash elsewhere on the body
Ringworm of the scalp can also develop into a kerion. This is a large, tender lesion over the area of the initial ringworm. This is caused by a hypersensitivity to the ringworm. It may be associated with a rash elsewhere and tender lymph nodes in the neck.
Nail infection (tinea unguium). An infection of the fingernail or toenail, this type is characterized by a thickened, deformed nail. This condition affects the toenails more often than the fingernails. It happens more often in adolescents and adults rather than young children. Symptoms of nail ringworm may include:
Thickening of the ends of the nails
Yellow color to the nails
Body ringworm (tinea corporis). This skin infection is characterized by a ring-like rash anywhere on the body or the face. It occurs in all ages, but is seen more often in children. It is more common in warmer climates. The symptoms of body ringworm may include:
Red, circular lesion with raised edges
The middle of the lesion may become less red as the lesion grows
Itching of the affected area
Ringworm looks like many skin conditions. Always talk with your child's health care provider for a diagnosis.
How are ringworm and other tinea infections diagnosed?
Ringworm is usually diagnosed based on a medical history and physical exam of your child. The lesions of ringworm are unique, and usually allow for a diagnosis simply on physical exam. In addition, your child's health care provider may order a culture, biopsy, or skin scraping of the lesion to confirm the diagnosis.
Treatment for ringworm and other tinea infections
Because the fungi can live indefinitely on the skin, recurrences of ringworm are likely. Treatment may need to be repeated. Specific treatment will be determined by your child's health care provider based on:
Your child's age, overall health, and medical history
Extent of the condition
Location of the ringworm
Your child's tolerance for specific medicines, procedures, or therapies
Expectations for the course of the condition
Your opinion or preference
Treatment for scalp ringworm (tinea capitis) may include the following:
Oral antifungal medicine. This medicine is usually prescribed for 4 to 8 weeks. Some children require longer treatment.
Use of a special shampoo (to help eliminate the fungus)
If a kerion is present, or if your child has a secondary abscess or bacterial infection, your child's health care provider may order antifungal medicine to treat the infection and steroids to help reduce the swelling and discomfort.
Treatment for ringworm of the body, groin, and foot is usually a topical antifungal agent or an oral antifungal medicine. The length of the treatment depends on the location of the ringworm.