What Does Ringworm Look Like?

Ringworm pictures can help you identify this common infection. Ringworm (dermatophytosis) causes a scaly rash, which may or may not be ring-shaped depending on which part of the body is affected. The infection is not caused by a worm but rather by one of about 40 different fungus types.

The itchy, circular rash usually starts small and expands outward. Its appearance can vary based on its location, such as on the torso, face, hands, scalp, buttocks, arms, and legs. Ringworm can also look different on different skin tones and be harder to spot on darker complexions compared to lighter complexions.

This article shows pictures of ringworm along with a description of signs and symptoms. In addition to discussing complications and risk factors, this article also explains how ringworm is diagnosed and treated and when it is time to see a healthcare provider.

What Are the Symptoms of Ringworm?

The signs and symptoms of ringworm can vary slightly by the fungus type but typically develop as follows:

• The rash starts as a small, scaly patch of skin that grows outward.
• The patch may be slightly raised or flat.
• The patch may be redder or darker along the edges or have a slightly raised border.
• The rash typically causes itching, tingling, or burning.
• The rash may start to ooze or form tiny blisters or pimples.
• Hair loss can occur if the rash develops on hairy parts of the body.
• The rash can be brown or gray in people with darker skin tones and red or pink in people with lighter skin tones.
  

The symptoms can also vary based on the part of the body the fungal skin rash affects.

The Body (Tinea Corporis)

Ringworm of the body (tinea corporis) causes a rash on the arms, legs, and other exposed body areas. It typically starts with a small, scaly area on the skin that itches. The scaly area progresses quickly to form the classic ringworm rash, circular in shape with slightly raised edges. As the rash spreads, the ring will grow outward in a symmetrical circular pattern.

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With that said, the rashes aren't always circular. You may have just one or several rashes, and they may either be separate or overlap. Small blisters may also form within the patchy skin, causing oozing and crusting.

In some cases, the skin inside the ring may be clear and appear normal. At other times, the rash may resemble a bullseye.

The Face (Tinea Faciei)

Ringworm on the face (tinea faciei) can cause a classic ring-shaped rash, but not always. Instead, you may simply have raised, red or brown, scaly patches of skin that itch.

Tinea faciei rashes tend to be photosensitive, meaning they can turn red or brown and become irritated when exposed to ultraviolet (UV) radiation from the sun. The rash can sometimes feel wet or develop crusting.

The Beard (Tinea Barbae)

In people with facial hair, ringworm in the beard area (tinea barbae) causes crusty, flaky areas of skin. The hair can break and fall out in large patches. Tinea barbae can also cause bumps and blisters that are easily confused with acne.

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Tinea barbae causes inflammation of hair follicles (folliculitis). It predominantly affects males and can affect those who are clean-shaven as well as those with heavy beards or mustaches.

The Scalp (Tinea Capitis)

Ringworm of the scalp (tinea capitis) is uncommon in adults and mainly seen in toddlers and school-aged children. It rarely causes a ring-shaped rash. Instead, you'll find flaky, itchy patches on the scalp that may be red, brown, silvery gray, or yellowish in color.

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Tinea capitis can cause hair shafts to become brittle and break, causing single or multiple patches of hair loss.

The Hands (Tinea Manuum)

Ringworm of the hands (tinea manuum) tends to affect the back of the hands, causing classic itchy, ring-shaped rashes.

On the palms and between the fingers, the symptoms tend to be less obvious with dryness, peeling, and cracking (reminiscent of athlete's foot). You may also notice a callus-like thickening of the skin.

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The Feet (Tinea Pedis)

Athlete's foot (tinea pedis) is caused by the same group of fungi that cause ringworm. But, instead of a ring-shaped rash, you'll get dry, peeling, itchy skin, especially between the toes. Your feet might also experience burning or stinging sensations.

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If left untreated, the soles of your foot may thicken like a callus. Athlete's foot is common in teens and adults and rarely seen before adolescence.

The Groin (Tinea Cruris)

Like athlete's foot, jock itch (tinea cruris) is caused by the same group of fungi that cause ringworm. It causes a raised, scaly, reddish-brown rash in skin creases around the groin that can itch, sometimes intensely.

The rash can easily spread to the genitals, thighs, buttocks, and stomach. Jock itch blisters in the groin area can easily be mistaken for genital herpes.

Jock itch is more common in males, especially during warmer weather conditions. It very rarely affects females. Like athlete's foot, jock itch is rare in children.

The Nails (Tinea Unguium)

Nail fungus (tinea unguium) can affect both fingernails and toenails but is more common in the toes. Also known as onychomycosis, this hard-to-treat fungal infection can cause nails to become discolored, thickened, and brittle. In severe cases, the nail may separate from the nail bed and fall off.

Tinea unguium affects roughly 10% of adults with older adults being most commonly affected. Males have nail fungus more than females.

What Are the Possible Complications of Ringworm?

Serious complications from ringworm are rare. In the vast majority of cases, ringworm goes away quickly with treatment. With that said, there are certain complications you need to watch out for, particularly if the infection is left untreated.

Hyperpigmentation

After the ringworm rash has healed, some people may find a dark mark left in its place. This is called post-inflammatory hyperpigmentation.

These marks are caused when inflammation (the body's response to injury) triggers the overproduction of melanin, a brownish pigment produced by skin cells called melanocytes. The discoloration can be long-lasting but generally fades over time.

Some people, including those with dark complexions, are more prone to post-inflammatory hyperpigmentation than others.

Secondary Infections

Secondary infections are those that occur when a primary (first) infection provides disease-causing organisms entry into the body. With ringworm, dryness and cracking of the skin provide bacteria easier access to susceptible tissue beneath the surface of the skin.

Signs of secondary bacterial infections may include:

• Increasing skin discoloration, like redness
• Worsening of swelling, warmth, or pain
• A pus-like or foul-smelling discharge from the wound
• Expanding discoloration or red or brown streaks emanating from the wound
• High fever with chills

Kerions

A type of skin abscess called a kerion can develop as a result of an immune reaction to the fungal infection. A kerion is a large, inflamed, pus-filled lump that most commonly develops on the scalp but can appear elsewhere on the body.

Kerions most commonly occur with tinea capitis or tinea barbae, causing folliculitis and large patches of hair loss.

The bald patches can be temporary or permanent, depending on how much damage has been done to the skin. Some people also experience fever and malaise (a general feeling of unwellness).

Majocchi's Granuloma

Although rare, the fungi that cause ringworm can cause a deeper infection called Majocchi's granuloma. This occurs when the fungus travels down hair follicles and infects the deeper skin layers, called the dermis.

Majucchi's granuloma causes hardened, pinkish or brownish lumps or lesions as well as pustules (pus-filled bumps). It can affect any hairy part of the body but is most often found on the scalp, face, forearms, and legs. Patchy hair loss is common.

Is Ringworm Contagious?

Ringworm is contagious and easily spread from person to person. It doesn't take much; merely brushing against a lesion on someone with ringworm may be enough to establish an infection.

Ringworm can be also passed by sharing clothing, towels, combs, or other personal care items with an infected person. Animals can also spread ringworm to people, including dogs and cats (and especially kittens and puppies).

What Causes Ringworm?

Ringworm can be caused by around 40 different fungus types. When an infection is established, the fungus produces spores that get embedded in the skin. This allows the fungal colony to grow, causing an expanding rash.

The fungi thrive on moist areas of skin, but certain types are more robust and can establish an infection on dry areas of skin.

Ringworm is largely caused by two different families of fungi:

• Ascomycete fungi, including Trichophyton, Microsporum, and Epidermophyton types
• Basidiomycete fungi, including Malassezia types

Risk Factors

Anyone can get ringworm, but certain people are at greater risk. These include:

• People with weakened immune systems who are less able to fight infections
• People who use public showers or locker rooms
• Athletes involved in contact sports like wrestling
• People who wear tight shoes and have sweaty feet
• People who have close contact with animals, particularly stray pets

How Is Ringworm Diagnosed?

Ringworm may seem obvious on physical inspection but, to confirm the infection, your healthcare provider will want to take a scraping of the rash and look at it under the microscope to see if there are characteristic spores.

Ringworm is confirmed by exposing scrapings to a solution called potassium hydroxide (KOH). The KOH solution works by destroying healthy skin cells, leaving only fungal cells behind.

The scrapings can also undergo a fast and simple test called polymerase chain reaction (PCR) that can detect the "genetic signature" of ringworm-associated fungi.

A quick method of diagnosing ringworm caused by Microsporum species is by exposing the rash to ultraviolet (UV) light, called a Wood's lamp. Under UV light, Microsporum species will appear blue.

How Is Ringworm Treated?

Ringworm usually doesn't get better on its own without treatment. The appropriate treatment for ringworm is a class of drugs called antifungals. These come in topical formulations you apply to the skin or oral formulations you take by mouth.

The choice and duration of treatment can vary based on the severity of the rash, the part of the body affected, and your immune status.

The following approaches are recommended:

• Body, groin, hands, or face: These can usually be treated with topical antifungals, either over-the-counter or prescription. People with jock itch should keep the groin area clean and dry and wear cotton underwear.
• Feet: Athlete’s foot can usually be treated with over-the-counter topical antifungals. Chronic or extensive athlete's foot may require oral antifungals like terbinafine, Sporanox (itraconazole), or Diflucan (fluconazole).
• Scalp or beard: While tinea capitis can be treated with topical antifungal or antifungal shampoos, the rash is often resistant to these preferred. The oral antifungal Grifulvin V (griseofulvin) is the preferred option.
• Nails: These infections are very hard to treat and invariably involve oral antifungals like Sporanox along with medicated nail polish or cream and possibly nail removal.

Do not use creams that contain steroids to treat ringworm. Steroid creams weaken the skin's defenses. This allows the ringworm infection to spread and cover an even larger area of your body.

Home Remedies

There is no home remedy guaranteed to clear ringworm, but some may be used to support antifungal treatment, including:

• Apple cider vinegar (may cause stinging)
• Tea tree oil (may cause skin irritation)
• Coconut oil (applied topically to the scalp and skin)
• Natural sunlight (but avoid overexposure or UV tanning beds)

Outlook for Ringworm

The outlook for ringworm varies depending on where the infection is located and how severe it is. Ringworm on the skin, including athlete's foot and jock itch, usually responds to over-the-counter ringworm creams, lotions, or powders within two to four weeks.

Ringworm on the scalp can be more difficult to treat. It usually requires prescription medication taken by mouth, and you may not see results for one to three months.

What Conditions Are Mistaken Ringworm?

There are many rashes that look like ringworm, some of which are caused by viruses, bacteria, parasites, or autoimmunity. These include:

• Eczema (atopic dermatitis)
• Genital herpes
• Impetigo
• Lichen planus
• Psoriasis
• Seborrheic dermatitis
• Pityriasis rosea
• Scabies
  

Can Ringworm Be Prevented?

Ringworm can't always be prevented, but there are ways to reduce your risk:

• Keep your skin clean and dry.
  
• Shower immediately after contact sports.
• Avoid walking barefoot in locker rooms or public showers.
• Don’t share clothing, towels, sheets, or other personal items.
• Wear shoes that allow air to freely circulate around your feet.
• Clip your fingernails and toenails short and clean.
• Change your socks and underwear at least once daily.
• Wash your hands with soap and water after playing with pets.

When to See a Healthcare Provider

Ringworm is rarely a serious medical condition, but certain signs and symptoms warrant a visit to a healthcare provider, particularly if:

• You've used over-the-counter antifungal medications for two weeks with no improvement.
• You have ringworm on the scalp or beard area (to avoid hair loss).
• You have ringworm over large areas of your body.
• You have signs of a secondary infection.
• The rash is spreading quickly (as ringworm generally does not progress rapidly and you may have something else).

Ringworm Doctor Discussion Guide

Get our printable guide for your next doctor's appointment to help you ask the right questions.

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Summary

Ringworm is a common fungal infection that causes a ring-shaped skin rash. But it can take other forms when it develops on the face, hands, scalp, feet, groin, or nails. In cases like these, there may be irregular patches of dryness, discoloration, and scaling as well as tiny blisters or pimples. Hair loss can also occur.

Although ringworm pictures can help you identify this infection, remember ringworm doesn't always cause a ring-shaped rash. Ringworm is easy to confuse with other skin conditions like psoriasis, eczema, or herpes. See a healthcare provider to obtain the right diagnosis and treatment for your symptoms.