How to manage ringworm in babies and children

What is ringworm?

Ringworm, also known as tinea or dermatophytosis, is a skin infection caused by a fungus. The infection may look like a worm in the shape of a ring – that's where the name ringworm comes from.

While anyone can get ringworm, it's most common in kids.

What are the signs of ringworm?

Ringworm looks like one or more scaly patches on the skin. While the patches don't always start out round, by the time they're about half an inch across, they usually form a scaly ring around a smoother center. The patches can appear anywhere on the body.

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Ringworm on the scalp is usually less ring-like. Instead, you might notice scaly patches or bald spots on your child's head. You may also see stubs of broken hairs in the middle of the bald spots.

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It's easy to confuse ringworm on the scalp with cradle cap, a much more common condition in babies. If you aren't sure what your child has, ask your healthcare provider to take a look.

Your child might also develop an area of inflammation, called a kerion, in response to the fungus. It'll appear as a moist, swollen area on the scalp, with pustules (little pimple-like bumps). It'll clear up once you treat the ringworm.

How did my child get ringworm?

Ringworm is transmitted through:

• Skin-to-skin contact with an infected person or animal (most commonly puppies and kittens)
• Sharing items with an infected person or pet (such as towels, combs, brushes, clothing, or pillows)
• Touching a contaminated surface (such as the floor in a pool area, shower, or locker room)

You'll usually start seeing signs of ringworm anywhere from four to 14 days after your child is infected.

How is ringworm diagnosed?

To diagnose ringworm, your healthcare provider will take a painless skin scraping or hair sample and examine it under a microscope or send it for a culture.

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How should I treat ringworm?

For ringworm on the body, your healthcare provider will probably suggest an over-the-counter antifungal cream. Apply it twice a day to the rash area and about an inch beyond its borders. Wash your hands well afterward.

It usually takes about three to four weeks to get rid of ringworm. Continue to apply the cream for a week after the rash is gone.

Some children are sensitive to antifungal creams, so try using just a little bit at first to see how your child's skin reacts. Stop using the cream and talk to your healthcare provider about alternatives if your child's rash gets worse instead of better.

If your child has a stubborn case of ringworm, your healthcare provider may prescribe something stronger than an over-the-counter cream. In rare cases, an oral medication is also necessary.

Ringworm of the scalp can be tougher to treat and can take six to eight weeks to clear up. Most likely, your doctor will prescribe an oral antifungal medicine as well as a medicated shampoo.

Don't use a steroid cream to treat a rash that may be ringworm. While it may help ease your child's itching, it can make ringworm worse and cause it to spread.

Are there possible complications from ringworm?

Your child could develop a bacterial infection from scratching their skin, so it's a good idea to keep their nails short and watch them closely. If you notice your child scratching, you may want to put little mittens or socks on their hands while they sleep.

Talk with your child's doctor if the rash doesn't look much better after about a week of treatment.

Should I keep my child home from daycare?

Ringworm is no longer contagious after 48 hours of treatment, so your child should be clear to go back to school or daycare then. Ask your daycare provider or school what their policy is.

Can I do anything to make sure my child doesn't get ringworm again?

It's hard to completely protect your child from ringworm, but there are a few things you can do to minimize their chances:

• Check your pets. Make sure that they don't have any scaly, hairless patches. If they do, take them to the vet for treatment.
• Practice good hygiene. Bathe and shampoo your child often and wash and dry between their toes. Also, make sure they wear clean socks and underwear every day.
• No bare feet. Shower shoes and sandals are especially important in public pool areas and gym locker rooms.
• Don't share items that the infection can live on. ell your children these are things they shouldn't share – even with their siblings: towels, combs, hairbrushes, hats, pillows, hair ties and headbands, clothing, and similar items.
• Do laundry. Wash bedding, towels, and clothing that came in contact with ringworm with hot water.
• Disinfect surfaces in your home, especially where pets have been. Ringworm can be killed with common disinfectants or detergents.
• Watch for signs in other family members. Get treatment immediately if needed.