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 doctors 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:

• Is malnourished

• Has poor hygiene

• Lives in a warm climate

• Has contact with other children or pets that have ringworm

• Is immunocompromised by disease or medication.

• Plays contact sports, such as 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 frequently 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 occurs 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

• Scalp ringworm (tinea capitis). Scalp ringworm is highly contagious, especially among children. It occurs mainly in children between the ages of 2 and 10. It rarely occurs 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, a large, tender lesion over the area of the initial ringworm. This is caused by a hypersensitivity to the ringworm and 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 occurs 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 frequently 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 resembles many skin conditions. Always consult your child's doctor for a diagnosis.

How is ringworm and other tinea infections diagnosed?

Ringworm is usually diagnosed based on a medical history and physical examination of your child. The lesions of ringworm are unique, and usually allow for a diagnosis simply on physical examination. In addition, your child's doctor may order a culture 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 doctor 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 medications, 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 medication. This medication is usually prescribed for four to eight 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 doctor may order additional medications, such as steroids, to help reduce the swelling.

Treatment for ringworm of the body, groin, and foot is usually a topical antifungal agent or an oral antifungal medication. The length of the treatment depends on the location of the ringworm.