Ringworm, also known as tinea corporis, is a common skin infection in children. Despite its name, ringworm is caused by a fungus, not a worm. The rash typically appears as a circular rash with clear skin in the center, giving it a ring-like appearance. It is easily treated with antifungal medications, does not cause any serious complications, and is mildly contagious.

What are the symptoms?

  • It starts as a small round or oval pink or red patch or cluster of tiny bumps.
  • It grows and forms a ring of small bumps or a raised border, with clear skin at the center of the patch. It looks similar to a ring.
  • The border often appears scaly.
  • It may have mild itching or irritation but does not usually bother the child very much.
  • Multiple patches may appear on different body areas, and some patches may merge to form irregular shapes.
  • Other conditions can cause a similar rash, including eczema, contact dermatitis, granuloma annulare, pityriasis rosea, and psoriasis.

What causes ringworm?

Ringworm is an infection caused by a fungus. These infections are also known as tinea and are caused by a type of fungus called a dermatophyte. The infection can spread from other children, dogs, cats, or the environment. It can also spread to different parts of the body. The same fungus can cause scalp infection (tinea capitis), athlete’s foot, jock itch, and nail infections.

What should I expect?

The patch starts small and slowly grows to form a ring of bumps with normal skin in the center. It is easier to recognize at this stage than at the very beginning. The rash is usually about 1 inch in diameter. When treated with medication, it usually goes away in 2-4 weeks.

How is it treated?

  • Ringworm is treated with a topical antifungal cream. Several are available over-the-counter: clotrimazole (Lotrimin AF, Mycelex, store brands); ketoconazole (Nizoral, store brands); miconazole (Monistat, Micatin, store brands); terbinafine (Lamisil, store brands); and tolnaftate (Tinactin, store brands).
  • Although the cream may say it is for athlete’s foot, the medication is the same for any form of ringworm on the skin.
  • The cream should usually be used 2-3 times a day for up to 3-4 weeks. It should be used for one week after the patch disappears.
  • Avoid scratching the area. You can cover the area with a bandage if this helps.
  • Avoid antifungal creams with a steroid (whether over-the-counter or prescription). They can make it worse or cause complications. They are used occasionally in some instances.
  • Do not share towels, clothes, or bedding.
  • Wash all clothing and bedding.

What complications should I look for?

  • If ringworm is in the scalp (tinea capitis), it must be treated with oral prescription medicine. Creams and shampoos will not work.
  • Further evaluation is necessary if the rash continues to spread or is not responding to treatment.
  • Some children develop an itchy rash on other body parts (known as an id reaction). This is not due to the medication. It is treated by controlling the itching and treating the ringworm.

How can I prevent my child from developing ringworm?

Ringworm spreads by close, skin-to-skin contact with other children and occasionally from pets, who may not have any symptoms. You cannot do much to prevent ringworm, but you should consider getting pets checked if your child keeps getting it.

When can my child return to school or daycare?

Ringworm is mildly contagious. Once treatment starts, your child can return to school or daycare. Some prefer to have the patches covered, and if this is easily done, then do it; however, it is unnecessary once treatment begins.

Athletes who have close body contact, such as wrestlers, may not be allowed to compete until the infection is gone.

When should I seek further care?

Call us for an appointment if:

  • The rash continues to spread after treatment for a week.
  • The rash is not gone after four weeks of treatment (it may be granuloma annulare, eczema, or another condition).
  • Scaling and hair loss are present in the scalp (ringworm in the scalp requires prescription oral medication).

For more information

Ringworm and Fungal Nail Infections Basics (CDC)

Ringworm of the Body (MedlinePlus)

Tinea Infections (The Society for Pediatric Dermatology)

Ringworm (American Academy of Dermatology)

References

Hawkins DM, Smidt AC. Superficial Fungal Infections in Children. Pediatric Clinics. 2014;61(2):443-455. doi:10.1016/j.pcl.2013.12.003

El-Gohary M, van Zuuren EJ, Fedorowicz Z, et al. Topical antifungal treatments for tinea cruris and tinea corporis. Cochrane Database Syst Rev. 2014;8:CD009992. doi:10.1002/14651858.CD009992.pub2

Alston SJ, Cohen BA, Braun M. Persistent and Recurrent Tinea Corporis in Children Treated With Combination Antifungal/ Corticosteroid Agents. Pediatrics. 2003;111(1):201-203. doi:10.1542/peds.111.1.201

Hill RC, Caplan AS, Elewski B, et al. Expert Panel Review of Skin and Hair Dermatophytoses in an Era of Antifungal Resistance. Am J Clin Dermatol. 2024;25(3):359-389. doi:10.1007/s40257-024-00848-1