Ringworm
Prevention and Control of Communicable Diseases
Ringworm
Ringworm is a fungal infection of the body, scalp, or feet. The scalp infection is most common in children, whereas infection of the feet is more common in adolescents and adults.
Cause
Several different types of fungus. (It is not a worm.)
Symptoms
Body - Appears as flat, spreading, ring-shaped areas on the skin (lesions). The edge of the lesion may be dry and scaly or moist and crusted. As the lesion spreads outward, the center often becomes clear.
Scalp - May be hard to detect in the early stages. It often begins as a small scaly patch on the scalp and may progress to larger areas of scaling. Mild redness, swelling, itching, and pustules (pus-filled bumps) may occur. Infected hairs become brittle and break off easily.
Feet - (Also called athlete’s foot.) Scaling or cracking of the skin, especially between the toes, or blisters containing thin, watery fluid may be seen. Itching is common. Serious problems can include bacterial skin infection (cellulitis) and fungal infections of the toenails.
Spread
May occur by touching the lesions of infected persons or pets (usually dogs and cats); by sharing objects that touched the lesions of an infected person, (e.g., hats, caps, combs, brushes, towels, pillows, bedding, sofas, clothing, hair ribbons, barrettes); or having contact with skin scales containing fungi on shower stalls or floors, swimming pool decks, and locker room benches or floors.
Incubation
Body - 7 to 21 days after exposure for symptoms to appear.
Scalp - 10 to 14 days.
Feet - Unknown
Contagious Period
Contagious as long as lesions are present. Contagiousness is reduced once treatment has begun.
Exclusion
Child Care or School: Until treatment has been started. If on the scalp, until 24 hours after treatment has been started.
Any child with ringworm should not participate in gym, swimming, and other close contact activities that are likely to expose others until after treatment has begun or the lesions can be completely covered.
Sports: Athletes with ringworm of the body in sports with person to-person contact cannot participate in matches for 72 hours after starting treatment unless area can be covered. Follow athlete’s healthcare provider’s recommendations and the specific sports league rules for return to practice and competition.
Diagnosis
Recommend parents/guardians call their healthcare provider if they suspect ringworm in household members. Contact a veterinarian if you suspect a pet has ringworm.
Treatment
Body – Antifungal ointments are used on skin lesions for 4 weeks.
Scalp – May require oral medication if lesions are extensive. Oral medications should be taken for 4 to 8 weeks. Antifungal shampoos may also be prescribed.
Foot – Antifungal ointments for 1 to 4 weeks. Oral medications may need to be taken for 6 to 8 weeks for severe or recurring problems.
Prevention/Control
- Wash hands after touching lesions on humans and pets.
- Ensure lesions are completely covered.
- Wash combs and brushes in hot, soapy water, if used by the infected person.
Check for signs of infection in all pets in the child care and school setting. Have a veterinarian evaluate any pet with a skin infection or problem. If infection is present, treatment should be started as soon as possible.
If the pet has ringworm, children should not be allowed to have contact with the pet until the rash has been treated and heals.
- DO NOT allow sharing of personal items such as brushes, combs, towels, bedding or pillows, clothing, hats, caps, hair ribbons, barrettes, and headgear (helmets).
- Have separate bedding and pillows for each child at the child care.
- Wash bedding in hot, soapy water daily while a person is infected.
- Provide separate storage space for personal items for each child or staff member.
- Vacuum carpeted areas and upholstered furniture regularly.
- Schools/Public facilities:
- Require shower shoes (e.g., flip-flops or water sandals) be worn in locker rooms or showers or on pool decks.
- Exclude from using locker rooms, showers, or pools when active lesions are present if not covered by a waterproof bandage.
- Disinfect showers and dressing rooms daily with an EPA-approved disinfectant.
For more information, call the Missouri Department of Health and Senior Services (MDHSS) Bureau of Communicable Disease Control and Prevention at 573-751-6113 or 800-392-0272 (24/7), or call your local health department.
Ringworm Parent Fact Sheet
Your child may have been exposed to:
Ringworm
Ringworm is a fungal infection. It is not a worm. The scalp infection is most common in children. Infection of the feet is more common in adolescents and adults.
If you think your child has Ringworm:
- Tell your child care provider or call the school.
- Need to stay home?
- Child Care and School:
Yes, until treatment has been started. If on the scalp, until 24 hours after treatment has been started. - Activities: Limit gym, swimming, and other close contact activities if the lesion cannot be covered or until after treatment has begun.
- Sports: Athletes follow your healthcare provider’s recommendations and the specific sports league rules.
- Child Care and School:
Symptoms
Body - Flat, spreading, round shapes on the skin. If your child is infected, it may take 7 to 21 days for symptoms to start.
Scalp - Begins as a small scaly patch on the scalp and may cover more of the head. Mild redness, swelling, itching, and pustules (pus-filled bumps) may occur.
Infected hairs become brittle and break off easily. If your child is infected, it may take 10 to 14 days for symptoms to start.
Feet (athlete’s foot) - Scaling or cracking of the skin or blisters. Itching is common.
Spread
- By touching the infected skin of a person or pet (usually, dogs and cats).
- By sharing or touching contaminated objects.
Contagious Period
As long as you can see the ringworm on your child’s skin. Once treatment has begun your child is less contagious.
Call your Healthcare Provider
- If anyone in your home has symptoms. Your doctor will decide if treatment is needed. It is important to follow your doctor’s treatment directions exactly.
- If you think a pet has ringworm, call a veterinarian.
Prevention
- Wash hands after touching infected skin on humans and pets. Your child may need help with handwashing.
- Cover skin lesions.
- Wash bedding, clothing, combs and brushes in hot, soapy water.
- Check all household members and all pets for signs of infection.
- DO NOT let children touch an infected pet’s skin until it has been treated and heals.
For more information, call the Missouri Department of Health and Senior Services (MDHSS) Bureau of Communicable Disease Control and Prevention at 573-751-6113 or 800-392-0272 (24/7), or call your local health department.