Ringworm: Types, How It Spreads and Treatment

Ringworm is a common skin infection caused by a fungus, not a worm. It usually shows as an itchy, scaly, ring-shaped rash. The same fungi cause athlete's foot, jock itch and scalp ringworm. Most skin cases clear with an antifungal cream from the pharmacy. Scalp ringworm in children is different: it needs a doctor and tablets.

Dr. Pedro Yelamo Vera is a GP licensed in Spain (Colegiado No. 484814280).

For a medical emergency, call 112 or go to the nearest local emergency department. Do not wait for a video consultation or an online reply.

What is ringworm, and what does it look like?

Ringworm is a fungal infection of the top layer of skin. The NHS says the main sign is a rash that may be scaly, dry, swollen or itchy. On the body it is often a ring with a raised edge and a clearer centre. Rings can grow, spread or overlap.

On brown or black skin the patch may look purple, brown or grey rather than red. On the face or scalp it can look less like a ring. The CDC says signs usually appear 4 to 14 days after contact with the fungus.

What are the types of ringworm?

Doctors name ringworm by where it grows. You may see the Latin names on a Spanish report.

• Body (tinea corporis, tiña corporal). Itchy rings on the trunk, arms or legs.
• Groin (tinea cruris, tiña inguinal). Also called jock itch. An itchy, red, scaly rash on the inner thighs and skin folds. It is more common in men and in hot weather.
• Scalp (tinea capitis, tiña del cuero cabelludo). Scaly patches with broken hairs or bald spots. It is most common in children.
• Feet (tinea pedis, pie de atleta). Athlete's foot. It is covered in full below.
• Nails. See our toenail fungus guide.

How do you catch ringworm?

The NHS and CDC list these routes:

• Skin contact with an infected person.
• Touching an infected pet or farm animal. A cat or dog may have patches of missing fur.
• Shared towels, bedsheets, combs and hair clippers.
• Walking barefoot on changing-room and shower floors.
• Soil, though this is less common.

Heat, sweat, tight clothes and contact sports raise the risk. In Spain, dermatologists in Málaga have also reported scalp ringworm spread in barber shops. Most cases were young men with short fade haircuts, and some passed it on at home.

How is ringworm treated?

For ringworm on the body, groin or feet, start with the pharmacist. Antifungal creams, gels, sprays or powders usually work. Common ingredients are clotrimazole, miconazole, terbinafine and ketoconazole.

• Follow the leaflet for how long to use it. The NHS says to finish the full course, even after the rash has gone. Stopping early is a common reason it comes back.
• Keep the skin clean and dry, and wash towels and bedsheets often.
• Do not scratch, as this can spread it to other parts of the body.

Widespread or stubborn ringworm may need antifungal tablets on prescription.

Can you buy ringworm cream without a prescription in Spain?

Often, but it depends on the product. Most clotrimazole creams are sold without a prescription. Some terbinafine creams are too, but many brands need one. The miconazole skin products on sale in Spain need a prescription. Antifungal tablets always need one. Our prescription status guide has the details.

This differs from home. In the UK, clotrimazole, miconazole and terbinafine creams are sold over the counter. In the US, the CDC lists all four main creams as non-prescription. In a Spanish pharmacy, ask for a crema antifúngica or antimicótica for tiña. If you are pregnant or breastfeeding, or treating a young child, ask the pharmacist which product suits you.

Why should you avoid steroid creams on ringworm?

Ringworm is easy to mistake for eczema or psoriasis. A steroid cream calms the itch, but the CDC warns it can make ringworm worse. DermNet calls this tinea incognito: the rash spreads and stops looking like ringworm. Never use a steroid cream alone on an unclear rash.

What is athlete's foot, and how do you get rid of it?

Athlete's foot is ringworm of the feet. The NHS describes itchy white patches between the toes. The CDC says it is most common between the little toe and the one next to it. The skin may be sore, flaky, cracked or bleeding. It can spread to the soles and sides of the feet, sometimes with small blisters.

The NHS says it is unlikely to clear without treatment. Pharmacy creams, sprays or powders usually work, but they take a few weeks. You do not need to stay off work or school.

To help it clear and stop it coming back:

• Dry your feet well, especially between the toes. Dab, do not rub.
• Use a separate towel for your feet and wash it often.
• Wear clean cotton socks every day.
• Do not wear the same shoes for more than two or three days in a row.
• Wear flip-flops in changing rooms and pool showers.
• Do not share towels, socks or shoes.

Treat it early. Left alone, the NHS says it can spread to the toenails, which are much harder to clear. It can also spread to the groin, so use a separate towel for your feet.

See a doctor about athlete's foot if pharmacy treatment has not worked, it is very painful, it spreads to your hands, or you have diabetes or a weak immune system. A hot, painful, red foot or leg can mean a skin infection and needs a check today.

How is scalp ringworm treated in children?

Scalp ringworm is mainly a childhood infection. It shows as scaly patches, broken hairs or black dots, and patches of hair loss. Glands in the neck may swell.

It always needs a doctor. The CDC says creams and lotions do not work on the scalp. The NHS says it usually needs antifungal tablets and an antifungal shampoo on prescription. The doctor may take a sample of hair and scale to confirm it.

• Your child can go to school or nursery once treatment has started. Tell the teacher.
• Check the scalps of brothers, sisters and other close contacts.
• Do not share combs, brushes, hats or pillows.
• Take a pet with bald patches to the vet.

See a doctor today if your child has a painful, swollen, boggy lump on the scalp that may leak pus. This is a kerion. It needs quick specialist care to lower the risk of a scar and lasting hair loss.

When should you see a doctor about ringworm?

• The rash has not improved after using a pharmacy antifungal as directed.
• It is on the scalp, face or beard.
• It is large, spreading or keeps coming back.
• You have diabetes or a weak immune system, for example from chemotherapy or steroid tablets.
• It is more severe than usual, or started after contact with someone with a severe rash. The CDC warns that a harder-to-treat type has been reported. Mention any recent travel.

Call 112 or go to urgencias if red, hot, swollen skin spreads quickly and you have a high fever, feel confused or feel very unwell. That is not ringworm alone. It can be a serious skin infection.

Talking it through with a doctor by video

Dr. Yelamo is a GP licensed in Spain. He sees adults, children and pregnant patients by video, every day from 07:30 to 20:30 (Spain time). In the visit he will:

• Look at the rash, scalp or feet on camera.
• Ask what creams you have tried, including any steroid cream.
• Explain whether a pharmacy cream is enough, or whether a skin sample or tablets make sense.

He does not promise any test or prescription before the visit. Where clinically appropriate, following a genuine evaluation. Treatment and prescriptions are issued solely at the doctor's discretion based on evidence-based clinical guidelines.

A prescription is never guaranteed: it is issued only where clinically appropriate after a genuine evaluation, as a private electronic prescription under Spanish law. This service is for urgent, non-emergency care. In an emergency, call 112.

See how the Urgent Care video visit works. It lasts 15 minutes and costs €50.

This guide is general information. It does not replace a consultation with your doctor.

Frequently asked questions

Sources

• NHS: Ringworm
• NHS: Athlete's foot
• CDC: Treatment of ringworm
• Patient.info (professional reference): Tinea capitis
• DermNet: Tinea incognito

Related guides

• Fungal skin infection care online
• Toenail fungus: signs, tests and treatment in Spain
• Which medicines need a prescription in Spain?
• Impetigo: symptoms and treatment
• Online doctor for minor skin issues in Spain
• Urgent Care video visit