What should you know about the start of ringworm?

Ringworm is a fungal infection of the skin, despite its name; it is not caused by a worm. Early changes may look like a small round or oval rash, with dryness, scaling, itch, or a slowly widening border. The centre can look less inflamed than the edge. Appearance varies by skin tone and body site, and irritation from eczema or contact with a product can look similar. Infection may pass through close skin contact or shared towels, clothing, hair tools, or sports equipment.

A rash is not automatically ringworm. A clinician may examine its shape and scale and may test skin scrapings when the diagnosis is uncertain, especially if the area is spreading or treatment has not helped.

Keep the area clean and dry, wash your hands after touching it, and avoid scratching. Do not share towels, clothing, brushes, or bedding; wash items that touch the affected skin regularly. A pharmacist or clinician can advise whether a topical antifungal treatment fits the location and appearance. Use it exactly as directed and avoid steroid cream on an undiagnosed ring-shaped rash unless a clinician has recommended it, because steroids can alter the appearance of a fungal infection. Scalp or nail involvement may need a different plan, including oral antifungal treatment.

Arrange medical advice if the rash involves the scalp, beard area, nails, face, or a large area; if it is painful, oozing, rapidly expanding, or accompanied by fever; or if another household member has a similar infection. Seek review when symptoms do not improve with an appropriate antifungal plan or keep returning. Prompt assessment is also sensible for a child, someone with reduced immunity, or anyone with diabetes.

Could this be ringworm or another cause of a scaly skin rash? Does the location require a skin test or oral medicine? How should I prevent spread at home, and when should the diagnosis be reconsidered?