Ringworm is a fungal infection of the skin in humans and domestic animals such as sheep and cattle. Fungi are organisms that survive by eating plant or animal material. Those that cause parasitic infection (dermatophytes) feed on keratin, the material found in the outer layer of skin, hair, and nails. These fungi thrive best on skin that is warm and moist.

This condition has been prevalent since before 1906, at which time Ringworm was treated with compounds of mercury(lead). Hairy areas of skin were considered too difficult to treat, so the scalp was treated with x-rays and followed up with antiparasitic medication .

It is estimated that in current times, up to twenty percent of the population is infected by Ringworm or one of the other dermatophytoses. It is especially common among people who play sports, wrestling in particular; wrestlers with Ringworm may be disqualified.

Misdiagnosis and treatment of Ringworm with a topical steroid can result in tinea incognito, a condition where Ringworm fungus will grow without typical features like a distinctive raised border.

Fungi thrive in moist, warm areas, such as locker rooms, tanning beds, swimming pools and in skin folds. The fungi may be present without any symptoms.

Advice often given to prevent Ringworm includes:

• Avoidance of sharing clothing, sports equipment, towels, or sheets.
• Washing clothes in hot water with fungicidal soap after suspected exposure to Ringworm .
• Avoidance of walking barefoot, wearing of appropriate protective shoes to the beach and flip-flops in locker rooms.
• After being exposed to places where the potential of being infected is great, one should wash with an antibacterial and anti-fungal soap or one that contains tea tree oil, which contains terpinen-4-ol.
• Avoid touching pets with bald spots as they are often carriers of the fungus.

To determine if your pet has Ringworm , it can be as simple as observing the circular bare patches on the skin. But, to truly know if it is Ringworm , your vet can do 1 of 3 tests.

• Woods Test- This is simply a black light with a magnifying lens. About 50% of the Ringworm fungus will show up as fluorescent under the black light.
• Microscopic test- Your vet will take a hair from around the infected area and place it in a special solution and view it under the microscope. This is effective for about 40%-70% of the infections.
• Culture Test- The most effective, yet longest, way to determine if there is Ringworm in your pet is to have a vet collect scales from the area and have it cultured.

Antifungal treatments include topical agents such as Miconazole, Terbinafine, Clotrimazole, Ketoconazole, or Tolnaftate applied twice daily until symptoms resolve - usually within one or two weeks. Topical treatments should then be continued for a further 7 days after resolution of visible symptoms to prevent recurrence. The total duration of treatment is therefore generally two weeks, but may be as long as three.

In more severe cases or where there is scalp Ringworm , systemic treatment with oral medications may be given.

To prevent spreading the infection, lesions should not be touched, and good hygiene maintained with washing of hands and the body.

Call your doctor if:

• Ringworm infects your scalp or beard.
• Your skin does not improve after 4 weeks of self-care.

Dr Harounian can be reached in two locations.

Metropolitan Los Angeles Clinic:	213-484-0040
West Los Angeles Clinic:	310-477-9210

Dr. Harounian is also a certified podiatrist in using the latest Pin Pointe Foot Laser Technology, treating Toenail infections.

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