Learn about ringworm stages and its symptoms: How fungal infection evolves in the skin

Introduction

Ringworm disease, despite its misleading name, isn’t caused by a worm but by a group of fungi known as dermatophytes. This common skin infection formally referred to as dermatophytosis, occurs when these fungi, which thrive on keratin—a protein found in skin, hair, and nails—invade the body.

Hello, I am Dr. Karma Patel, a dermatologist with expertise in diagnosing and treating ringworm infections. I am passionate about providing care through tele-dermatology, making it convenient for patients to receive timely and effective treatment from the comfort of their homes. If you’re experiencing symptoms like itching in inner parts or signs of a ringworm infection, consult a dermatologist online at neodermatologist.com. Our certified dermatologists specialize in treating fungal infections and have successfully treated over 15,000 cases. Click here to know how you can get a free online consultation with a dermatologist for a ringworm infection that you have. 

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In this blog, we will explore ringworm symptoms, its common types, ringworm stages, and how it evolves on the skin. Let’s dive in!

What is Ringworm Disease?

Ringworm, or dermatophytosis, is a fungal infection affecting the skin, scalp, or nails. It is highly contagious and can spread through direct contact with an infected person, animal, or contaminated objects like clothing, towels, or bed sheets. Poor hygiene and humid conditions often exacerbate the condition.

Common Types of Ringworm   

• Tinea corporis: Ringworm on the body (glabrous skin) excluding palms and soles, groins and face. 
• Tinea capitis: Ringworm of the scalp, often leading to hair loss.
• Tinea pedis: Athlete’s foot, affecting the feet.
• Tinea cruris: Jock itch rash, affecting the groin area.
• Tinea faciei: Ringworm on glabrous skin of the face (non-bearded areas).
• Tinea manuum: ringworm infection of hand.

Stages of Ringworm 

• Exposure and Colonization

Ringworm spreads through direct contact with an infected person, animal, or contaminated objects like clothes, bed sheets or towels. Factors like trauma, maceration and increased hydration of the skin promotes inoculation of pathogenic fungi. The microscopic fungal spores land on the skin and begin to colonize. 

• Initial Invasion

Infection occurs when the viable hyphae are deposited on the surface of the host. After 12 hours of inoculation spores and the outer layer (stratum corneum) adherence occurs, and by 24 hours of inoculation extracellular initial growth of germ tubes occurs. By the third day itself the invasion of the outer stratum corneum takes place. The dermatophytes use enzymes to break down the keratin in your outer skin layer (stratum corneum). The initial breakdown of the proteins changes the skin pH from acidic to alkaline, which in turn activates more enzymes for the maintenance of the infection. Penetration of fungal elements is much faster at 35 degree celsius and it also requires 90% humidity for the penetration into stratum corneum. This initial invasion sometimes causes no ringworm symptoms at all, and you may be unaware you are infected. 

There are two factors which are important in determining the size and duration of the lesion once the infection is established. The first is the growth rate of the organism and second is epidermal turnover rate. 

• Inflammation and the Classic Ring

As the fungi spread outwards, the immune system detects them launches an inflammatory response. There is an increased epidermal turnover at the inflammatory periphery of the lesion and in the other areas epidermal turnover is almost the same as normal skin. This creates the hallmark ringworm symptoms:

Ringworm rash: A circular, red rash with a raised, scaly border which can spread to other parts due to excessive humidity and moisture in these parts. In people with low immunity, and co-illnesses such as diabetes, it evolves and spreads more quickly than in others. In diabetics ringworm infection can also take longer duration to go away and chances of recurrences are also higher than in others. 

The center of the rash may clear somewhat, giving it a classic "ring" appearance. 

Itching and discomfort are common.

Inappropriate treatment with topical steroids decreases the inflammation and alters the clinical appearances. 

Inflammatory response of the host and increased epidermal turnover leads to shedding of the organisms at the inflammatory ring while those just ahead maintain the infection. 

• Expansion and Complications:

If left untreated, ringworm can spread to other parts of the body and penetrate deeper into the skin layers, and household members. Secondary bacterial infections may also occur. To prevent complications, early diagnosis and treatment are essential.

Ringworm Symptoms in Humans

• Red, scaly, circular rash with a clear centre (ring-like appearance)
• Itching and irritation in the affected area
• Raised, inflamed, or blistered edges of the rash
• Scaling or flaking skin in the infected area

Treatment Options for Ringworm on Skin

Effective treatment varies by the stage and severity of the infection. In early stages of the infection topical anti-fungal medications may suffice to clear the infection. In advanced cases, it is advised consulting a dermatologist as these are the experts who are specialized in diagnosing and treating ringworm infection. A dermatologist can prescribe anti-fungal medications both oral and topical as per the severity and a stage of the ringworm infection and also can advise on do's and don't in ringworm infection.

Prevention Tips for Ringworm Disease 

Good hygiene practices (washing hands regularly, not sharing personal items) are essential to prevent the spread of infection. 

Read more about Ringworm infection treatment and prevention tips here. 

Why Consult a Dermatologist Online?

At neodermatologist.com, our experienced dermatologists provide:

• Accurate diagnosis of ringworm symptoms.
• Tailored treatment plans.
• Guidance on managing and preventing the recurrence of ringworm disease symptoms.

We offer photographic and video consultation services for quick and effective care. Upload photos of the affected area, fill in your medical history, and book an appointment. Our team is committed to providing responses within 20 minutes.

Conclusion

Understanding the stages of ringworm disease is crucial for early detection and treatment. With proper care and hygiene, you can manage symptoms and prevent the spread of this common fungal infection. If you’re dealing with ringworm symptoms, consult a dermatologist at neodermatologist.com for expert advice and care.

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