Ringworm: What It Looks Like, What the Cream Won't Fix, and When to Get It Seen

Ringworm is a common fungal skin infection, not a worm. On the body it usually looks like a red or darker, scaly, itchy ring with a clearer center that slowly grows outward. Most cases on the skin clear up with an over-the-counter antifungal cream used for two to four weeks. Ringworm on the scalp or nails, or a rash that's spreading or not improving after two weeks of cream, needs a prescription.

What does ringworm look like?

• On the body: a round or oval patch with a raised, scaly, red or darker border and a clearer center. It may itch. There can be one ring or several, and they can join together.
• On the scalp: scaly, itchy patches with broken hairs or bald spots, sometimes with swollen, tender bumps. Most common in children.
• On the feet (athlete's foot): itching, peeling and cracking between the toes or on the soles.
• In the groin (jock itch): a red, itchy rash in the folds of the groin and inner thighs.
• On the nails: thick, discolored, brittle nails.

On darker skin, the ring may look brown, purple or gray rather than red.

How you catch it

The fungi that cause ringworm live on skin, hair and surfaces, and spread by:

• Pets: cats, especially kittens, and dogs can carry it, sometimes with patchy hair loss and sometimes with no signs at all
• People: skin-to-skin contact, common in wrestling and other contact sports
• Shared items: towels, hairbrushes, hats, bedding and gym mats
• Damp floors: locker rooms, showers and pools

Treating ringworm on the skin

• Use an over-the-counter antifungal cream, such as clotrimazole or terbinafine, as the label directs, usually once or twice a day
• Spread it about an inch past the edge of the rash
• Keep using it for one to two weeks after the rash looks gone. Stopping early is the most common reason it comes back.
• Keep the area clean and dry

Avoid steroid creams like hydrocortisone on a rash that might be ringworm. They can calm the itch but make the infection spread and harder to recognize.

When cream isn't enough

• Scalp and nail ringworm don't respond to creams. They need prescription antifungal medicine by mouth.
• Widespread ringworm, or a rash that isn't improving after two weeks of cream
• A weakened immune system or diabetes
• Uncertainty: eczema, psoriasis and some other rashes can look like ringworm. Our rash guide covers the common ones.

Stopping it from spreading

• Wash your hands after touching the rash or a pet that might have it
• Don't share towels, combs, hats or bedding, and wash them in hot water
• Wear sandals in locker rooms and public showers
• Keep skin dry, especially in skin folds and between the toes
• Take a pet with patchy hair loss or scaly skin to the vet, since you'll keep catching it until the pet is treated

When to get seen

Come in, or start with a telehealth visit, if the rash is on the scalp, face or nails, is spreading, hasn't improved after two weeks of cream, or you're not sure it's ringworm. A clinician can usually diagnose it by looking, and can prescribe stronger treatment if it's needed. At an AfterOurs clinic, a standard self-pay visit is $175, and a self-pay in-clinic visit never costs more than $330. Telehealth is $75. We contract with all major commercial and government plans, including Colorado Medicaid and Medicare. See our rashes page and the cost and insurance page.

Get seen the same day if the rash becomes painful, hot, swollen, or starts to drain pus, or a red streak spreads from it, which can mean a bacterial infection. Go to the ER if that comes with a high fever, chills or feeling very unwell.

Where to find us

Four clinics across metro Denver, all ages welcome, se habla español:

• Hampden (Southeast Denver): 8 AM–11 PM daily
• Littleton: 8 AM–11 PM daily
• Thornton: 8 AM–11 PM daily
• Highlands: Mon–Fri 5–11 PM, Sat–Sun 8 AM–11 PM

Walk in, or book online.