Ringworm is a fungal infection that fortunately doesn’t have anything to do with worms. The fungus, also known as tinea, takes on a circular, worm-like appearance in infants and children.
Ringworm is highly contagious and easily transmitted. In the United States, people-to-people transmission causes the majority of cases, but pets-to-people transmission is most common worldwide.
While babies can get ringworm anywhere, two common locations are on the scalp and the body (including the face).
Ringworm in these areas can often resemble other conditions, so it’s important to be aware of the distinctive appearance that ringworm can take on over time in babies.
Ringworm often starts as red, scaly patches of skin. You may note only a single patch, or instead see several patchy areas.
If the areas are on the scalp, you might at first think they are dandruff or cradle cap. Scalp ringworm can cause hair loss and/or hair breakage on the affected area.
Scalp ringworm is most common in children ages 2 to 10.
Ringworm can occur on the face, too. When this occurs, the itchy areas of skin may look like eczema, or atopic dermatitis.
Over time, the patchy areas start to grow in ring-like circles that are between 1/2 inch and 1 inch in diameter with a raised border and clear area in the center. You may notice your little one itching these areas.
A scalp ringworm can also enlarge into what’s known as a kerion. A kerion is a lesion over the area where the ringworm first appeared.
If a child has a kerion, they also may have symptoms like a rash and tender lymph nodes in the neck. Other areas of the skin that may be affected include:
- cheeks
- chin
- eye area
- forehead
- nose
Tinea can affect any parts of your baby’s body, but may not always appear in the ringworm-like shape. Ringworm of the body is called tinea corporis and is also common in children.
Other types of fungal infections include tinea of the groin (jock itch) and feet (athlete’s foot), but these occur mostly in teenagers and adults. They’re very uncommon in children.
Doctors often diagnose ringworm by a physical examination and taking a medical history.
Ringworm can be distinctive in appearance, so doctors can usually diagnose it with a physical examination. But they can also take a few scrapings of the skin and examine them under a microscope.
Some babies and infants are more likely to get ringworm than others. Risk factors include:
- living in warm climates (tinea thrive in warm, moist environments)
- being in contact with other children and/or pets that have ringworm
- being considered immunocompromised, which includes receiving treatments for cancer
- being malnourished
Occasionally, a family will bring home a new pet that may be infected with the disease, and an infant will rub their face on the pet. This can contribute to ringworm.
Treatments for ringworm depend on the severity of the ringworm itself. For example, if your child has one or two small areas of patchy, scaly skin, a doctor may prescribe a cream treatment. Examples of creams used to treat ringworm include:
- clotrimazole
- miconozole
- terbinafine (consult your doctor for use under age 12)
- tolnaftate
These creams are typically applied to your child’s skin anywhere from two to three times per day. You’ll usually apply it to the affected area, plus a circular area around it.
In addition to these treatments, your child’s pediatrician may also prescribe an antifungal shampoo if the ringworm affects the scalp, though these aren’t often effective.
If your baby’s scalp ringworm doesn’t start to clear up after a few days, or your child’s ringworm is spread on a larger portion of skin, your child’s doctor may prescribe an oral (liquid) antifungal medication.
More severe and far-reaching infections on your baby’s skin can take anywhere from four to six weeks to fully go away.
Pets can unfortunately pass ringworm to infants. Carefully watch your pet’s fur for any itching, scaling, and/or bald spot areas that could indicate ringworm. Identifying and treating their ringworm can prevent your little one from being affected.
Additionally, you shouldn’t share the following items with other children:
- barrettes
- brushes
- combs
- hair clips
- hats
If your child or another baby has ringworm, sharing these objects can easily transmit the fungal infection.
Ringworm can be an inconvenience and uncomfortable for babies, but it’s highly treatable. Through regular topical skin applications, you can help your child become ringworm-free.
Many children become reinfected, so it’s important to take preventive steps to keep your child from having it again.
“Ringworm, a fungal infection of the skin or scalp, is common in children over 3, but uncommon in infants. It’s easily treated when it affects the skin, but treatment of scalp lesions usually requires several weeks of medication taken by mouth.” – Karen Gill, MD, FAAP