Ringworm on Black skin might appear brown or gray rather than red or pink. Black people, especially children, are more likely to get ringworm on their scalp than other groups.
Ringworm (tinea) is a contagious fungal infection that affects the skin, nails, and scalp. Various fungi can cause ringworm. Despite its name, it is not a worm.
Ringworm is typically itchy. When left untreated, ringworm can spread, leading to secondary bacterial infections caused by scratching. Untreated ringworm can also cause nail deformity and hair loss.
Ringworm rash can appear differently on Black skin than on white skin. This may result in misdiagnosis and delayed treatment for People of Color.
This article details what ringworm looks like on Black skin and the areas of the body most likely to be affected. It also covers how to treat ringworm.
Ringworm causes a small, ring-shaped rash to appear 4 to 14 days after infection. The rash can look circular or like a flat patch with a raised, scaly border. The ring shape is what gives the condition its name.
Untreated, a ringworm rash slowly gets bigger. It may also change shape.
On less-pigmented skin, ringworm tends to look pink or red. But on darker skin, ringworm patches can look brown or gray. The outside raised border may be darker than the inside patch.
The skin may also take on a scaly or cracked appearance.
You can get ringworm anywhere on your body or scalp. The infected area determines the name of the infection.
Locations for ringworm infections include:
Scalp (tinea capitis)
Ringworm of the scalp is a common form of this infection in People of Color. African American and Hispanic children are the most affected demographics for tinea capitis.
Sharing hair accessories such as combs and brushes is a common form of transmission between children.
Like all types of ringworm, tinea capitis can be extremely itchy. The following may also occur:
- bald spots
- dry, flaky skin
- broken or fragile hairs
- open sores
Untreated ringworm of the scalp can result in severe inflammation and permanent hair loss.
Feet (tinea pedis)
Tinea pedis, aka athlete’s foot, can cause severe itching and scaling, especially between your toes. In People of Color, it can look like a grayish-brown rash on the feet. Peeling skin and blisters within ringworm patches can also form.
The fungus that causes tinea pedis lives in damp areas, like public showers and locker rooms.
Nails (tinea unguium)
Tinea unguium (nail fungus) most commonly affects toenails but can also affect fingernails. It can cause nails to thicken. Ragged nail edges and a crumbly, brittle texture are also common symptoms.
Hands (tinea manuum)
You can inadvertently spread ringworm to your hands by touching or scratching an infected area, such as your feet or groin. It can also be passed to another by touching a person or animal with ringworm.
Tinea manuum usually starts on just one hand. An untreated infection can spread to fingers and the backs of hands.
Ringworm on hands can cause itching and peeling skin. In People of Color, the rash that forms can look brownish or grayish.
Groin (tinea cruris)
Tinea cruris, aka jock itch, is more likely to affect adolescents and teens assigned male at birth than children or older people. On Black skin, jock itch can cause a grayish-brown rash to form in the groin area and skin folds of the inner thighs. This rash may burn and itch.
Risk factors for jock itch include:
- obesity
- tight clothing
- excessive sweating
- diabetes
Beard (tinea barbae)
This rare form of ringworm affects the skin and hair of the face, chin, and upper neck, where beards and mustaches grow.
Historically, animals were the greatest source of transmission for this rare form of ringworm. People who worked with farm animals or livestock were at the greatest risk. But
Because it is rare, people sometimes mistake tinea barbae for more common bacterial infections. When misdiagnosed or left untreated, beard ringworm can spread into hair follicles, causing inflammation, scarring, and hair loss.
Getting a diagnosis of ringworm before treatment will help ensure that you use the right type of medication.
A healthcare professional may diagnose ringworm by assessing the appearance of the rash. They may take a small skin scraping to confirm the diagnosis. If ringworm affects the scalp or beard, they may also send a hair sample for analysis.
It can be helpful to see a dermatologist with expertise in treating skin of color because they may be able to recognize the condition more quickly. Only about 3% of dermatologists in the United States are Black. The Black Derm Directory can help you locate one.
Representation matters
A 2020 study found that less than 5% of images in medical textbooks showed dark skin. When healthcare professionals don’t receive adequate training on what conditions look like on skin of color, they may be more likely to misdiagnose a condition.
Ringworm treatments are the same for all skin types, including Black skin. The location of the infection, not skin tone, determines the type of treatment needed.
Since a fungus causes ringworm, you’ll need antifungal medications to clear up the infection.
Minor ringworm rashes on the skin may clear up with the use of over-the-counter (OTC) topical antifungal medications. If OTC treatments don’t work, you may have a different condition. Or, you may need a stronger prescription antifungal medication.
If the rash is large or has spread to multiple areas of the body, you may need prescription topical or oral medications.
Treatment for toenail fungus typically needs prescription-strength medication.
Treating ringworm of the scalp or beard involves prescription oral antifungal medications. A dermatologist might also recommend an antifungal shampoo.
It can take a month or longer for ringworm to resolve completely. If a doctor has prescribed medication, be sure to follow the instructions exactly and take it for as long as prescribed.
Learn about home remedies for treating ringworm.
Are Black people more likely to get ringworm in certain locations?
Anyone can get ringworm. But Black people are more likely to get ringworm of the scalp (tinea capitis) than other demographic groups. Children are particularly vulnerable to this condition.
The fungal species most likely to cause tinea capitis are Microsporum and Trichophyton.
Does ringworm affect Black people differently?
Ringworm affects all skin types in the same way. But Black and darker-skinned people may have a delay in getting a diagnosis if a healthcare professional doesn’t recognize the condition or test for it. When this occurs, complications such as secondary infections and hair loss may result.
Does ringworm leave a scar on dark skin?
It can. Ringworm scarring may occur if you don’t treat the infection fully or promptly. Scarring on black skin can be darker than the surrounding skin.
You may be able to prevent ringworm by following these tips:
- Wash your hands frequently and thoroughly, especially after touching animals.
- Keep your skin, hair, and beard clean and dry.
- Don’t share hair accessories or tools.
- Wear water-resistant footwear around pools, public showering facilities, and locker rooms.
- If you get manicures and pedicures, go to salons that use only sterilized equipment.
- Don’t wear sweaty clothing or socks for prolonged periods.
Ringworm is a fungal infection that can cause a ring-like rash. This rash can look different on Black or highly pigmented skin than on light skin. On Black skin, ringworm may cause a brownish-gray rash.
Some healthcare professionals may not recognize ringworm on Black skin. To avoid the spread of ringworm or complications, It’s important to get an accurate diagnosis and treatment promptly.