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Tinea Infections (Ringworm)

What are tinea infections?

Different fungi, depending on their location on the body, cause ringworm. It is caused by a fungal infection—not an actual worm. Fungi on the skin, hair, and nail bed are called dermatophytes. Also referred to by healthcare providers as Tinea infections, infection on the scalp, arms, legs, face, and trunk is characterized by ring-shaped, red, scaly patches with clearing centers. Tinea infections of the feet, nails, and genital areas are not generally referred to as ringworm, as they may not take on the typical ring shape. There is an increased risk of contracting ringworm and other tinea infections if a person:

  • Is malnourished

  • Has poor hygiene

  • Lives in a warm climate

  • Has contact with other people or pets that have ringworm

  • Is immunocompromised by disease or medicine

  • Plays contact sports, such as wrestling 

  • Uses communal baths or locker rooms 

What are the most common types of tinea infections?

The most common types of ringworm include the following:

  • Athlete's foot (tinea pedis). This common condition mostly affects teen and adult males. It affects children before puberty less often. Contributing causes include sweating, not drying the feet well after swimming or bathing, wearing tight socks and shoes, and warm weather conditions. Symptoms of athlete's foot may include:

    • Whitening of the skin between the toes

    • Scaling of the feet

    • Itchy rash on the feet

    • Blisters on the feet

  • Jock itch (tinea cruris). Ringworm may be hard to cure. This condition is also more common in males and happens more often during warm weather conditions. It is very rare in females. Symptoms of jock itch may include:

    • Red, ring-like patches in the groin area

    • Itching in the groin area

    • Pain in the groin area

    • Does not usually involve the scrotum

  • Scalp ringworm (tinea capitis). Scalp ringworm is highly contagious, especially among children. It happens mainly in children between the ages of 2 to 10. It rarely happens in adults. Symptoms of scalp ringworm may include:

    • Red, scaly rash on the scalp

    • Itching of the scalp

    • Hair loss on the scalp

    • Rash elsewhere on the body

    Ringworm of the scalp can also develop into a kerion, a large, tender lesion over the area of the initial ringworm. This is caused by a hypersensitivity to the ringworm and may be associated with a rash elsewhere and tender lymph nodes in the neck.

  • Nail infection (tinea unguium). An infection of the finger or toe nail, this type is characterized by a thickened, deformed nail. This condition more often affects the toenails than the fingernails. It happens more often in adolescents and adults rather than young children. Symptoms of nail ringworm may include:

    • Thickening of the ends of the nails

    • Yellow color to the nails

  • Body ringworm (tinea corporis). This skin infection is characterized by a ring-like rash anywhere on the body or the face. It happens in all ages, but is seen more often in children. It is more common in warmer climates. The symptoms of body ringworm may include:

    • Red, circular lesion with raised edges

    • The middle of the lesion may become less red as the lesion grows

    • Itching of the affected area

The symptoms of ringworm may resemble other skin conditions. Always talk with your healthcare provider for a diagnosis.

How is ringworm and other tinea infection diagnosed?

Ringworm is usually diagnosed based on a medical history and physical exam. The lesions of ringworm are unique, and usually allow for a diagnosis simply on physical exam. In addition, your healthcare provider may order a culture or skin scraping of the lesion to confirm the diagnosis.

Treatment for ringworm and other tinea infection

Ringworm may be hard to cure. Specific treatment will be discussed with you by your healthcare provider based on:

  • Your age, overall health, and medical history

  • Extent of the condition

  • Location of the ringworm

  • Your tolerance for specific medicines, procedures, or therapies

  • Expectations for the course of the condition

  • Your opinion or preference

Treatment for scalp ringworm (tinea capitis) or nail infection (tinea unguium) is hardest to treat and usually includes an oral antifungal medicine for many weeks. Some people need longer treatment. Treatment for scalp ringworm may also involve the use of a special shampoo, to help eliminate the fungus. If a kerion is present (a large, tender, swollen lesion) or you have developed a secondary abscess or bacterial infection, your healthcare provider may order additional medicines, such as steroids, to help reduce the swelling.

Treatment for ringworm of the body, groin, and foot is usually a topical antifungal agent or an oral antifungal medicine. The length of the treatment depends on the location of the ringworm. Because the fungi can live indefinitely on the skin, recurrences of ringworm are likely. Treatment may need to be repeated.

If you have ringworm symptoms, see your healthcare provider for treatment recommendations. It is important to note that common home remedies do not effectively treat this condition. 

Medical Reviewers:

  • Goode, Paula, RN, BSN, MSN
  • Lehrer, Michael Stephen, MD