The scaly, reddish and circular rash found on the skin is one of the common skin infections in people of all ages. The rash that may or may not itch is actually called Ringworm. The name Ringworm commonly misleads people into thinking that this is a type of worm infection while in fact it is a fungal infection. It is caused by a group of fungi called dermatophytes meaning “skin fungi”. These skin fungi only live on the dead layer of keratin at the top of the skin This fungal infection can be passed on from person to person by coming in contact with an infected person’s skin, or sharing of infected personal items such as combs, towels, clothes and others. Pets can also get ringworm and they too can transmit the fungal infection to humans. People can also get infected with ringworm in areas susceptible to the growth of fungi like damp and warm areas such as locker rooms or pool surfaces. There are different types of ringworm infection, each named based on their specific locations. It is also possible that one can have a number of ringworm infections at the same time.
In order to treat the skin infection, proper diagnosis must be done. A wrong medication used to treat the skin infection may not be an effective treatment and may probably make the infection worse. Usually ringworm is instantly diagnosed based on its appearance and location. If this is not the case, microscopic examination of skin scrapings and culture of the infected skin can lead to a diagnosis. Most cases of ringworm are treated with just the use of non-prescription topical antifungal medications. However, if the fungal infection does not improve with topical medications or in severe and recurrent cases, systemic antifungal medications in the form of pills may be necessary.
Ringworm treatment for humans involves the use of topical antifungals such as creams. Topical antifungals effectively clear ringworm that affects the body such as ringworm in the groin area commonly known as Jock Itch. There are however fungal infections that does not respond to topical treatments like scalp ringworm and nail ringworm. These types of ringworm require the use of systemic antifungals through oral medications.
The commonly prescribed antifungals include clotrimazole (Canesten), miconazole (Monistat), fluconazole (Diflucan), ketoconazole (Nizoral) and itraconazole (Sporanox). These antifungals belong to the azole drug family which is effective in eliminating fungal infection of the body, foot, scalp, groin and others. It works by inhibiting the enzyme that is responsible for the conversion of ergosterol. Ergosterol is the main compound in fungal cell membrane, therefore its decrease will result to the damage of the cell membrane and hence, the death of the cell. This drug class is available in a variety of brand names in both topical and oral drug preparations, over-the-counter and prescription drugs.
Terbinafine is a synthetic allylamine that is also effective in eliminating a variety of ringworm infection with almost the same mechanism as the azole drug class. It also works by inhibiting an enzyme although a different one from which the azoles are inhibiting. The enzyme squalene oxidase is also part of the synthesis of ergosterol. Terbinafine is available under the brand Lamisil, which is also available as both topical and oral drug preparations. Naftifine under the brand Naftin is also an allylamine antifungal. Its exact mechanism is unknown although it is also believed to be involved in the inhibition of sterol synthesis to bring about fungal cell death.
Griseofulvin is another commonly prescribed ringworm treatment for humans available in pill form under the brand Grisovin and others. It is an effective antifungal drug in treating ringworm of the body, feet, groin, scalp and nails. It works by preventing the fungi from multiplying and growing by inhibiting the cell division phase of the fungi and also binds to human keratin making it resistant to fungal infections.
Topical antifungals are used for at least 2 weeks to 4 weeks and oral antifungals are usually taken on at least a week to three-month duration of therapy. Clotrimazole in combination with the corticosteroid betamethasone that is prescribed for the treatment of an itching, burning or inflamed ringworm infection however should be used not more than 2 weeks due to the complications brought about by corticosteroids. Each person will vary in the exact dosage for it will depend on the age of the patient, severity of the infection and the response to the medication. Before using any antifungals, it is best to advice the health care professional of any current medical condition one has and other medications one is taking to prevent untoward side effects, complications and drug interactions. It is important that the instructions on use of antifungals are strictly followed to prevent recurrence of the fungal infection.