Skin Ringworm (Child)
Ringworm is a skin infection caused by a fungus. It's not caused by a worm. Ringworm is contagious. It can be spread by contact with people or animals infected with the fungus. It can also be spread by contact with an object that is contaminated by an infected person or animal.
A ringworm infection causes a red, ring-shaped patch on the skin. The rash may be small or a couple of inches across. The ring is often clear in the center with a scaly, red border. The area is dry, scaly, itchy, and flaky. There may also be blisters. These can ooze clear or cloudy fluid (pus). It can be diagnosed by the appearance of the rash. Or a scraping may be taken for testing.
Ringworm is most often treated with an antifungal cream. It may take a week before the infection starts to go away. It may take a few weeks to clear completely. In severe cases, when the infection is gone, the skin may have scarring.
Home care
Your child’s healthcare provider may prescribe a cream to kill the fungus. Or you may be told to buy a cream at the drugstore. Some creams are available without a prescription. Ask the pharmacist for help choosing the right over-the-counter medicine. You may also be advised to use medicine to help ease itching. Follow all instructions for using any medicine on your child. In difficult cases, particularly those involving hair follicles, medicines by mouth may also be needed to treat the infection.
General care
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If your child was prescribed a cream, apply it exactly as directed. Be sure to not touch the rash. Wash your hands with soap and clean, running water for at least 20 seconds before and after applying the cream. This is to help prevent spreading the fungus.
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Make sure your child does not scratch the affected area. This can delay healing and may spread the infection. It can also cause a bacterial infection. You may need to use “scratch mittens” that cover your child’s hands. Keep the child's fingernails trimmed short.
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If there are blisters, apply a clean compress dipped in Burow’s solution (aluminum acetate solution). This is available in stores without a prescription. Use disposable cloths or wash the cloth well after use. This keeps the infection from spreading.
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Wash any items such as clothing, blankets, bedding, or toys that may have touched the infection.
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Apply wet compresses to the rash to help ease itching. Wash these before reusing. This keeps the infection from spreading.
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Check your child’s skin every day for the signs listed below.
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Have your child take antifungal medicine for as long as it's prescribed. The infection may become hard to clear up if the medicine is stopped too soon or used incorrectly.
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If a skin treatment (topical) is prescribed, use it everywhere the ringworm is found for the treatment to work.
Special note to parents
Ringworm of the skin is very contagious. Keep your child from close contact with others and out of day care or school until treatment has been started unless the rash can be covered completely. Any child with ringworm should not take part in gym or other close contact activities that are likely to expose others until after treatment has begun or the rash can be completely covered. Athletes should follow their healthcare provider's recommendations and the specific sports league rules for returning to practice and competition. Wash your hands well with soap and clean, running water before and after caring for your child. Teach all other people in the house to follow the same hand washing technique. This is to help prevent spreading the infection.
Follow-up care
Follow up with your child’s healthcare provider, or as advised.
When to seek medical advice
Call your child’s healthcare provider right away if any of these occur:
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Your child has a fever (see “Fever and children” below)
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Rash that does not improve after 10 days of treatment
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Rash that spreads to other areas of the body
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Redness or swelling that gets worse
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Fussiness or crying that can’t be soothed
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Bad-smelling fluid leaking from the skin
Fever and children
Use a digital thermometer to check your child’s temperature. Don’t use a mercury thermometer. There are different kinds and uses of digital thermometers. They include:
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Rectal. For children younger than 3 years, a rectal temperature is the most accurate.
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Forehead (temporal). This works for children age 3 months and older. If a child under 3 months old has signs of illness, this can be used for a first pass. The provider may want to confirm with a rectal temperature.
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Ear (tympanic). Ear temperatures are accurate after 6 months of age, but not before.
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Armpit (axillary). This is the least reliable but may be used for a first pass to check a child of any age with signs of illness. The provider may want to confirm with a rectal temperature.
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Mouth (oral). Don’t use a thermometer in your child’s mouth until they are at least 4 years old.
Use the rectal thermometer with care. Follow the product maker’s directions for correct use. Insert it gently. Label it and make sure it’s not used in the mouth. It may pass on germs from the stool. If you don’t feel OK using a rectal thermometer, ask the healthcare provider what type to use instead. When you talk with any healthcare provider about your child’s fever, tell them which type you used.
Below are guidelines to know if your young child has a fever. Your child’s healthcare provider may give you different numbers for your child. Follow your provider’s specific instructions.
Fever readings for a baby under 3 months old:
Fever readings for a child age 3 months to 36 months (3 years):
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Rectal, forehead, or ear: 102°F (38.9°C) or higher
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Armpit: 101°F (38.3°C) or higher
Call the healthcare provider in these cases:
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Repeated temperature of 104°F (40°C) or higher in a child of any age
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Fever of 100.4° F (38° C) or higher in baby younger than 3 months
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Fever that lasts more than 24 hours in a child under age 2
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Fever that lasts for 3 days in a child age 2 or older