Are you up to scratch?

14th January 2005 at 00:00
Ringworm may be common and highly contagious, but it's relatively easy to prevent and treat, writes Jill Wyatt

Ringworm: it's not as nasty as it sounds. Without doubt, a healthy immune system is a distinct advantage for teachers who face a daily onslaught from the various bacteria, viruses and fungi that thrive in the closed confines of a classroom. But while only the lucky few will escape sniffing, wheezing and coughing their way through the winter months along with their charges, not all childhood ailments are as infectious as the common cold.

For example, the fungi that cause the skin infection tinea - more commonly known as ringworm - seem to prefer children to adults, although not exclusively. Research suggests that the risk of transmission is low in schools but moderate within families - you need to be exposed to it for a prolonged period.

Children with weak immune systems (for example, those suffering from diabetes, cancer and HIV) are particularly prone to infection.

Ringworm sounds quite unpleasant, but it has nothing to do with worms burrowing their way in or out of the skin. Its name derives from the red ring that often appears on an infected person's body.

How do I know if I've got it?

Various organisms from a group called "dermatophytes" cause ringworm in different parts of the anatomy, including the body (Tinea corporis), the scalp (Tinea capitis) and the feet (Tinea pedis).

The first sign of ringworm on the scalp may be something that looks like severe dandruff and which may be mistaken for psoriasis. Sometimes scaly patches appear and cause temporary baldness. Infected hairs will become brittle and break off easily. A more severe infection can cause painful pustules on the scalp and swelling of glands in the neck.

Ringworm on the body shows itself as a flat, round and often itchy patch anywhere on the skin, except for the scalp and feet. It is particularly commonin the groin area. The rash expands and then clears at the centre to produce a red ring. One or more patches can appear and these sometimes overlap.

Athlete's foot is also a form of ringworm. It causes scaling or cracking of the skin, especially between the toes, while nails affected by ringworm become thicker, discoloured, chalky or brittle.

Ringworm may seem simple to self-diagnose, especially if the classic round, red lesion with a ring of scale around the edges is present. But it is far safer to seek confirmation and treatment by a doctor.

How do Icatch it?

The infection can be spread by direct skin-to-skin contact with an infected person. If someone with ringworm touches or scratches the rash, the fungus sticks to the fingers or gets under the fingernails. The fungus can then spread when that person touches someone else.

It can also be passed on from pets, and cats are often carriers. Objects or surfaces that an infected person or pet has touched - such as hats, combs, brushes, bed linen and so on - are potential sources of infection.

Can it be prevented from spreading?

Prevention is better than cure, but that's not easy since the fungus is very common. In theory, ringworm is contagious even before symptoms appear (4 to 14 days after contact, depending on the type).

Make sure children wash their hands regularly and that they have good personal hygiene. Make sure all infected persons and pets get appropriate treatment and avoid contact with infected persons and pets.

You should also avoid sharing any personal items and keep all areas of common use such as showers and gyms as clean as possible.

To prevent the spread of infection, make sure children who have athlete's foot do not walk around without shoes and socks on. They can continue to go swimming as long as they keep flip-flops or other suitable footwear within easy reach to wear around the pool.

An outbreak of ringworm should not be a cause for alarm. Indeed, most schools do not include it in the list of infections that justify the exclusion of pupils, although a few do request that parents keep children at home until treatment has started.

How do I get rid of it?

Ringworm is treated with a fungus-killing medicine such as griseofulvin, which can be taken in tablet or liquid form by mouth, or topical cream.

For athlete's foot, you can buy anti-fungal creams, powders and sprays that contain an azole drug: clotrimazole (Canesten), econazole (Ecostatin or Pevaryl), miconazole (Daktarin) and sulconazole (Exelderm).

You can buy most of the above treatments over the counter at any chemist's.

If these don't work, then you need to see a doctor to confirm the precise nature of the infection.

FAST FACTS

* Ringworm is widespread around the world - anyone can get it.

* This contagious fungal infection can affect the scalp, body, feet, or the nails on fingers and toes.

* The fungi that cause ringworm feed on the dead skin and hair cells.

* Symptoms include an itchyflaky rash that may have a ring-shape with a raised edge.

* It is spread by either direct or indirect contact with an infected person or pet or their belongings (and very occasionally through soil).

* Scalp ringworm usually appears 10 to 14 days after contact. It can be treated with fungus-killing medicine taken in tablet or liquid form by mouth or as a cream applied directly to the affected area.

* Ringworm is hard to prevent and mildly unpleasant to suffer from, but won't do any lasting damage to your health.

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