When you get a red circular rash on your skin, you must first make sure whether it’s Ringworm or not. For that, you need to be aware of the characteristic features, types, and symptoms of Ringworm.
What Is Ringworm? Types And Symptoms
Ringworm, otherwise known as “tinea corporis” or “dermatophytosis” is a common fungal skin infection. It is caused by a class of fungi called dermatophytes that feed on the dead cells of the skin, hair, and nails and tend to thrive in the warm, moist folds of the skin (3). Ringworm infection causes a characteristic ring-like circular rash that is red and itchy. The rash can have a red-colored center or a normal one of your skin color. Ringworm is further classified as per its location on the body.
Tinea capitis
Ringworm of the scalp is known as Tinea capitis. It is usually seen in children in their growing years or around adolescence. It usually appears as scaly patches of balding spots on the scalp with a loss of hair. This ringworm might commonly spread from one child to another in their school (4).
Tinea pedis
Commonly known as ‘Athlete’s foot’, Tinea pedis is the ringworm infection of the foot that causes scaling and inflammation in between the toes, especially the last two. It usually causes redness, itching, and burning sensation on the sole of the feet as well (5).
Tinea manum
This affects the skin of the hand, especially in between the fingers. It usually leads to thickening of the skin in between the fingers (6). Tinea manuum is usually accompanied by Tinea pedis.
Tinea unguium
Ringworm of the nails is also a common occurrence. It causes the fingernails to look thick, white, opaque, and brittle, while the toenails appear yellow, thick, and brittle (7).
Tinea barbae
This fungal infection of the beard on the face and neck results in swelling and marked crustings, often resulting in hair breakage (8). It was also commonly known as barber’s itch in earlier days when people used to visit the barber for haircuts and shave.
Tinea faciei
Ringworm on the face, other than the beard, is known as Tinea faciei. It usually occurs as red scaly patches without a defined ring, and that might cause difficulty in its diagnosis (9).
Tinea cruris
Commonly known as ‘Jock’s itch’, the tinea in the folds of the groin area usually appears as reddish-brown patches and might extend further down to the inner thighs (10). It is usually caused due to sweating or wearing tight clothes and can easily be confused with other yeast infections or psoriasis. Ringworm is contagious and is often spread through contact. Household items, shared linen, or even pets and animals can transfer this fungal infection from one person to another.
If It’s Not Ringworm, Then What Else Could It Be?
A ring-like circular rash similar to ringworm, in certain cases, might get diagnosed as some other skin condition. Since these would require a different line of treatment, it is vital to get the correct diagnosis done in consultation with your medical practitioner (2). A few of the skin conditions that commonly mimic ringworm are as follows:
Pityriasis rosea
Pityriasis rosea is a common and benign rash that appears red, scaly, and itchy. It typically starts as one single large spot known as the ‘herald patch’ on the back, chest, or abdomen, and is then commonly followed by more small patches or bumps in a pattern that resembles a pine tree (11, 12). It is, in the absence of this big red circle on skin, when the diagnosis might get difficult. It usually resembles ringworm and you might feel unwell for a day or two before it shows up. Human Herpes Virus (HHV-7 and HHV-6) have been implicated as the causative agent in most cases but the cause remains largely unclear (13).
Contact Dermatitis
Contact dermatitis is a kind of eczema that is usually formed as an allergic reaction when the skin comes in contact with certain irritants in soaps and cosmetics, detergents, or materials like metals or latex (14). It can also refer to the more common ‘diaper rash’ or the skin peeling and cracking due to excessive handwash. Since Contact dermatitis causes patches of thickened scaly skin, it tends to get confused with ringworm easily.
Nummular Eczema
Nummular eczema is another skin condition that is commonly mistaken as ringworm. ‘Nummular’ means ‘coin’ in Latin and this rash is known to appear as coin-shaped patches of dry and scaly skin with variable levels of itching and burning sensation. Bug bites, medications, and contact with metals such as nickel are known to be common triggers. It is usually aggravated by soaps, cosmetics, and abrasive fabric like wool (15).
Granuloma Annulare
Another common ringworm-like skin condition that appears as raised, flesh-colored rings is Granuloma annulare. It may show up on any part of the body and are most often these bumps are localized in one area. The patches may look red to start with but that disappears once the ring forms. The rings could be ¼ of an inch- 2 inches in diameter. There is usually no itching or scaling. While the exact cause has not been established yet, in certain cases, it is associated with diabetes, thyroid, and trauma (16).
Psoriasis
Psoriasis is an auto-immune condition in which the immune system attacks its skin cells, leading to hyperproduction and inflammation. New skin cells get overproduced before the old ones can be shed off resulting in thick, scaly inflamed skin patches. These might itch or get sore with bleeding when scratched. This chronic condition is usually triggered by stress, medications, infections, environmental factors, or injury (17). Since Psoriasis resembles a few other skin conditions, and a blood test can’t establish the same, a skin biopsy might be prescribed for a confirmed diagnosis.
Lyme Disease
Lyme disease is caused due to tick bites and is usually manifested early on as a round red rash (shaped like a bull’s eye) called erythema migrans. This is a classic symptom found in over 70% of the cases and treatment is usually started just based on the same (18). Typically, it occurs as one lesion but in some cases, people might also have multiple lesions. The rash usually appears after 7-14 days but can show up as early as 3 days or as later as 32 days. The rash tends to expand in size without proper treatment. Early diagnosis and treatment help prevent the chronic effects that are usually seen later on in the disease.
When To See A Doctor?
Rashes on the skin tend to resolve on their own in little time. But it is important to get a professional opinion when they take more time to resolve or you notice any unusual changes. Even though a red circular rash is characteristic of Ringworm, occasionally, it could be something more serious. It is always better to get a rash examined by a doctor, to be able to follow the correct line of treatment.
Treatment For Red Circles On Skin
When you get a red circular rash on your skin, it is important to establish whether it is Ringworm or any of the other skin conditions mentioned above. This can only be done through proper diagnosis by your Dermatologist. Based on the diagnosis, the line of treatment would then vary accordingly. Ringworm or most Tinea infections are superficial fungal infections that can usually be treated with topical antifungal creams, lotions, or powders in about 2-4 weeks. Non-prescription OTC products like Clotrimazole, Miconazole, Terbinafine, Ketoconazole can be helpful in treating Ringworm by following the dosage instructions on the package. You would need to get in touch with your dermatologist if the infection seems to be getting worse. (19) Oral antifungals might then be prescribed to resolve the infection better. In rashes like contact dermatitis, eczema, and Lyme disease that are caused by external factors (chemical irritants, allergens, or micro-organisms), it is helpful if one can identify and remove the triggers from the surroundings. These are usually treated with alcohol-free moisturizers, warm baths, topical corticosteroids, antihistamines, and antibiotics. Pityriasis Rosea is usually treated with topical steroids or antihistamines, to reduce the itchiness and discomfort in general (20) Any rash that’s caused due to internal causes would require a more intensive treatment rather than just topical creams and lotions. For instance, Psoriasis can sometimes resolve on its own but most often, is managed with topical steroids, Immunosuppressants, and UV light therapy (21). In the case of Granuloma annulare, the rings often disappear on their own in a few months and may not require any treatment. But sometimes, these lesions might get widespread and require medical consultation for a more intensive line of treatment. In all the above, the doctor can also help diagnose if the rash involves any other kind of infection or potential complications and might prescribe antibiotics or other lines of treatment as deemed suitable.
Can stress cause red circles on the skin? Stress may cause rashes on the skin (called hives). It may also worsen existing conditions like eczema or psoriasis. What does a bacterial circle rash look like? The bacterial rash will have a red center surrounded by a clear ring of red bumps.
