Red flags & when to go in person for Fungal Skin Infection (Ringworm)

Audience: pediatric

Ringworm is a common fungal skin infection that often appears as a red, itchy, circular rash with clearer skin in the middle. It can affect children of all ages and usually spreads through direct contact with infected people, animals, or surfaces. Many cases of ringworm can be treated safely at home using antifungal creams or medications. However, it is important to recognize when the infection might be more serious or when it does not improve with initial treatment. This guide helps families understand the warning signs, or "red flags," that mean a child should see a healthcare provider in person. It also explains what telemedicine can and cannot do for ringworm and offers practical steps to prepare for a virtual visit. Remember, this information is for education only and is not a substitute for professional medical advice or diagnosis.

Red flags — go in person / ER

• Rapidly spreading, painful, or swollen rash
• Presence of fever or child feeling unwell
• Rash on scalp causing hair loss or scarring

What telemedicine can do

• Identifying typical ringworm rashes from images and history
• Recommending initial antifungal treatments
• Providing advice on skin care and preventing spread
• Monitoring treatment progress remotely

What telemedicine cannot do

• Diagnosing complicated or unusual infections needing lab tests
• Treating severe infections with systemic symptoms
• Managing infections with signs of bacterial superinfection
• Performing physical examination or skin scrapings

What is Ringworm?

Ringworm is not caused by a worm but by a fungus that lives on the skin. It often looks like a round or oval patch with a red, scaly border and clearer skin in the center. It can appear anywhere on the body, including the scalp, feet, groin, and nails. Ringworm spreads easily, especially among children, through skin-to-skin contact, sharing clothes, towels, or combs, and contact with pets.

Common Symptoms in Children

Children with ringworm may have:

Symptoms usually develop within days to weeks after exposure to the fungus.

When to Seek In-Person Care (Red Flags)

Some signs mean your child should see a healthcare provider in person promptly:

These signs may require stronger treatment or further tests.

How Telemedicine Can Help

Telemedicine allows you to connect with a healthcare provider remotely, often through video or phone. For ringworm, telemedicine can:

However, telemedicine cannot replace physical examination or tests if the infection is severe or complicated.

Preparing for a Telemedicine Visit

To get the most from your virtual visit:

After the Telemedicine Visit

Follow the healthcare provider's instructions carefully. Typical steps include:

If symptoms worsen or new red flags appear, seek in-person care promptly.

How to prepare for your tele-visit

• Take clear, well-lit photos of the rash from multiple angles
• Note the start date and progression of the rash
• List any treatments used and their effects
• Prepare to describe symptoms like itching, pain, or fever
• Have the child available during the tele-visit for live examination if possible

After your tele-visit

• Use prescribed antifungal treatments exactly as directed
• Keep the affected skin clean and dry
• Avoid sharing personal items to prevent spread
• Monitor for any worsening symptoms or side effects
• Schedule follow-up visits if recommended
• Seek in-person care if red flags develop

FAQs

Can ringworm go away without treatment?

Ringworm may sometimes improve on its own, but treatment with antifungal creams or medications usually helps clear the infection faster and prevents spreading to others.

Is ringworm contagious to other family members?

Yes, ringworm is contagious and can spread through direct skin contact or sharing personal items. It's important to keep the infected area covered and avoid sharing towels, clothing, or bedding.

How long does ringworm usually take to heal?

With proper treatment, ringworm often improves within 2 to 4 weeks. If the infection lasts longer or worsens, medical advice should be sought.

Can pets give ringworm to children?

Yes, pets like cats and dogs can carry the fungus that causes ringworm and pass it to children. If you suspect your pet has ringworm, consult a veterinarian.

When should I avoid using over-the-counter treatments and see a doctor?

If the rash is very large, painful, blistering, or accompanied by fever, or if it does not improve after 2 weeks of treatment, you should see a healthcare provider in person.

Sources

1. Ringworm — MedlinePlus, U.S. National Library of Medicine.
2. Tinea (Ringworm) Infections — Centers for Disease Control and Prevention (CDC).
3. Ringworm (Tinea) — Mayo Clinic.
4. Dermatophytosis (Ringworm) — National Library of Medicine.

This telemedicine guidance is for educational purposes only and is not a substitute for in-person medical care. If your child shows any red flags or if symptoms worsen, seek prompt evaluation by a healthcare professional.