Fungal Skin Infections: Ringworm, Athlete's Foot, and Jock Itch

You've got an itchy, red, circular rash. Or maybe your feet are peeling and burning between the toes. Or there's an uncomfortable rash in your groin that won't go away. Welcome to the world of fungal skin infections - incredibly common, annoying, but usually easy to treat.

The same types of fungi cause ringworm, athlete's foot, jock itch, and nail infections. Despite the name "ringworm," there are no worms involved - just microscopic fungi that love warm, moist environments.

Let's break down the most common fungal infections, how to treat them, and how to prevent them from coming back.

What It Feels Like

Fungal infections vary by location but share common features:

Ringworm (Tinea Corporis):

• Circular, ring-shaped rash with raised, scaly border
• Clearer (sometimes slightly lighter) center
• Red or pink on light skin, darker on darker skin
• Itchy, sometimes burning
• Can appear anywhere on body
• May start as small spot and expand outward

Athlete's Foot (Tinea Pedis):

• Itching, burning, or stinging between toes (most common) or on soles
• Peeling, cracking, scaling skin
• Redness and inflammation
• Sometimes blisters
• Unpleasant odor in some cases
• Can spread to toenails

Jock Itch (Tinea Cruris):

• Red, itchy rash in groin, inner thighs, or buttocks
• Raised, scaly border with clearer center (ring pattern)
• Burning sensation
• Worse with friction from clothing or physical activity
• May spread to surrounding areas

Nail Fungus (Onychomycosis):

• Thickened, discolored nails (yellow, white, or brown)
• Brittle, crumbly, or ragged nails
• Distorted nail shape
• Nails may separate from nail bed
• Usually painless but can become uncomfortable

Scalp Ringworm (Tinea Capitis):

• Scaly, itchy patches on scalp
• Hair loss in affected areas
• Broken hair shafts
• Sometimes painful, swollen areas
• More common in children

Common Causes

Fungal infections are caused by dermatophytes - fungi that feed on keratin in skin, hair, and nails.

How You Get Them

Direct contact:

• Person-to-person (touching infected skin)
• Animal-to-person (cats, dogs, farm animals can carry ringworm)
• Contaminated objects (towels, clothing, bedding, combs)

Environmental exposure:

• Walking barefoot in locker rooms, pools, showers (athlete's foot)
• Warm, moist environments (gyms, saunas)
• Contaminated surfaces

Risk Factors

Moisture and warmth:

• Sweating heavily
• Tight, non-breathable clothing
• Wet feet for extended periods
• Hot, humid climates

Close contact:

• Contact sports (wrestling, football)
• Crowded living conditions
• Sharing personal items

Weakened immune system:

• Diabetes
• HIV/AIDS
• Cancer treatment
• Immunosuppressive medications

Other factors:

• Poor hygiene
• Previous fungal infections
• Obesity (skin folds create warm, moist environment)
• Peripheral vascular disease

When to See a Doctor

Most fungal infections respond to over-the-counter treatments, but see a doctor if:

• Infection doesn't improve after 2-4 weeks of OTC treatment
• Infection is severe or spreading rapidly
• You have diabetes (fungal infections can lead to complications)
• Scalp or nail infection (these typically need prescription meds)
• Signs of bacterial infection (increased redness, warmth, pus, fever)
• You have a weakened immune system
• Infection keeps coming back

Treatment and Management

Over-the-Counter Antifungals

For ringworm, athlete's foot, and jock itch, start with OTC antifungal creams, ointments, lotions, or powders:

Common OTC antifungals:

• Clotrimazole (Lotrimin)
• Miconazole (Micatin)
• Terbinafine (Lamisil)
• Tolnaftate (Tinactin)
• Butenafine (Lotrimin Ultra)

How to use:

• Apply as directed (usually 1-2 times daily)
• Continue for full duration - typically 2-4 weeks
• Keep applying for 1-2 weeks after symptoms clear (fungi may still be present)
• Clean and dry affected area before applying
• Wash hands before and after application

Important: Don't stop treatment when symptoms improve. Stopping too early allows infection to return.

Prescription Treatments

Stronger topical antifungals: For infections not responding to OTC options.

Oral antifungals:

• Terbinafine (Lamisil)
• Itraconazole (Sporanox)
• Fluconazole (Diflucan)

Required for:

• Scalp ringworm (always needs oral medication for 1-3 months)
• Nail infections
• Widespread or severe infections
• Infections not responding to topical treatment

Treatment duration:

• Skin infections: 2-4 weeks
• Scalp infections: 1-3 months
• Nail infections: 6-12 weeks (sometimes longer)

Important Warnings

Do NOT use steroid creams (hydrocortisone, betamethasone) for fungal infections. Steroids may temporarily reduce itching but make the fungal infection worse and harder to treat. Many people mistakenly use steroid creams thinking they'll help - they won't.

Additional Measures

For athlete's foot:

• Keep feet clean and dry
• Dry thoroughly between toes after bathing
• Wear moisture-wicking socks
• Change socks daily (or more if sweaty)
• Alternate shoes - don't wear same pair daily
• Wear shower shoes in public areas
• Antifungal powder in shoes

For jock itch:

• Wear loose, breathable underwear (cotton or moisture-wicking)
• Change underwear daily
• Shower immediately after sweating
• Dry groin area thoroughly after bathing
• Avoid tight jeans or athletic wear for extended periods
• Wash athletic supporters/cups regularly

For ringworm:

• Wash bedding, clothing, towels in hot water
• Vacuum carpets and furniture
• Disinfect hard surfaces
• Isolate infected pets and treat (vet visit needed)
• Avoid sharing personal items

Prevention

Personal hygiene:

• Shower daily, especially after sweating
• Dry skin thoroughly, especially skin folds
• Change sweaty clothes promptly
• Wear clean, dry clothes

Footwear:

• Don't walk barefoot in public areas (pools, locker rooms, showers)
• Wear shower shoes or flip-flops
• Choose breathable shoes
• Alternate shoes to allow drying
• Antifungal powder if prone to athlete's foot

Clothing:

• Wear loose, breathable fabrics
• Moisture-wicking materials for exercise
• Change underwear and socks daily
• Wash gym clothes after each use

Avoid spreading:

• Don't share towels, clothing, or personal items
• Wash hands after touching infected areas
• Keep infected areas covered
• Treat pets with ringworm (and yourself)
• Disinfect contaminated surfaces

For recurrent infections:

• Treat underlying risk factors (diabetes control, weight management)
• Consider preventive antifungal powder
• Address moisture issues (better ventilation, absorbent clothing)
• Strengthen immune system

Living with Recurrent Infections

Some people are prone to fungal infections. If yours keep coming back:

Identify the source:

• Re-infection from untreated family members or pets
• Contaminated shoes, clothing, or environment
• Underlying health issues

Long-term prevention:

• Regular use of antifungal powder
• Strict hygiene practices
• Treating all family members simultaneously
• Replacing shoes and personal items that may be contaminated

Maintenance therapy:

• Some people benefit from periodic antifungal treatment
• Discuss with your doctor if infections recur frequently

The Bottom Line

Fungal skin infections are common, contagious, and annoying - but they're also very treatable. Most cases respond well to over-the-counter antifungals if you use them correctly (full duration, even after symptoms clear).

The key to successful treatment is consistency and prevention. Treat the full course, address moisture and hygiene issues, and take steps to prevent reinfection.

If OTC treatments aren't working after 2-4 weeks, see a doctor for stronger medication. Scalp and nail infections always need prescription treatment.

With proper treatment and prevention, you can clear fungal infections and keep them from coming back.

References

1. CDC - Treatment of Ringworm and Fungal Nail Infections
2. Cleveland Clinic - Ringworm (Tinea Corporis): What It Looks Like, Causes & Treatment
3. Johns Hopkins Medicine - Tinea Infections (Ringworm)
4. MedlinePlus - Tinea infections | Ringworm | Jock itch
5. Cedars-Sinai - Tinea Infection medical information
6. UpToDate - Patient education: Ringworm (including athlete's foot and jock itch)