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How fungal infection evolves in the skin

Understanding Ringworm: How the Infection Takes Hold 

Ringworm, despite its name, isn't caused by a worm. It's a fungal infection of the skin, formally

known as dermatophytosis. These fungi, called dermatophytes, thrive on keratin, a protein

found in your skin, hair, and nails. Dermatophytes have the ability to invade hair, nails and skin

of living hosts.

Hello all, I am Dr. Karma Patel, a dermatologist having expertise in diagnosing and treating

ringworm infection online. I am passionate about diagnosing and treating patients through


You can consult on neodermatologist.com if you are having itching in inner parts, having

ringworm skin infection with a dermatologist online. We are a team of board-certified

dermatologists experienced in diagnosing and treating ringworm infection online.

All you need to do is log into neodermatologist.com. Select the Itching In Inner Parts service

where we provide you with 2 types of consultation services namely basic and premium. Fill up

your history form, upload the photographs of the affected area and book an appointment with

us. We are fast to reply, we are ready to take the 20 minute challenge. Basic consultation

service offers photographic consultation with a dermatologist whereas in premium consultation

you get an opportunity to use the features such as video conferencing where you can talk to

dermatologist on a video call. A dermatologist can take your medical history and also examine

the affected area if required, before putting the diagnosis and prescribing treatment.

In this blog, we will focus on what ringworm infection is, its common types, ringworm

symptoms and how it evolves into the skin.

Common types of ringworm disease include:

Tinea corporis: Ringworm on the body.

Tinea capitis: Ringworm of the scalp, often causing hair loss.

Tinea pedis: Athlete's foot, affecting the feet.

Tinea cruris: Jock itch, affecting the groin area.

Tinea faciei: Ringworm infection of glabrous skin of face (non bearded)

Now let’s discuss different ringworm stages.

The Stages of Infection

1. Exposure and Colonization: Ringworm disease spreads through direct contact with

an infected person, animal, or contaminated objects like clothes, bed sheets or towels.

trauma , maceration and increased hydration of skin promotes inoculation of pathogenic

fungi. The microscopic fungal spores land on your skin and begin to colonize.

2. Initial Invasion: Infection occurs when the viable hyphae are deposited on the surface

of the host. After 12 hours of inoculation spores and stratum corneum (the outer layer of

the skin) adherence occurs, and by 24 hours extracellular initial growth of germ tubes

occurs. By the third day itself the invasion of the outer stratum corneum takes place.

The dermatophytes use enzymes to break down the keratin in your outer skin layer (the

stratum corneum). The initial breakdown of the proteins changes the skin pH from acidic

to alkaline, which in turn activates more enzymes for the maintenance of the infection.

Penetration of fungal elements is much faster at 35 degree celsius and it also requires

90% humidity for the penetration into stratum corneum. This initial invasion sometimes

causes no symptoms at all, and you may be unaware you are infected.

There are two factors which are important in determining the size and duration of the lesion

once the infection is established. The first is the growth rate of the organism and second

epidermal turnover rate.

3. Inflammation and the Classic Ring: As the fungi spread outwards, your body's

immune system detects them and launches an inflammatory response. There is an

increased epidermal turnover at the inflammatory periphery of the lesion and in other

areas epidermal turnover is almost the same as normal skin. This creates the hallmark

ringworm symptoms:

Ringworm rash - A circular, red rash with a raised, scaly border which can

spread to other parts due to excessive humidity and moisture in these parts. Poor

hygiene and a hot and humid environment can also play an important role in

increased risk of spreading the ringworm infection. In people with low immunity,

and co-illnesses such as diabetes, it evolves and spreads more quickly than in

others. In diabetics ringworm infection can also take longer duration to go away

and chances of recurrences are also higher than in others.

○ The center of the rash may clear somewhat, giving the classic "ring" appearance.

○ The rash can be intensely itchy.

The classical lesion is annular, oval. It is minimally inflamed, with a sharply defined enlarged

border and often with some central clearing.

Inappropriate treatment with topical steroids decreases the inflammation and alters the clinical


Inflammatory response of the host and increased epidermal turnover leads to shedding of the

organisms at the inflammatory ring while those just ahead maintain the infection.

4. Expansion and Potential Complications: Left untreated, ringworm can continue to

spread. The infection might move to other parts of the body or penetrate deeper into the

skin layers. It can also spread to other close contacts in the household through direct

contact or through fomites such as towels, bedsheets, clothes etc. In rare cases, this can

lead to secondary bacterial infections.

Good hygiene practices (washing hands regularly, not sharing personal items) are essential to

prevent the spread of ringworm infection. Make sure to keep and wash clothes, towel, bed

sheets separately of an infected person to prevent its spread. Avoid sharing personal

items.Make a habit of wearing loose fitting, cotton clothes and keep your inner parts dry as

moist will provide a hospitable environment for fungi to thrive. By practicing good hygiene

habits, you can help prevent the spread of fungal infections and keep everyone in the family


I hope the information provided above was helpful.

It is always advisable to consult a dermatologist online on neodermatologist.com, if you are

suffering from a ringworm skin infection. We are a team of board-certified dermatologists

having expertise in diagnosing and treating fungal infections. And we are passionate about

treating patients with ringworm infection online. We have treated more than 15 thousand

patients having ringworm infection till date. A dermatologist not only can diagnose and treat your

ringworm skin infection but can also provide you with the valuable advice, do’s and don’ts in

ringworm disease and can educate about the ringworm symptoms, ringworm stages,

importance of course completion and ringworm disease itself.

Thank you

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