Fungal skin infections are among the most common — and most misunderstood — skin conditions in school-age children. Parents in Robbinsville, Princeton area, Mercer County, and across New Jersey are often surprised to learn that "ringworm" has nothing to do with worms, and that these infections are very treatable. Here's what you need to know.

What Are Fungal Rashes?

Fungal skin infections (called tinea infections) are caused by a group of fungi called dermatophytes that feed on the dead outer layer of skin, hair, and nails. There is no actual worm involved — the name "ringworm" comes from the circular, ring-like appearance of the rash.

The three types most commonly seen in children are:

Ringworm (Tinea Corporis)

Tinea corporis affects the skin of the body and face (but not the scalp, beard, or feet — those have different names).

A circular or oval patch with a raised, red, scaly border and clearer center
Sometimes multiple overlapping rings
May be itchy and slightly raised around the edges
Can appear anywhere on the body

Direct contact with an infected person or animal (cats and dogs are common sources)
Touching contaminated objects like towels, clothing, or wrestling mats
Moist, warm environments favor fungal growth

Treatment: Over-the-counter antifungal creams containing clotrimazole, miconazole, or terbinafine (like Lotrimin or Tinactin) applied twice daily for 2–4 weeks usually clear ringworm effectively. Apply to the rash and 1 inch around the border.

Athlete's Foot (Tinea Pedis)

Athlete's foot affects the skin of the feet, especially between the toes and on the soles.

Itchy, scaly, or cracked skin between the toes (most commonly between the 4th and 5th toes)
Redness, burning, or stinging
Peeling or blistering skin on the soles or edges of the feet
Sometimes a foul odor

Walking barefoot on contaminated surfaces (locker rooms, pool decks, showers)
Wearing damp socks or tight shoes that don't let feet breathe
Sharing shoes or socks

Treatment: OTC antifungal creams, sprays, or powders applied daily. Keep feet dry — change socks after sports, wear sandals in public locker rooms, and choose breathable footwear. Treat for 2–4 weeks and continue for 1 week after the rash clears.

Scalp Ringworm (Tinea Capitis)

Scalp ringworm is especially common in school-age children (ages 3–12). Unlike body ringworm, it cannot be cured with over-the-counter creams — it requires a prescription oral antifungal medication.

Scaly, sometimes gray or black patches on the scalp
Hair loss in patches (the hair breaks off close to the scalp, leaving "black dots")
Itching of the scalp
Sometimes swelling and tenderness, or a large boggy swelling filled with pus (called a kerion) — this needs prompt treatment

Direct contact with an infected person
Sharing combs, brushes, hats, pillowcases, or headbands
Contact with infected animals

Treatment: Oral antifungal medications (griseofulvin or terbinafine) taken daily for 4–8 weeks are required. Antifungal shampoos (like ketoconazole or selenium sulfide) can help reduce spread to others and should be used twice weekly while being treated, but shampoo alone is not enough to cure the infection.

General Prevention Tips for All Fungal Infections

Don't share personal items: combs, brushes, hats, towels, clothing
Wear sandals or flip-flops in public showers, locker rooms, and pool areas
Keep skin dry — change out of wet swimwear and damp clothing promptly
Wash hands after touching pets
Wash sports equipment and uniforms regularly
Treat pets with ringworm (your vet can help)

When to See Your Pediatrician

You notice scalp involvement — patches of hair loss, scaly scalp, or any soft swelling on the scalp
OTC antifungal treatment hasn't improved body ringworm after 2 weeks
Your child has a large, painful, swollen area on the scalp (kerion)
Athlete's foot isn't clearing with OTC treatment, or the infection has spread to the nails
You're unsure whether what you're seeing is a fungal infection

Remember, scalp ringworm always requires prescription treatment — don't wait on a "watch and see" approach for the scalp. The sooner oral medication starts, the faster your child recovers.

Fungal Rashes in Children: Ringworm, Athlete's Foot, and Scalp Ringworm