Nothing to do with worms. A common fungal infection with a distinctive ring-shaped rash.
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Ringworm is a fungal skin infection. There is no worm involved — the name comes from the ring shape it makes, and it causes a great deal of unnecessary alarm.
It is the same family of fungus that causes athlete's foot, jock itch and fungal nail infection, just in a different place. It is common, it is treatable, and it responds well to the right cream.
The single most important thing on this page: steroid cream makes ringworm worse. Applied to a fungal rash — often because it looked like eczema — a steroid calms the redness and itch for a few days while the fungus spreads underneath. The result loses its ring shape and becomes almost unrecognisable. This is called tinea incognito, it is common, and combined steroid-and-antifungal creams are a frequent culprit.
Two other things worth knowing. Ringworm on the scalp cannot be treated with cream — it needs oral medication, and untreated it can cause permanent hair loss. And groin ringworm usually comes from your own feet, which is why treating the groin alone means it keeps coming back.
Dermatophytes — fungi that live on keratin, the protein in skin, hair and nails. They thrive in warm, moist conditions.
Ringworm is usually diagnosed by appearance, and a good photograph is often enough — which makes this well suited to a remote consultation.
Skin scrapings, hair or nail clippings for laboratory confirmation — taken before starting oral treatment, and worth doing where:
If you have groin ringworm, treat your feet too, even if they look fine. Athlete's foot is the reservoir that reinfects the groin, and treating one without the other produces an endless cycle.
Creams do not work on the scalp, because the fungus is inside the hair shaft. It requires oral antifungal treatment for several weeks, ideally after a confirmatory sample.
Untreated scalp ringworm can cause permanent scarring hair loss, so this is not one to wait out. An antifungal shampoo is used alongside to reduce spread to others, but never instead.
Also oral, and prolonged — several months. Confirm with clippings first; a great many thickened nails are not fungal at all, and treating them for months achieves nothing.
Ringworm is not an emergency. Seek prompt medical attention for:
Book an appointment for:
Put your socks on before your underwear. Pulling underwear up over infected feet transfers fungus straight to the groin — and this one change breaks a cycle that otherwise repeats indefinitely. It is almost never mentioned, and it costs nothing.
No exclusion is needed for body ringworm once treatment has started, provided the area is covered. Scalp ringworm needs oral treatment started before returning.
Antifungal creams — terbinafine, clotrimazole, miconazole — are all over the counter for a few pounds and treat most ringworm. A pharmacist can supply them without an appointment, and your NHS GP treats it free. We would not charge you for this.
The mistake that costs people months is steroid cream. Hydrocortisone or a stronger steroid applied to ringworm settles the redness and itch while the fungus spreads underneath, producing an atypical rash — tinea incognito — that is then genuinely hard to recognise. If a rash improved on steroid cream and then got worse or spread, that history alone points to fungal infection.
Where a consultation is worth paying for is when it is not responding, or when it is on the scalp. Scalp ringworm needs oral antifungal treatment and never clears with cream — that is the single most consequential distinction here, and in a child with patchy hair loss and scaling it is the diagnosis to think of first.
Nail involvement also changes things, needing months of oral treatment and a nail clipping first.
Free and worth doing: treat pets if they have bald scaly patches, since they are a common source, and do not share towels while it is active.
NICE Clinical Knowledge Summary, Fungal skin infection — body and groin, is the principal reference. It recommends topical antifungal treatment as first-line, continued for one to two weeks beyond clinical clearance.
CKS explicitly warns against topical corticosteroids, which produce tinea incognito — an altered, less typical appearance that delays correct diagnosis.
NICE CKS, Fungal skin infection — scalp, is explicit that tinea capitis requires systemic antifungal treatment, since topical agents cannot reach the hair follicle, and recommends sampling hair and scale for mycology before starting.
CKS recommends oral terbinafine or itraconazole for extensive or resistant body infection.
CKS notes zoophilic transmission from cats, dogs, guinea pigs and cattle, which is the basis for the advice about pets, and advises that affected animals be treated by a vet.
No — and this is worth saying first, because the name genuinely frightens people. Ringworm is a fungal infection of the skin, named only for the ring shape it makes as it spreads outwards.
Because it was probably a steroid, or a combined steroid-and-antifungal. Steroids suppress the redness and itch while the fungus spreads underneath, and the rash loses its ring shape and becomes hard to recognise — tinea incognito. If a rash improved for a few days on a steroid cream then spread, say so, because it changes the diagnosis.
Almost always because your feet are the source. Treat your feet at the same time, even if they look normal, and put your socks on before your underwear — pulling pants up over infected feet transfers the fungus straight back. That single change breaks the cycle.
Two to four weeks usually — and crucially, keep going for one to two weeks after it looks completely clear, applying about 2cm beyond the visible edge. Stopping the day it disappears is the commonest reason it returns.
No. Scalp ringworm needs oral antifungal treatment — the fungus is inside the hair shaft where cream cannot reach. It also matters that it is treated promptly, because untreated scalp ringworm can cause permanent scarring hair loss. Please get it seen.
Yes for body ringworm, once treatment has started and the area is covered. Scalp ringworm needs oral treatment started first. For contact sports like wrestling and judo, most clubs require a period of treatment before you return — check with yours.
Quite possibly — kittens, guinea pigs and rabbits are common sources, and ringworm caught from an animal tends to be more inflamed. Get the animal seen by a vet, because treating yourself while it stays infected simply means catching it again.
August 23, 2026
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Yes. Care is led personally by Dr Mohammad Khan, so you are not passed between clinicians. Continuity is the point of a small practice: someone who knows your history and is listening attentively rather than working through a checklist.
Yes, with your consent. We can access your Summary Care Record during the consultation, so your current medications, allergies and significant history are in the room. That means fewer questions you have already answered elsewhere, and safer prescribing.
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Twenty unhurried minutes and a comprehensive assessment. A written treatment plan is included, along with any prescription, sick note or referral letter arising from the consultation, at no extra charge.
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It means the diagnosis can usually be made from your history and photographs, and that treatment can be arranged safely without examining you. Where a condition is not marked treatable online, it is because examination is the diagnosis — listening to a chest, feeling an abdomen, examining an ear or a joint — or because a procedure or device is needed.
Yes, where there is a genuine bacterial infection — cellulitis, impetigo, bacterial urine infections, confirmed strep throat. We will also frequently tell you that you do not need one. Most sore throats, coughs, colds and earaches are viral, and an antibiotic gives you the side effects with none of the benefit.
If your problem turns out to be genuinely outside what we can do remotely, the doctor will tell you straight away, point you to the right service, and refund your fee in full. We would rather do that than fill twenty minutes to justify the charge.
Call 999 or go to A&E — do not book an online appointment and do not wait for a reply to an email. For urgent problems that are not emergencies, NHS 111 is available 24 hours a day, online or by phone, and can direct you to the right service.
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