Ringworm vs. Eczema: How to Tell the Difference (Image Guide)

alejandrophotography/iStock via Getty Images

Chances are you've heard of ringworm. It's a circular skin rash that can happen in people of all ages, but it's usually seen in children. Eczema is another common skin rash. Because it can also be round, people often mistake eczema for ringworm.

Ringworm and eczema have some things in common, and that can make it difficult to tell them apart. Both ringworm and eczema can be red, itchy, and flaky. And they can both last on the skin for weeks or months. But there are some key features of each condition that make them unique.

Let's take a closer look at how you can tell the difference between ringworm and eczema, and how to treat them.

What's the difference between ringworm and eczema?

One main difference between ringworm and eczema is whether they can be cured or not. You can cure ringworm, but there's no cure for eczema. Once you treat ringworm, the rash goes away. But eczema is a chronic condition. This means that it often needs long-term treatment to manage the symptoms.

Let's review other key differences between ringworm and eczema below.

Causes

The other main difference is the cause of each rash. Ringworm is a rash caused by tinea - a type of fungus that lives on the skin.

Eczema is not an infection - it's a chronic rash. Eczema usually stems from a faulty skin barrier. This allows the skin to get dry and irritated more easily, which can lead to eczema. Eczema can have many triggers, including stress, temperature, and exposure to allergens.

Location

Ringworm can happen anywhere on the body, including the nails and scalp. There are many different kinds of tinea infections based on where you have the rash. They include:

• Tinea corporis (ringworm on the body)

• Tinea capitis (scalp ringworm)

• Tinea cruris (jock itch)

• Tinea pedis (athlete's foot)

Eczema usually happens on the folds of the skin. This commonly includes places like:

• The neck

• Behind the knees

• Inside the elbows

• The hands

• The wrists

Shape

Ringworm is usually round or curved in shape. The name describes the raised, round shape that the ringworm rash usually takes. It often shows up as one or more small patches on the skin.

Eczema, on the other hand, can take many shapes or be widespread. An eczema rash can be round, but it doesn't have to be.

Pictures of ringworm vs. eczema

Here are some pictures of ringworm and eczema to help you tell the difference between the two conditions.

What are the symptoms of ringworm vs. eczema?

Ringworm and eczema have some similarities in their appearance. But there are a few key things that can help tell them apart, like the rash's location and shape.

How do you get ringworm?

The fungus that causes ringworm can be spread by touch. The infection can pass from person to person and animal to person. In rare cases, it can pass from object to person. The most common way to get a ringworm infection is from touching another person or animal with it.

Certain factors can increase your risk of getting a ringworm infection. These include:

• Warm climate: Fungus is more common in warmer climates. If you live somewhere tropical, your risk of ringworm is higher.

• Close-contact activities: Sports with heavy contact, like wrestling or jiu jitsu, increase your risk of ringworm.

• Heavy sweating: Fungus tends to thrive in warm, moist areas. Moisture from sweat increases your risk of ringworm.

• Animal contact: Having close contact with animals, like with pet ownership, may increase your risk of ringworm.

• Diabetes: If you have diabetes, you're at a higher risk of fungal infections like ringworm.

How do you treat ringworm?

Antifungal medications can easily treat ringworm. Antifungal creams (like clotrimazole and miconazole) can usually treat small ringworm infections. These creams are often available over the counter (OTC). Antifungal creams are safe to use long term and can help prevent fungal infections in people who are at higher risk.

However, OTC antifungal creams won't always help. You may need to see a healthcare professional if your ringworm rash:

• Covers a large section of skin

• Has not improved with OTC creams

• Is located on the scalp

These cases often need treatment with oral antifungal medications. There are many options - terbinafine is a common one.

Antifungal pills are very effective, but they have some risks. For people who have liver disease, these pills can put stress on the liver. For healthy people, this is usually not a real risk. In fact, recent data shows that regular lab monitoring of liver function isn't necessary for healthy people taking antifungal medications.

Ringworm on the scalp can be harder to treat, since creams don't penetrate well through hair. And it can also lead to hair loss, so don't delay in seeking medical care for a scalp rash. Treatment for ringworm on the scalp often uses oral antifungal pills right from the start.

How do you treat eczema?

There are many treatment options for eczema. These include medications, at-home treatments, and in-office treatments with a healthcare professional. The specific treatment depends on how severe your symptoms are.

Medications

Anti-inflammatory creams can treat most mild cases of eczema. Anti-inflammatory pills and injections can treat serious cases of eczema. Common medications that treat eczema include:

• Corticosteroid pills, like prednisone

• Steroid creams, like triamcinolone

• Nonsteroidal creams, like pimecrolimus and tacrolimus

• Antibiotic creams, like mupirocin

• Oral immunosuppressants, like methotrexate, cyclosporine, or Rinvoq (upadacitinib)

• Immunosuppressant injections, like Dupixent (dupilumab)

At-home treatments

There are also treatments that you can do at home to improve symptoms of eczema. These include:

• Moisturizers: Daily moisturization can help soothe skin and decrease eczema flare-ups.

• Wet dressings: Layering skin with ointment and a wet layer of bandages can help lock in moisture.

• Relaxation: Using techniques to relax can decrease itchiness. Laughter can help reduce stress in children with eczema.

In-office treatments

Sometimes in-office procedures can be helpful in treating eczema. Ultraviolet light treatment (phototherapy) reduces the inflammation caused by eczema. It's best for those with moderate to severe eczema who haven't responded to other treatments.

How do you diagnose ringworm and eczema?

A healthcare professional can diagnose most cases of ringworm and eczema with a physical exam. But sometimes it can be hard to tell them apart just by looking at them. Certain tests can help make the right diagnosis.

A skin scraping test looks at skin flakes under a microscope to see if there's fungus. For a skin biopsy, a dermatologist cuts a very small piece of the skin and examines it for fungus. Eczema and ringworm look very different on a skin scraping or biopsy, making them the most certain way to tell them apart.

Are ringworm and eczema serious?

Overall, ringworm and eczema aren't serious or life-threatening. Ringworm will go away with treatment. But there may be some temporary skin changes. In some cases, the skin can become discolored where the rash was. If the ringworm is on the scalp, you may notice some hair loss where the rash used to be.

Eczema is a chronic condition. So, it may last a long time, or disappear and come back. Itching can be intense. In severe cases, it may affect quality of life. Excessive scratching can also lead to frequent infections. Sometimes these infections can be serious, including those with MRSA bacteria.

Should you seek medical care for symptoms of ringworm or eczema?

If you have rashes that last more than 2 weeks and don't get better, you should see a healthcare professional. Ringworm and eczema rashes can look the same, but the treatments are different. So it's important to know which one you have.

In fact, OTC treatments that can improve eczema - such as steroid creams - will actually make ringworm worse. This can sometimes be a clue that you have ringworm and not eczema. So, if you're concerned about ringworm or eczema, it's best to have an evaluation to get the right diagnosis.

Frequently asked questions

Images used with permission from VisualDx (www.visualdx.com).

Public link

Please use the above public link if you want to share this noodl on another website.