January 15, 2012

Spotlight on Training: Ringworm

Ringworm is actually a fungus, not a worm. The first symptom of ringworm is severe localized itchiness. Basically it starts out as a little, red,  itchy pimple. Soon this grows to solid pink circles on the skin, usually  between the size of a pimple and a quarter. The border of these circles will eventually develop scaly red skin and the center become paler. Related  forms of ringworm can also occur on the scalp (causing hair loss), the  crotch (‘jock itch’) and the foot (‘athlete’s foot’). Just remember that all ringworm starts small – be suspicious of an itchy or scratchy area, especially when it associated with a small red area.

Take ringworm seriously. It’s ugly, itchy and very contagious. Once someone in a team gets infected with ringworm it spreads like wildfire and stays around for a very long time unless strict measures are taken quickly.  A ringworm infection at a club can cause people to quit: do you really  want less people to train with?

With ringworm there is usually a 1 to 2 week incubation period between exposure and visible infection. The fungal spores that spread ringworm can survive on a variety of surfaces for a long time, so eradicating this  sucker is really difficult. To make matters worse, some people are asymptomatic carriers meaning that they carry the infection and can infect others but don’t have the characteristic skin markings.

If being infected with ringworm doesn’t bother you too much then think about your training partners, ESPECIALLY those training partners who have children. Children are very susceptible to ringworm and if it gets in their scalps it can cause permanent scarring and baldness. The standard treatment for ringworm of the scalp in children is 6 weeks of  prescription oral medication that has potentially serious side effects,  so PLEASE be considerate.

If you have ringworm stay off the mat! This is the most difficult part of the treatment for many grapplers, who just want to keep on training. Stay off the mats until your ringworm is under control or you’ll turn  your infection into a club-wide epidemic. After the red circles have cleared up the grappler is no longer infectious and can return to training. It  usually takes about a week to treat if you catch it early; delay treatment and it could take a lot longer.

Simply covering up the infected sites is NOT sufficient! Many  times people will just put some tape over the itchiest ringworm sores and go train anyhow – this is not cool. For one thing the offenders in question might not have noticed every single sore, and also they ave certainly been scratching those sores all day, spreading fungal spores to their hands and any other bodypart they touch with their hands. Stay off the mats.

Treat the infection with an antifungal cream. There are many antifungal creams and gels available. ‘Lamisil’ is one of the best creams, but usually requires a doctor’s prescription.

There are also over-the-counter medications like tolnaftate (‘FungiCure’, and others). I haven’t found the clotrimazole products as effective – sometimes all they do is suppress the fungus. Most products are applied  twice daily. Some creams also contain hydrocortizone or cortate, but this  just reduces the inflammation and doesn’t actually kill the fungus. As a rule of thumb, if your ringworm isn’t a lot better after one or wo weeks of using over the counter anti-fungal creams go to a doctor  or walk-in clinic and ask for a Lamisil prescription.

You can also take prescription oral medications (like an oral form of  lamisil or ketoconazole) for severe and/or stubborn cases. These may be  hard on your liver and you should take them with care.

Keep on applying the topical medication for one week after your  infection clears up! Often it appears that the infection is gone,  but the ringworm is actually only dormant and will soon come back. Apply the cream or gel for at least one additional week. If you are taking orals take the full course of prescribed anti-fungal medications.

Change your bedding every couple of days and don’t share towels – your training partners may be pissed if you infect them, but that is nothing compared to how upset your spouse or ‘special friend’  is going to be if he/she catches it. Besides, if you are treating your  ringworm but sleeping in the same old bedding or using the same towel every day you are basically re-infecting yourself. Use your bath towels  and wash cloths only once, and then wash them.