How To Tell The Difference Between Ringworm vs. Eczema

Eczema is a general term for several conditions that cause skin inflammation, redness, swelling, dryness, and itch. There are seven different types of eczema: atopic dermatitis, dyshidrotic eczema, contact dermatitis, discoid eczema, neurodermatitis, seborrheic dermatitis, and stasis dermatitis.

If you have broken out in an itchy, red rash over your body that is causing lesions, you may have a type of eczema known as nummular eczema, also called discoid eczema or nummular dermatitis. This rash presents as scattered circular, itchy, and sometimes oozing patches that can be coin-shaped. 

Ringworm (tinea corporis) exhibits similar symptoms. Contrary to its name, which implies a worm that may be buried under your skin, this contagious fungal infection is known as ringworm because it manifests as a circular, ring-like rash.

Tell-tale signs of a ringworm infection include red, itchy, scaly skin, and in some areas, hair loss. Knowing the difference between ringworm and eczema will determine what treatment is appropriate for you.

In this article, I will discuss similarities and differences between ringworm and eczema, their causes, and how each is treated.

Symptoms 

Ringworm and eczema can exhibit similar symptoms, making it challenging to self-diagnose. While both are irritations of the skin, there are subtle differences in their symptoms that can help you differentiate between the two. 

Ringworm

Ringworm is a contagious fungal infection caused by a fungus that can live on your skin, hair, or nails. Once you have contracted ringworm, symptoms can appear within 4-14 days, depending on the location of the body that is affected.

In most cases, symptoms of ringworm on the skin appear faster than symptoms on the scalp. 

Symptoms of ringworm include:

• Red, scaly, cracked, itchy skin anywhere on the body 
• A scaly, ring-shaped rash
• Red bumps on the skin
• Slightly raised, expanding rings
• Hair loss, if on the scalp or areas of facial hair
• Discolored, thick, or brittle fingernails or toenails

Eczema 

According to the National Institute of Allergy and Infectious Diseases, approximately 30% of the U.S. population will experience eczema at some point during their life. This can appear as red, itchy, swollen, or dry skin. The severity, symptoms, and causes vary from person to person. 

One type of eczema, called nummular eczema, manifests as a rash that looks similar to ringworm—the two can be easily mistaken.

Symptoms of nummular eczema can include:

• Coin-shaped lesions that appear on the arms, legs, torso, and/or hands
• Red, pinkish or brown, scaly and inflamed skin surrounding the lesions
• Itching and burning sensation of the skin

Since nummular eczema and ringworm can look nearly identical, it is best to consult with an experienced healthcare provider to help you tell the difference.  

Causes 

Nummular eczema and ringworm have similar symptoms, but their causes are different. Ringworm is caused by direct contact with a fungal spore, whereas eczema is a skin condition that is caused by the immune system’s reaction to the external environment. 

Ringworm

Ringworm is caused by fungi that live on your skin, and can be spread in various ways, typically through other humans, animals, and the environment.

• Humans: Humans can spread the fungal infection from one person to another through skin-to-skin contact.
• Animals: Animals, especially pets, can be likely carriers of ringworm. Kittens and puppies are notorious for contracting ringworm, but you can also get it from coming into contact with other animals, including cattle, goats, rabbits, and birds. Hairless, circular, or irregularly shaped patches of scaling, redness, or crusting on the skin are tell-tale signs that an animal has ringworm. You may notice them scratching these areas too. Always wash your hands with warm, soapy water after touching an animal you suspect has ringworm. If you have just adopted a new pet, organize a vet checkup to ensure the health of your pet.
• Objects: Ringworm can live on various fabrics and surfaces. Direct contact with an infected surface can transfer the infection to humans. Wash and dry all bedding, towels, clothing, and other fabrics thoroughly, and regularly disinfect all surfaces where ringworm might be growing.
• The environment: In rare cases, ringworm can be transferred to humans through contact with infected soil. But this would typically require prolonged exposure for the infection to occur. 

Eczema 

Healthy skin retains moisture. This helps protect you from bacteria, irritants, and allergens that can aggravate the skin and cause eczema.

Eczema is caused by a combination of immune system activation, genetics, environmental triggers, and stress that affects the skin’s ability to provide this protection from bacteria. The immune system overreacts to small irritants or allergens, and can cause the skin to become inflamed. 

Nummular eczema, coin-shaped eczema that can easily be mistaken for ringworm, tends to affect males more than females. It can be triggered by very dry skin or exposure to an allergen, but can also occur for no clear reason due to the body’s own overactive immune response.

Diagnosis

Both ringworm and eczema can be diagnosed by a physical examination with a healthcare professional. 

Ringworm 

If you suspect you have ringworm, visit your healthcare provider. Your doctor will usually diagnose ringworm by first doing a physical examination of your skin.

They may use a black light to view the affected area—depending on the type of fungus, ringworm infection may fluoresce under black light. In some cases, where further confirmation is needed, your doctor may do a skin biopsy or fungal culture.

This involves taking a sample of your skin or discharge from a blister and sending it to a lab to test for the presence of fungus. This is rarely needed for simple ringworm, which is diagnosed by exam alone.

Eczema 

Eczema is diagnosed through a physical examination from your healthcare provider. No lab test is needed. They will review your medical history and may also use patch testing or other tests to rule out other skin diseases or identify conditions that may be causing your eczema.

If you suspect eczema may be a result of an allergen, tell your healthcare provider. It may be necessary to carry out an allergy test.

Treatment Options 

There are several over-the-counter (OTC) treatment options available for ringworm and eczema. Ringworm can be cured entirely with antifungal treatments. There is no cure for eczema, but OTC and prescription treatment options can reduce your symptoms significantly. 

Ringworm 

Antifungal topical treatments are available over-the-counter for treatment of ringworm.

These include:

• Clotrimazole (Lotrimin, Mycelex): This is a topical fungal cream, spray, or solution that you put directly on the affected area(s). 
• Ketoconazole (Xolegel): Available as a cream or shampoo, ketoconazole is an antifungal medicine used to treat skin infections caused by a fungus (yeast). It can also prevent ringworm from coming back.
• Miconazole: Approved by the U.S. Food and Drug Administration (FDA) as an antifungal medication, miconazole can be applied to the infected site to kill off harmful fungi living on the skin.

Contact your healthcare provider if the infection doesn’t go away or continues to spread, as there are prescription antifungals that may be used. These are almost never needed for ringworm.  

Eczema

There is no cure for eczema and flare-ups can occur at various points in their lives.

The following medications can soothe and treat various types of eczema:

• Anti-inflammatory creams and ointments: Hydrocortisone cream is an anti-inflammatory cream that can be applied directly to the affected area to ease itching and inflammation, and can actually heal mild eczema flares. If your eczema is more severe, your healthcare provider may recommend a prescription steroid or non-steroid antiinflammatory ointment. Steroid creams should not be used for long periods of time, and should only be used on the face or genitals as directed by a healthcare provider.
• Emollient creams and ointments: Since eczema may be triggered by dry skin and can cause dry, tight skin, emollient creams or ointments that help to protect the skin and replenish moisture are an important part of treatment. There are many over-the-counter options, including Aquafor and Eucerin. 
• Allergy medications: Several OTC antihistamines, such as cetirizine (Zyrtec), loratadine (Claritin), and diphenhydramine (Benadryl), are available at your local pharmacy. These can help the itching and inflammation of eczema.

When to See a Medical Professional 

If you have tried OTC treatments and home remedies and are still struggling with symptoms of ringworm or eczema, visit a medical professional such as a general practitioner or dermatologist.

If you have been taking prescription medications for your ringworm or eczema and are experiencing adverse side effects, contact your provider immediately. 

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