Ringworm, Facial (Tinea Faciei)

Who's At Risk?

Anyone can get facial ringworm, and it is most common in warm, moist climates. When tinea appears on the part of the face where the beard would be, it is called tinea barbae. In general, tinea infections are quite common, but facial ringworm infections happen most in teens and young adults or in anyone with an immunosuppressive disease.

Signs & Symptoms

The most common locations for facial ringworm include the following:

• Cheeks
• Nose
• Around the eye
• Chin
• Forehead

Facial ringworm appears as one or more pink-to-red scaly patches ranging in size from 1 to 5 cm. The border of the affected skin may be raised and may contain bumps, blisters, or scabs. Often, the center of the lesion has normal-appearing skin with a ring-shaped edge, leading to the nickname “ringworm,” even though it is not caused by a worm.

Facial ringworm can be itchy, and it may get worse or feel sunburned after exposure to the sun.

Self-Care Guidelines

If you suspect that you have facial ringworm, you might try one of the following over-the-counter antifungal creams or lotions:

• Terbinafine
• Clotrimazole
• Miconazole

Apply the cream to each lesion and to the normal-appearing skin 2 cm beyond the border of the affected skin for at least 2 weeks until the areas are completely clear of lesions. Because ringworm is very contagious, avoid contact sports until lesions have been treated for at least 48 hours.

Since people often have tinea infections on more than one body part, examine yourself for other ringworm infections, such as in the groin (tinea cruris, jock itch), on the feet (tinea pedis, athlete’s foot), and anywhere else on the body (tinea corporis).

Make sure any household pets are evaluated by a veterinarian to be certain that they do not have a dermatophyte infection. If the veterinarian discovers an infection, the animal should be treated.

Treatments

To confirm the diagnosis of facial ringworm, your physician might scrape some surface skin material (scales) onto a glass slide and examine it under a microscope. This procedure, called a KOH (potassium hydroxide) preparation, allows the doctor to look for tell-tale signs of fungal infection.

Once the diagnosis of facial ringworm is confirmed, your physician will probably start treatment with an antifungal medication. Most infections can be treated with topical creams and lotions, including:

• Terbinafine
• Clotrimazole
• Miconazole
• Econazole
• Oxiconazole
• Ciclopirox
• Ketoconazole
• Sulconazole
• Naftifine

Rarely, more extensive or long-standing infections may require treatment with oral antifungal pills, including:

• Terbinafine
• Itraconazole
• Griseofulvin
• Fluconazole

The ringworm should go away within 4–6 weeks after using effective treatment.

Visit Urgency

If the lesions do not improve after 1–2 weeks of applying the over-the-counter antifungal creams, see your doctor for an evaluation.

Trusted Links

• Clinical Information and Differential Diagnosis of Tinea Faciei (Ringworm of Face)

References

Bolognia, Jean L., ed. Dermatology, pp.1179. New York: Mosby, 2003.

Freedberg, Irwin M., ed. Fitzpatrick’s Dermatology in General Medicine. 6^th ed. pp.1998. New York: McGraw-Hill, 2003.