Ringworm, a Primer on Treatment and Prevention

Ringworm sucks. 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.

Ringworm is a fungus that lives quite happily in the soil, bothering no-one. The problem often starts when people wear their outside shoes onto the mat. The fungus enters into the skin through scratches and abrasions (common in grappling) and then the trouble begins. Once the epidemic has begun, the main mode of transmission is probably person-to-person.

The first symptom of ringworm is severe localized itchiness. Soon this is followed by the appearance of solid pink circles on the skin, usually between the size of a dime and a quarter. The border of these circles will eventually develop scaly red skin. Related forms of ringworm can also occur on the scalp (causing hair loss), the crotch ('jock itch') and the foot ('athlete's foot').

If you have ringworm:

• Stay off the mat. This is the most difficult part of the treatment for may grapplers, but if you infect someone else they'll just reinfect you. This is how the epidemic begins. Treat the infection: after the site has cleared up the grappler is no longer infectious.

• Use an antifungal cream. There are many antifungal creams and gels available: the ones that work best for me contain at least 1% tolnaftate ('FungiCure', and others). Other products contain other active ingredients (like clotrimazole), but I haven't found them as effective. Most products are effective if applied twice daily. Some creams also contain hydrocortizone or cortate, but this just functions to reduce the inflammation and doesn't actually kill the fungus.

• Be diligent and keep on using the cream for at least a week after the infection has cleared up. Often it appears that the infection is gone, but the ringworm is actually only dormant. Apply the cream or gel for at least one additional week

• See your doctor if ringworm is still present after one week of using over the counter (OTC) anti-fungal creams. Your doctor may be able to prescribe you something stronger

• Oral medication (such as ketoconazole) may also be required for severe and/or stubborn cases

If you have ringworm OR if there is ringworm going around your club

• Inspect your partners carefully and refuse to wrestle someone with 'the worm'. You are not being rude: they are being inconsiderate by not staying off the mats while infectious

• Wash the mats before every practice, using a dilute bleach solution or anti-fungal cleaning agents

• Shower thoroughly as soon as possible after every practice

• Wash your gi, rashguards, kneepads, towels, etc. after every practice

• Change your bedding every couple of days- 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 every night you are basically re-infecting yourself.

Additional information on ringworm can be found at the following sites:

http://www.bcwrestling.com/news/news/ring_worm.html
http://www.masonwrestling.com/ringworm.htm
http://www.foliw.org/newsletter/ringworm.html
http://www.surgerydoor.co.uk/medcon/detail2.asp?level2=Ringworm
http://www.nlm.nih.gov/medlineplus/ency/article/001439.htm
http://dmoz.org/Health/Conditions_and_Diseases/Infectious_Diseases/Fungal/Ringworm/
http://encarta.msn.com/find/Concise.asp?ti=00B18000
http://www.drkoop.com/template.asp?page=newsdetail&ap=93&id=501748
http://www.drkoop.com/template.asp?page=newsdetail&ap=93&id=501841
http://www.luhs.org/health/topics/derm/ring.htm