What you use will depend on the area of the body that needs treatment. If you have ringworm of the scalp, use a shampoo with selenium sulfide, such as Selsun Blue. Ringworm is not contagious after 2-3 days of treatment. Use an anti-fungal cream (such as Lotrimin) 2 times per day. Here are six simple ways to treat ringworm. Wash all items you take off before wearing them again. These cookies may also be used for advertising purposes by these third parties. To prevent the spread of scalp ringworm, never wear someone else's hat or cap. Tinea corporis (ringworm) typically presents as a red, annular, scaly, pruritic patch with central clearing and an active border (Figure 1). Centers for Disease Control and Prevention. Beard: Ringworm in the beard area requires prescription antifungal medicine and a tailor-made treatment plan. The active ingredient in this ringworm fungus treatment is clotrimazole, which relieves the discomfort of ringworm symptoms and is clinically proven to cure most ringworm. Note, however, if you have a pet with ringworm, they're likely to stay contagious for up to three weeks once you start treating them. Dermatologists care for people of all ages. If the ringworm is on your skin, an OTC antifungal cream, lotion, or powder may work. Ringworm on the scalp (tinea capitis) usually needs to be treated with prescription antifungal medication taken by mouth for 1 to 3 months. A culture, which is more sensitive than the KOH preparation,10,11 can be performed by moistening a cotton applicator or toothbrush with tap water and rubbing it over the involved scalp. Will my ringworm be contagious once I start treating it? For infections that get worse or don't go away, there are prescription topical products that can treat ringworm, such as: Fungal infections on the scalp must be treated with a prescription antifungal. Some tips for performing KOH preparations are available online (eTable A). It will also prevent reinfection once yours has cleared up. But tinea can also infiltrate the feet (where its known as athletes foot) or the groin (hello, jock itch). ringworm of the foot (interdigital and plantar tinea pedis; athlete's foot); yeast infections of the skin (cutaneous candidiasis). Free shipping for many products! Ringworm vs. Eczema: What Are the Differences? Yes, but not for long. If you have what feels like razor bumps or acne on the back of your neck or scalp, you may have acne keloidalis nuchae. Find out how a board-certified dermatologist helped Natalie see clear skin before her wedding. By looking at the sample under a microscope, a doctor can see if it contains any of the fungi that cause ringworm. If the athletes foot is more severe or fails to clear in two weeks, a dermatologist can prescribe stronger medicine. Satchell AC, Saurajen A, Bell C, Barnetson RS. Involvement of the plantar and lateral aspects of the foot with erythema and hyperkeratosis is referred to as the moccasin pattern of tinea pedis.4, Tinea corporis, tinea cruris, and tinea pedis can often be diagnosed based on appearance, but a KOH preparation or culture should be performed when the appearance is atypical.2, Tinea corporis, tinea cruris, and tinea pedis are generally responsive to topical creams such as terbinafine (Lamisil) and butenafine (Lotrimin Ultra), but oral antifungal agents may be indicated for extensive disease, failed topical treatment, immunocompromised patients, or severe moccasin-type tinea pedis. An infection of the skin caused by a fungus. To clear ringworm, you must treat it everywhere on your body at the same time. This medication is also used to treat a skin condition known as pityriasis (. Use these professionally produced online infographics, posters, and videos to help others find and prevent skin cancer. You may need to apply cool compresses 2 to 6 times a day. Culture has poor sensitivity, but good specificity.30. Do not use combination products such as betamethasone/clotrimazole because they can aggravate fungal infections. To treat the itch, it often helps to apply a wet, cool washcloth to the area for 20 to 30 minutes. However, DO NOT treat ringworm with apple cider vinegar. Wash your hands each time you touch your rash and before you touch anyone else. KOH can damage microscope lenses. ", : "Antifungal activity of tea tree oil from Melaleuca alternifolia against Trichophyton equinum: an in vivo assay. But it can take months or years to clear up some fungal nail, blood and lung infections. Ringworm causes red, ring-shaped patches on the skin. Do not use a steroid to ease the itch: These medications weaken the immune system and could make a fungal infection worse rather than help heal it.To treat itching caused by ringworm, you can apply a cool, wet washcloth to the area for 20 to 30 minutes. Oral terbinafine is first-line therapy for tinea capitis and onychomycosis because of its tolerability, high cure rate, and low cost. Stopping early may fail to clear the infection. University of Michigan. The pimples slowly spread and form a round or oval ring, typically to 1 inch (12 to 25 mm) in size. In fact, everyone with whom the infected person lives needs to use an antifungal shampoo. Ringworm can be transmitted between dogs and cats and humans. Treat your itching, cracking, scaling, burning, redness, soreness, chafing and irritation by applying this globe miconazole 2% strength antifungal cream. Therefore, use an old microscope, and avoid spills and excess KOH on the slide. You should contact your healthcare provider if: We take your privacy seriously. says. Cathy Wong is a nutritionist and wellness expert. Policy. You may also need to follow preventive measures to avoid reinfection. You typically apply the antifungal twice a day for 10 to 14 days. If you're using an OTC product, follow the recommendations on the label. If you're prescribed a prescription drug to treat ringworm of the scalp, your healthcare provider may suggest you also use an OTC shampoo that contains ketoconazole, such as Nizoral. Good news, says Dr. Vij: Its generally easy to treat.. Wash everything you wear or touch in hot water before wearing or using it again. Do not, in general, treat tinea capitis or onychomycosis without first confirming the diagnosis with a potassium hydroxide preparation, culture, or, for onychomycosis, a periodic acidSchiff stain. 2023 Dotdash Media, Inc. All rights reserved, Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Itching and other symptoms tend to get better in a few days. Skin scrapings and hair can be examined under the microscope immediately. Even if your symptoms are gone soon after you start treatment, it's important to continue using medication for as long as your healthcare provider prescribes. Usecondoms or another form ofcontraception if youre on it. Follow these key tips to manage ringworm: Ringworm is highly contagious, therefore it is very important to do everything you can to prevent it from spreading to another person. In kids, the scalp is a common spot. The ringworm may fail to clear if you stop taking it sooner than prescribed. However, results of the Wood lamp examination can be falsely negative if the patient has bathed recently. Over-the-counter antifungals can kill the fungus and promote healing.. Antifungal medications kill the fungus by interfering with the fungus' ability to form cell walls. Dermatologists team up to improve patient care, JAK inhibitors: A newer type of medication, Free materials to help raise skin cancer awareness, Dermatologist-approved lesson plans, activities you can use. How Often You Should Wash Your Sheets (and the Gross Reasons Why), How To Treat an Infected Belly Button Piercing, How to Avoid Athletes Foot and Staph Infections in the Locker Room, How You Can Stop Foot and Toenail Fungus In Its Tracks, 6 Sore Throat Remedies That Actually Work. All Rights Reserved. In many cases, your doctor may recommend a drug you can buy over the counter (OTC) at your local drugstore. people with scarring as a result of trying to treat ringworm with vinegar.. Most of the time, ringworm treatment involves an over-the-counter (OTC) or prescription cream, ointment, or other topical medication that's applied directly to the rash. Keep the infected area clean and dry. Lotrimin Ringworm Cream is an odorless, greaseless . . In many cases, your doctor may recommend an over-the-counter (OTC) medicine you can get at the drugstore. JAK inhibitors are helping patients with alopecia areata, eczema/atopic dermatitis, psoriasis, and vitiligo. Your doctor will write a prescription for an antifungalmedication that youll have to take by mouth for 1 to 3 months. The scraped scale should fall onto a microscope slide or into a test tube. Repeat up to 3 times daily. Some people suggest applying this would-be home remedy and covering the spot Do not use griseofulvin to treat onychomycosis because terbinafine (Lamisil) is usually a better option based on its tolerability, high cure rate, and low cost. The clinical diagnosis can be unreliable because tinea infections have many mimics, which can manifest identical lesions. The Miconazole: apply twice a day and continue for 10 days after the skin is back to normal. Adjust the light filter and drop the condenser to achieve a low light level and increased refraction. With treatment, a ringworm infection on a part of the body without hair (glabrous skin) is likely to clear up within two to four weeks of the start of treatment. Keep using the cream for at least 7 days after the rash is cleared. Clinically proven Lotrimin Daily Prevention.*. It's more likely it will take two to four weeks for your symptoms to disappear completely if you're using a topical medication. Wash your hands immediately after touching a ringworm rash. After heating the slide, tap down the coverslip to compress the sample and separate the hyphae from the squamous cells. There a several forms of ringworm that humans can experience. Ringworm on the scalp needs to be treated with prescription antifungal medication. Note that the options below haven't been tested enough to be recommended. Find many great new & used options and get the best deals for Antifungal Cream - Athletes Foot Cream, Treatment for Jock Itch, Ringworm at the best online prices at eBay! Copyright 2023 American Academy of Family Physicians. 2005 - 2023 WebMD LLC. For more information, seeWebsite Privacy. Ringworm is highly contagious and can be spread between people and animals, so it's important to take measures to keep your skin and clothing clean. Financial assistance for medically necessary services is based on family income and hospital resources and is provided to children under age 21 whose primary residence is in Washington, Alaska, Montana or Idaho. Similarly, in a small study published in the Journal of the American Academy of Dermatology in 2000, ajoene was more effective than terbinafine (which is the active ingredient in Lamisil) in treating athlete's foot. If the infection is on yourskin as in the case of athletes foot orjock itch your doctor will likely suggest an OTCantifungal cream, lotion, or powder. Do not treat tinea capitis solely with topical agents, but do combine oral therapy with sporicidal shampoos, such as selenium sulfide (Selsun) or ketoconazole. Antifungal medications that treat ringworm on the skin include: You'll probably notice that the scaly rash disappears before the general redness of your skin goes away. Your child doesn't have to miss any child care or school for ringworm. engage in close contact, such as wrestlers. For non-prescription creams, lotions, or powders, follow the directions on the package label. Dogs and cats can also get (and spread) ringworm. By clicking Accept All Cookies, you agree to the storing of cookies on your device to enhance site navigation, analyze site usage, and assist in our marketing efforts. You can review and change the way we collect information below. Skin: An antifungal ointment or cream often clears ringworm on the skin. even any worms involved. Oral fluconazole is an option,32 but for most patients oral terbinafine is the treatment of choice because of its superior effectiveness,33 tolerability, and low cost.31,3438 Because toenails grow slowly, assessment of cure takes nine to 12 months. However, doctors warn that, due to its acidic nature, apple cider vinegar can cause open sores and scarring when used to treat ringworm. Cookies used to track the effectiveness of CDC public health campaigns through clickthrough data. Others need a prescription. Unless otherwise indicated, all trademarks are owned by Bayer, and its affiliates, or licensed for its use. Ringworm is a common fungal infection that can affect the skin, scalp, and nails. Continue treatment until gone. However, some clinicians may not have immediate access to a microscope or have a Certificate of Provider-Performed Microscopy,39 and transporting skin scrapings to a distant laboratory will not support immediate point-of-care treatment decisions. Disinfect items you want or need to keep. Fight fungus with the power of Lotrimin AF Ringworm Cream . This material may not otherwise be downloaded, copied, printed, stored, transmitted or reproduced in any medium, whether now known or later invented, except as authorized in writing by the AAFP. Sign up for our Health Tip of the Day newsletter, and receive daily tips that will help you live your healthiest life. Mosby Elsevier, Spain, 2008:1138-46. When cleaning the area with ringworm, wash the affected area (s) and dry it (them) with a clean towel. Contains 1% Clotrimazole: This clinically proven ingredient relieves itchy, red skin as it treats the fungus that causes ringworm. Studies show this vinegar does have some antifungal. Conversely, if a nonfungal lesion is treated with an antifungal cream, the lesion will likely not improve or will worsen. Finally, we performed multiple targeted searches in PubMed and reference lists of previously retrieved studies to fill in remaining information gaps, such as the performance characteristics of laboratory tests used to diagnose fungal infections. If you haveringworm on your scalp or in many different places on your body, OTC treatments may not be enough. You should only use tea tree oil topically as it is toxic if ingested. Popular choices include clotrimazole (Lotrimin) and tolnaftate topical (Tinactin). Ringworm Treatment for Babies and Toddlers. Wash your clothes regularly and keep them dry when not in use. Thank you for taking the time to confirm your preferences. For most cases that affect the skin, the first ringworm treatment option is a non-prescription antifungal medicine. The sound of ringworm is enough to make your skin crawl. It can smooth out deep wrinkles and lines, but the results arent permanent. Find many great new & used options and get the best deals for Creobic Scabies Treatment Cream Cure Skin Ringworm Parasites Itching Anti Fungus at the best online prices at eBay! $14.04. Nondiscrimination and Interpreters Notice, One or more ring-shaped spots caused by a fungus, Has a rough edge and clearing of the center, Clearing of the center as the patch grows, Often only on one side of the face or body. No prescription is needed. In addition, results from Gotucream are backed by a solid 30 day money back guarantee. This is because of close body contact during matches. USD Now $9.98. After applying this medicine, do not wash the affected area for at least 3 hours. To use it, soak a cotton ball in undiluted apple cider vinegar and. It needs direct skin contact to be passed this way. Keep the affected area clean and dry. Ringworm Remedies and Treatments There are two types of treatments for ringworm: topical and oral. are famously lax about keeping their hands to themselves) and athletes who . Data Sources: A PubMed search was completed using the MeSH heading Tinea[Majr] and including meta-analyses, guidelines, randomized controlled trials, and reviews. Shampoos can't replace the oral medicine, but you can use shampoo in addition to them. Sometimes, another prescription medicine is prescribed. Its common to have athletes foot and ringworm on one or both hands. The child with tinea capitis will generally have cervical and suboccipital lymphadenopathy, and the physician may need to broaden the differential diagnosis if lymphadenopathy is absent.7 However, lymphadenopathy can also occur in nonfungal scalp disease, and the absence of lymphadenopathy in an otherwise typical presentation should not delay aggressive treatment for tinea capitis.9. Your dermatologist may need to remove unhealthy tissue to help the area heal. This article will explain the various types of medications used to treat ringworm (tinea). If the ringworm has spread to a fingernail, you will need to take an antifungal medicine to get rid of the infection. Because the scrapings will easily blow off the slide, shield it from drafts or apply KOH preparation to the slide before transport. Medications that weaken your immune system and fungal infections. American Academy of Dermatology. If it's between your toes, for example, it may be easiest to use an antifungal spray or powder. It works by killing the fungus or preventing its growth. Cultures are usually not necessary to diagnose tinea corporis.2 Skin biopsy with periodic acidSchiff (PAS) stain may rarely be indicated for atypical or persistent lesions. Washing your hands after treating ringworm helps stop the disease from spreading to other areas of your body. Thankfully its not nearly as creepy (or as crawly) as it sounds. The acute form presents with erythema and maceration between the toes, sometimes accompanied by painful vesicles. Terbinafine. Examples include Grifulvin V or Gris-PEG (griseofulvin), Sporanox (itraconazole), terbinafine, and Diflucan (fluconazole). When will my ringworm symptoms go away once I start treatment? To relieve itching, apply a cool compress to the uncomfortable area for 20 to 30 minutes at a time as needed. Once treatment has started, the child may return to school, but for 14 days should not share combs, brushes, helmets, hats, or pillowcases, or participate in sports that involve head-to-head contact, such as wrestling.2,17 Household members should be clinically evaluated but not necessarily tested for tinea capitis.17 Many experts recommend treating all asymptomatic close contacts with a sporicidal shampoo, such as 2.5% selenium sulfide or 2% ketoconazole, for two to four weeks.2 If children do not improve, parents should be asked about adherence to the treatment regimen. Tinea capitis may progress to kerion, which is characterized by boggy tender plaques and pustules. Over-the-counter and prescription treatments can stop the fungus from spreading to other parts of your body or to others. Wash towels before using them again. It requires direct skin-to-skin contact. Find out by selecting your child's symptom or health condition in the list below: Seattle Childrens complies with applicable federal and other civil rights laws and does not discriminate, exclude people or treat them differently based on race, color, religion (creed), sex, gender identity or expression, sexual orientation, national origin (ancestry), age, disability, or any other status protected by applicable federal, state or local law. Nails: You need prescription medicine to clear ringworm from the nails. How long do you need to take antifungal drugs? Topical miconazole is used to treat tinea corporis (ringworm; fungal skin infection that causes a red scaly rash on different parts of the body), tinea cruris (jock itch; fungal infection of the skin in the groin or buttocks), and tinea pedis (athlete's foot; fungal infection of the skin on the feet and between the toes). Side effects usually are mild and dont last long. Take your animal to the vet for an exam and treatment. Heres what you need to know. Treatment courses for onychomycosis are long (three to six months), failure rates are high (Table 42,12,1720 ), and recurrences are common (up to 50%).31 In older adults, treatment of onychomycosis is often optional, but most adolescents and young adults request treatment for cosmetic reasons or discomfort from shoes. Children who have scalp ringworm often receive a medicine called griseofulvin. This is especially important if you play contact sports. Throw away any disposable items that might have been infected. Product details. Lotrimin AF Ringworm Cream delivers an antifungal cream treatment in a greaseless, odorless and non-staining cream that's easy to apply. To treat the itch, it often helps to apply a wet, cool washcloth to the area for 20 to 30 minutes. Black dot, caused by Trichophyton tonsurans, is most common in the United States (Figure 4). ), Cleveland Clinic is a non-profit academic medical center. The active ingredient in this ringworm fungus treatment is clotrimazole, which relieves the discomfort of ringworm symptoms and is clinically proven to cure most ringworm. Policy. Other studies show that it works against athlete's foot when applied as a cream. While it Apply a topical antifungal Most cases of ringworm can be treated at home. Apple cider vinegar has strong antifungal properties, so it may help treat ringworm when applied topically to the affected area. Cathy Wong is a nutritionist and wellness expert. 8.8. It comes as a cream, powder, tincture, or spray. Centers for Disease Control and Prevention. Often it's caught from puppies or kittens that have it. Creams, lotions, or powders don't work for ringworm on the scalp. Dermatomycoses due to pets and farm animals : neglected infections? ", Smart Grocery Shopping When You Have Diabetes, Surprising Things You Didn't Know About Dogs and Cats, Smoking Pot Every Day Linked to Heart Risks, Artificial Sweetener Linked to Heart Risks, FDA Authorizes First At-Home Test for COVID and Flu, New Book: Take Control of Your Heart Disease Risk, MINOCA: The Heart Attack You Didnt See Coming, Health News and Information, Delivered to Your Inbox, Understanding Ringworm -- Diagnosis and Treatment, Minor Athlete Infections and Other Annoyances: How to Prevent and Treat Them. Superficial fungal infections. In: Wolff K, Goldsmith LA, et al. Clean the affected area with soap, and dry with a different towel from the rest of your body. Lotrimin cream, Cruex spray powder, Mycelex, Pedesil (, Desenex topical powder, Fungoid cream, Micatin cream, Lotrimin AF athlete's foot spray or powder, Lotrimin AF Jock Itch spray powder (. As much as possible, don'twear clothing or footwear that can cause you to sweat. Ringworm is highly contagious and often occurs when someone touches another person or an animal that has the infection. Pictures and symptoms of the red, scaly rash. Ajoene, which is a natural compound extracted from garlic, has also shown promise in the treatment of ringworm. Here is some care advice that should help. Lesions may be single or multiple and the size generally ranges from 1 to 5 cm, but larger lesions and confluence of lesions can also occur. Wear shower shoes. Provides Effective Relief From Itching Download the drug facts (PDF) > False-negative results on KOH preparations are common and are usually caused by inadequate material on the slide. Typically, this medication has to be applied two to three times a day for at least a week before the ringworm infection begins to clear. The Centers for Disease Control and Prevention (CDC) cannot attest to the accuracy of a non-federal website. Wear fresh clothes, especially undergarments, every day. ", J Prosthodont: "Antifungal Activity of Apple Cider Vinegar on Candida Species Involved in Denture Stomatitis. Ringworm (Tinea Corporis) Ringworm of the body (tin ee uh COR por is) is an infection of the skin caused by a fungus (a plant which is too small to see). Dermatophytes are usually limited to involvement of hair, nails, and stratum corneum, which are inhospitable to other infectious agents. was $49.99 $49.99. Ringworm remains contagious during the first 48 hours of treatment in people and for about 3 weeks from the start . Early studies show it does work as an antifungal against ringworm. Many fungal infections get better within 7 days of treatment with terbinafine - nail infections can take 3 months or more. Still, youd surely rather avoid the infection in the first place. ", Mayo Clinic: "Ringworm (body)", Tea tree oil., Phytomedicine: "Antifungal activity of tea tree oil from Melaleuca alternifolia against Trichophyton equinum: an in vivo assay.". 2012;63(11):848-58. doi:10.1007/s00105-012-2379-y. When it looks like you have ringworm on your scalp or beard area, your dermatologist may remove some hair. Learn more about tinea versicolor treatment here. The miconazole 3 day ringworm treatment cream works well for treatment of athletes ' feet and it is highly effective. Ive seen Tinea pedis (athlete's foot) typically involves the skin between the toes, but can spread to the sole, sides, and dorsum of the involved foot (Figure 3). Scan the slide under low power, and use high power to confirm hyphae in suspicious areas. Sobera JO and Elewski BE. Your dermatologist may also examine other areas of your body. Keeping things clean prevents the infection from spreading to other parts of your body as well as to other people and animals in your household. Also searched were Essential Evidence Plus, the Cochrane Database of Systematic Reviews, and UpToDate. Find patient medical information for Ringworm topical on WebMD including its uses, side effects and safety, interactions, pictures, warnings and user ratings. However, some preliminary research suggests there may be natural remedies that work for some people. Taking a sample is easy. You or your child has ringworm on the scalp. The spores of T. tonsurans will be contained within the hair shaft, but for the less common Microsporum canis, the spores will coat the outside of the hair shaft. You may need stronger medicine. It will also provide a list of home remedies that can help ease symptoms and prevent it from spreading to other people. Leah Ansell, MD, is a board-certified dermatologist and an assistant professor of dermatology at Columbia University. And those itchy red patches are all too common. These considerations may warrant antifungal treatment in the absence of hyphae under the microscope.2 In a European study of 45,000 patients with suspected onychomycosis, general physicians performed a confirmatory test in only 3% of patients and dermatologists in only 40%.40 However, accurate diagnosis is important, especially for onychomycosis and tinea capitis, because these disorders have many mimics and the treatment is prolonged. Tinea corporis (ringworm), includes tinea gladiatorum and tinea faciei, Tinea manuum (commonly presents with one-hand, two-feet involvement), Tinea barbae (beard infection in male adolescents and adults), Tinea incognito (altered appearance of dermatophyte infection caused by topical steroids), Pityriasis versicolor (formerly tinea versicolor) caused by, Uncommon fungal skin infections that involve other organs (e.g., blastomycosis, sporotrichosis), Tinea corporis (annular lesions with well-defined, scaly, often reddish margins; commonly pruritic), Gray or silver scale; nail pitting; 70% of affected children have family history of psoriasis, Personal or family history of atopy; less likely to have active border with central clearing; lesions may be lichenified, Target lesions; acute onset; no scale; may have oral lesions, Dusky; erythematous; usually single, nonscaly lesion; most often triggered by sulfa, acetaminophen, ibuprofen, or antibiotic use, No scale, vesicles, or pustules; nonpruritic; smooth; commonly on dorsum of hands or feet, Sun-exposed areas; multiple annular lesions; female-to-male ratio 3:1, More confluent scale; less likely to have central clearing, Typically an adolescent with a single lesion on neck, trunk, or proximal extremity; pruritus of herald patch is less common; progression to generalized rash in one to three weeks, Greasy scale on erythematous base with typical distribution involving nasolabial folds, hairline, eyebrows, postauricular folds, chest; annular lesions less common, Tinea cruris (usually occurs in male adolescents and young men; spares scrotum and penis), Involves scrotum; satellite lesions; uniformly red without central clearing, Red-brown; no active border; coral red fluorescence with a Wood lamp examination, Red and sharply demarcated; may have other signs of psoriasis such as nail pitting, Tinea pedis (rare in prepubertal children; erythema, scale, fissures, maceration; itching between toes extending to sole, borders, and occasionally dorsum of foot; may be accompanied by tinea manuum [one-hand, two-feet involvement] or onychomycosis), Distribution may match footwear; usually spares interdigital skin, Tapioca pudding vesicles on lateral aspects of digits; often involves hands, May have atopic history; usually spares interdigital skin, Shiny taut skin involving great toe, ball of foot, and heel; usually spares interdigital skin, Involvement of other sites; gray or silver scale; nail pitting; 70% of affected children have family history of psoriasis, Tinea capitis (one or more patches of alopecia, scale, erythema, pustules, tenderness, pruritus, with cervical and suboccipital lymphadenopathy; most common in children of African heritage), Discrete patches of hair loss with no epidermal changes (i.e., no scale); total loss of hair or fine miniature hair growth; exclamation point hairs; no crusting; no inflammation; possible nail pitting, Personal history or family history of atopy; less often annular; lymphadenopathy uncommon; alopecia less common, Alopecia less likely; hair pluck is painful, Alopecia uncommon; lymphadenopathy uncommon; greasy scale; typical distribution involving nasolabial folds, hairline, eyebrows, postauricular folds, chest, No scale; commonly involves eyelashes and eyebrows; hairs of varying lengths, Onychomycosis (discolored [white, yellow, brown], thickened nail with subungual keratinous debris and possible nail detachment; often starting with great toe but can involve any nail), Other nail dystrophies, most commonly associated with repeated low-grade trauma, psoriasis, or lichen planus, Appearance can be indistinguishable from onychomycosis; may have other manifestations of alternate diagnosis, Do not use nystatin to treat any tinea infection because dermatophytes are resistant to nystatin.

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