Ringworm vs. Nummular Eczema: Symptoms to Look For - Verywell Health

Ringworm and eczema are both skin conditions that cause dry, inflamed, and itchy skin. However, the causes and treatment options for each are very different.

Ringworm, also known as tinea, is a fungal infection that causes a ring-shaped rash with a raised, scaly border. It can occur anywhere on the body and is highly contagious. Eczema, on the other hand, is a chronic skin condition that causes dry, red patches of skin.

One type of eczema called nummular eczema is often confused with ringworm because it also causes a circular rash. Nummular eczema causes red or brown coin-shaped or oval patches over the arms, hands, legs, and torso. Nummular eczema is not contagious.

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Frequent Symptoms

Ringworm and nummular eczema can appear as very similar rashes. They both cause circular, dry, itchy patches of skin. 

Ringworm 

Ringworm can appear anywhere on the body, but is most often found on the feet (athlete's foot), groin area (jock itch), scalp, hands, nails, and beard. Symptoms tend to start about four to 14 days after exposure to the fungus that causes the infection. 

Common symptoms of ringworm include:

• Ring-shaped rash
• Itching
• Scaly skin
• Redness
• Cracked skin
• Hair loss

Ringworm commonly affects children, but it can affect people of all ages. There are known risk factors that make it more likely for certain individuals to have it. Anyone who has frequent physical contact with others, such as athletes like wrestlers, is more at risk of developing ringworm.

Other risk factors include using public showers and locker rooms, living in a tropical area, sweating heavily, living in close contact with others, sharing towels and razors with others, and having diabetes or obesity.

Eczema 

Nummular eczema is a chronic condition and is not contagious. The sores can heal in three to four weeks. You're more likely to experience nummular eczema on extremely dry skin or skin that has been injured. People who have other types of eczema are also more likely to experience nummular eczema.

Common symptoms of nummular eczema include:

• Tiny red bumps
• Blisters
• Red or brown (depending on your skin tone) raised rash
• Itching
• Scaly skin 

Rare Symptoms 

Ringworm 

In addition to an itchy rash, ringworm can also cause hair loss. This happens when the affected patch of skin fills with pus or crusts over. Hair in the affected area then falls out. This is especially common in the scalp and beard area. 

Eczema 

One possible complication of eczema is a skin infection. Symptoms of a skin infection include pus, golden scab over the rash, and swelling. Because nummular eczema is so itchy, it's natural to scratch the skin. However, this puts you at risk of developing an infection.

Home Remedies and Lifestyle

Home remedies and lifestyle changes can be very helpful in managing and even preventing a ringworm infection and flares of nummular eczema. 

Ringworm 

Ringworm is a common infection. It requires an antifungal medication to treat it. Fortunately, there are lifestyle changes you can make right away to lower your risk of coming in contact with the fungus that causes ringworm.

The fungus that causes ringworm can live on surfaces, so it is important to avoid touching public spaces with your bare skin. For example, if you choose to shower in your gym locker room, wear flip-flops to avoid touching the shower stall.

Wash your hands frequently, especially after petting animals. Never share personal items like combs or towels. Because ringworm thrives in hot, moist environments, change your socks and underwear daily, and always change out of sweaty or damp clothing right away. 

Eczema 

Treatment options for nummular eczema, including home remedies and lifestyle changes, focus on relieving symptoms and preventing flares.

Daily moisturizing is considered the first line of treatment for eczema. Hydrating your skin regularly can decrease the itching and swelling associated with eczema. 

Look for moisturizers with the following ingredients:

• Humectants work by pulling water from the dermis (the second layer of skin) to the epidermis (the top layer of skin). This process increases the level of moisture in the stratum corneum, the layer of dead cells that comprise the outermost crust of the epidermis. 
• Occlusives like beeswax and mineral oil increase the water content of your skin by preventing water loss through evaporation. They are most effective when applied to damp skin, such as after toweling off following a shower. 
• Emollients like lanolin and propylene glycol linoleate act as lubricants that fill in the crevices between skin cells. They can improve skin hydration and smoothness. 

Lifestyle modifications that may relieve eczema symptoms include:

• Using a humidifier
• Avoiding irritants like dyes, scents, and chemicals in skincare products
• Taking short, lukewarm showers and baths
• Wearing loose-fitted, cotton clothing
• Avoiding very cold or very hot weather

Over-the-Counter (OTC) Medication

When home remedies and lifestyle changes are not successful in improving your symptoms, it's time to move on to the next step. Many cases of both ringworm and eczema can be treated at home with over-the-counter (OTC) treatments.

Ringworm 

Common forms of ringworm like athlete's foot and jock itch can often be treated at home with over-the-counter medication. Antifungal creams, lotions, and powders are meant to be used for about two to four weeks. If you have not noticed any improvement after that time, see your primary care physician.

Common topical antifungal treatments that can be purchased without a prescription include:

• Clotrimazole
• Miconazole
• Terbinafine
• Ketoconazole 

Don't Use Nystatin to Treat Ringworm

Nystatin should never be used to treat ringworm. It is effective for treating Candida yeast infections, but it's not meant to treat tinea.

Eczema 

When moisturizing alone does not improve your eczema symptoms, the next step is trying an OTC medication. Topical corticosteroids come in the form of creams and ointments, and are used to improve itching and swelling. Most topical corticosteroids should be used twice daily.

Hydrocortisone (Cortisone-10 and Cortaid) creams and ointments are common OTC topicals used to improve symptoms of eczema. 

Get a Diagnosis Before Trying Topical Corticosteroids at Home

While topical corticosteroids are effective at treating eczema, they can actually make ringworm worse. Steroids may improve the itching and swelling, but they cannot kill the fungal infection. This may lead to the infection spreading and weakening your skin's defenses. Using steroid cream can also cause ringworm to change its appearance. This makes it harder for your primary care doctor to diagnose it and provide the right treatment.

Prescriptions 

Many cases of ringworm and eczema can be treated with OTC medications at home. When those treatments are not effective, see your primary care doctor for a prescription.

One form of ringworm that will not respond to OTC topical treatments is scalp ringworm. This type requires a prescription oral antifungal from a physician. These medications often need to be taken for one to three months.

Common prescription antifungal medications include:

• Griseofulvin
• Terbinafine
• Itraconazole 
• Fluconazole 

Prescription options for eczema include topical steroids, topical calcineurin inhibitors, and antibiotics. Prescription steroids have a higher potency than OTC forms. Topical calcineurin inhibitors like pimecrolimus and tacrolimus help block the inflammatory response to the skin and can be used in addition to steroids.

An antibiotic may be prescribed if you have developed a skin infection from scratching. If prescription medications are not helpful, your primary care physician may recommend light therapy or wet wrap therapy. 

Summary

Ringworm and nummular eczema are commonly confused with each other because both conditions cause a circular-shaped rash and dry, itchy skin. If you are experiencing these symptoms, it's important to see a primary care doctor for diagnosis because the two conditions require different treatment. Both can be treated with home remedies, OTC medications, and prescription medications. However, some treatments like topical corticosteroids used for eczema can make ringworm worse.

A Word From Verywell

Ringworm and nummular eczema share many of the same symptoms, so it can be difficult to tell them apart. Ringworm is a fungal infection and easily spreads between humans and animals. Eczema is a chronic inflammatory skin condition and is not contagious. 

Any change in your skin can feel embarrassing, especially when it is visible to others. Fortunately, both conditions are treatable. Ringworm can be cured with an OTC antifungal cream at home or with a prescription antifungal from your primary care doctor. While there is no cure for eczema, it can be managed with OTC topical medications and prescriptions. 

If you are unsure whether you are experiencing ringworm or eczema, see your doctor. They can tell the difference between the two conditions and will help you start healing your skin right away. 

Frequently Asked Questions 

What rashes look like ringworm? 

Ringworm appears as a ring-shaped patch of dry, scaly, red skin. Nummular eczema is a type of eczema that causes a similar rash to ringworm. It leads to coin-shaped or oval patches, which can easily be mistaken for the rash caused by ringworm. 

Do ringworm and eczema have the same symptoms?

Ringworm and nummular eczema share many of the same symptoms, such as round, scaly, itchy patches of skin. 

Can ringworm and eczema get infected?

Ringworm is a fungal infection. Eczema is not an infection, but can potentially lead to one. Chronic scratching of the skin can lead to a bacterial skin infection that requires antibiotic treatment.