In many of the United States, spring is right around the corner, and spring is the time of year that children get ringworm. Here are answers to the most frequently asked questions about this common fungal condition.

Q. What are ringworms?

A. Ringworms are not actually worms and the noun is not used as a plural. Ringworm (known in the medical literature as ringworm capitis) is a fungal skin infection, related to athlete’s foot, that causes a characteristic round rash. It usually starts as a pimple and grows outward. It can make skin flaky and hair brittle, brittle enough to break off and leave a temporary bald spot. There are many strains of ringworm and the species that cause infections in the United States (T tonsurans) is the most likely to leave a bald spot.

The ringworm fungus starts on dead skin. Simply exfoliating with a mild cleanser and warm water every day reduces ringworm infection.

Q. What about raw vinegar for ringworm?

A. The thing about raw vinegar for ringworm is that it affects you, not you. Dilute a quarter cup (60 ml) of vinegar in three quarters of a cup (180 ml) of warm water and apply to the affected area three times a day. If you don’t want to smell like pickles, be sure to rinse the vinegar off your skin after it has been allowed to sit for about 5 minutes. The improvement should be visible in 2-3 days.

Q. How often do people get ringworm?

A. Less than 1% of the population in developed countries have ringworm at any given time, although some areas of Southeast Asia have local infection rates as high as 14%. In North America, ringworm outbreaks occur primarily among children 6 to 10 years of age and are transmitted at school. Strains of ringworm that occur in the Middle East are passed between family members of all ages.

Q. What can you tell me about ringworm medications? Diabetes is my main health problem.

A. When it comes to ringworm medications, diabetes is a concern primarily because it is associated with dry skin. But you would need skin moisturizers no matter what. In diabetic children, the natural remedies to cure ringworm are the same as for non-diabetic children.

About drugs, the thing about prescription drugs is that they are used on you, not you, the opposite of natural ringworm cures. If you have chronic hair loss, a medication your doctor prescribes, such as griseofulvin, will keep the fungus within the hair shaft at bay long enough for new keratin to grow around the hair follicle.

If you don’t already have hair loss, herbal remedies may be more effective. Tea tree oil, in an 8-20% cream, rubbed into the skin three times a day can stop the progression of ringworm into the hair follicle.

What you need to know about tea tree oil is that it does more to improve symptoms than it does to kill the ringworm at the source, but if the fungus is just chewing on the flaking dead skin, it doesn’t care. Clinical trials have shown that tea tree oil is superior to at least one drug (tolnaftate) in controlling itching, inflammation, scaling, and redness, while Rx prescription is better at killing the fungus. It is possible to use both.

Q. How is ringworm in children treated?

A. Natural remedies to cure ringworm are the same for children and adults, except that you must be very sure not to use pure tea tree oil on children. (Creams are always preferable.) Also, it’s a good idea to make sure kids don’t share combs or bedding, and that you wash your hands every time you help your child wash or groom.

Q. What is the difference between ringworm and impetigo?

A. Ringworm itches, impetigo hurts. Her hair falls out in ringworm, but her hair stays in impetigo.

Ringworm is never fatal and is usually easily controlled. Just be sure to prevent reinfection by washing your hands, clothes, towels, bedding, and children frequently to stop the spread of infection.