School Childcare

Communicable Disease Guide for
Schools and Child Care Settings

SCHOOL/CHILDCARE GUIDANCE
RINGWORM
Ringworm is a fungal infection of the body, scalp, or feet. The scalp infection is most
common in children, whereas infection of the feet is more common in adolescents and
adults.
CAUSE
Several different types of fungi; not a worm
SYMPTOMS
Symptoms vary by location of the fungal infection:
Body - Appears as flat, spreading, ring-shaped areas on the skin (lesions). The edge of the
lesion may be dry and scaly, or moist and crusted. As the lesion spreads outward, the
center often becomes clear.
Scalp - May be hard to detect in the early stages. It often begins as a small scaly patch on
the scalp and may progress to larger areas of scaling. Mild redness, swelling, itching, and
pustules (pus-filled bumps) may occur. Infected hairs become brittle and break off easily.
Feet - (Also called athlete’s foot.) Scaling or cracking of the skin, especially between the
toes, or blisters containing thin, watery fluid may be seen. Itching is common. Serious
problems can include bacterial skin infection (cellulitis) and fungal infections of the toenails.
SPREAD
May occur by touching the lesions of infected persons or pets (usually dogs and cats); by
sharing objects that touched the lesions of an infected person, (e.g., hats, caps, combs,
brushes, towels, pillows, bedding, sofas, clothing, hair ribbons, barrettes); or having contact
with skin scales containing fungi on shower stalls or floors, swimming pool decks, and locker
room benches or floors.
INCUBATION (time from exposure to onset of symptoms)

Body – 4 to 10 days
Scalp – 10 to 14 days
Feet - unknown
CONTAGIOUS PERIOD
Contagious as long as lesions are present, but reduced after treatment begins
EXCLUSION
Child care or School: Until treatment has been started or if the lesion cannot be covered. If
on the scalp, until 24 hours after treatment has been started. Any child with ringworm
should not participate in gym, swimming, and other close contact activities that are likely to
expose others until 72 hours after treatment has begun or until the lesions can be
completely covered.
DIAGNOSIS
Recommend parents/guardians call their healthcare provider if they suspect ringworm in
household members. Contact a veterinarian if you suspect a pet has ringworm.
TREATMENT
The particular medication and duration of treatment depends on the location of the
infection. Scalp infections usually require treatment with an oral antifungal medication.
August 2014
Communicable Disease Guide for
Schools and Child Care Settings
SCHOOL/CHILDCARE GUIDANCE
Infections of other areas of the skin can be treated with topical antifungal medications. Nail
infections can be challenging to treat, and may be treated with oral and/or topical antifungal
medications. Courses of treatment may range from 2 to 6 weeks or more, depending on the
severity of the infection and your doctor's recommendations.
PREVENTION/CONTROL
 Wash hands after touching lesions on humans and pets.
 Ensure lesions are completely covered.
 Wash combs and brushes in hot, soapy water, if used by the infected person.
 Check for signs of infection in all pets in the child care and school setting. Have a
veterinarian evaluate any pet with a skin infection or problem. If infection is present,
treatment should be started as soon as possible.
 If the pet has ringworm, children should not be allowed to have contact with the pet
until the rash has been treated and heals.
 DO NOT allow sharing of personal items such as brushes, combs, towels, bedding or
pillows, clothing, hats, caps, hair ribbons, barrettes, and head gear (helmets).
 Have separate bedding and pillows for each child at the child care.
 Wash bedding in hot, soapy water daily while a person is infected.
 Provide separate storage space for personal items for each child or staff member.
 Vacuum carpeted areas and upholstered furniture regularly.
 Schools/Public facilities:
- Require shower shoes (e.g., flip-flops or water sandals) be worn in locker rooms or
showers or on pool decks.
- Exclude from using locker rooms, showers, or pools when active lesions are present
if not covered by a waterproof bandage.
- Disinfect showers and dressing rooms daily with an EPA-approved disinfectant.
For more information please contact Contra Costa Public Health at 925-313-6740 and visit
our website at http://cchealth.org/cd/ or
http://www.cdc.gov/fungal/diseases/dermatophytes/index.html
August 2014

School Childcare

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Communicable Disease Guide for

Schools and Child Care Settings

INCUBATION (time from exposure to onset of symptoms)

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