Ringworm or Candida: What’s the Difference?

Medically Reviewed by Laura J. Martin, MD on April 06, 2012
5 min read

It can begin as a small sore, scaly skin, or a rash. Then it often spreads, itches, or burns.

If you're experiencing any of these symptoms, you may have a fungal infection. The infections can affect anyone, but if you (or your children) play sports or are engaged regularly in other physical activities, your chance of contracting these is higher.

”Fungus is everywhere,” says Jeffrey Weinberg, MD, associate clinical professor of dermatology at Columbia University College of Physicians and Surgeons.

"It's not just in the gym," he says. It's there, of course, but it's also in school locker rooms, fine hotels, your house, and other places.

Knowing how to recognize a potential fungal skin infection early and what to do about it can minimize your misery.

Even if you're just an everyday exerciser or a junior varsity member, you can take notes from the competitive athlete community. In 2010, the National Athletic Trainers' Association (NATA) issued its guidelines for skin disease prevention, including fungal infections.

It did so because of the number of outbreaks involving skin diseases, including fungal infections, among competitive athletes. More than half of all infectious disease outbreaks in competitive sports, from 1922 through 2004, involved skin diseases, the association found.

The NATA guidelines are aimed at reducing that toll. What works for them can also work for you.

WebMD also asked two dermatology experts for an update on what you should know about fungal skin infections. We zeroed in on two common culprits causing fungal skin infections -- ringworm and Candida. Here's what we found out.

Both types of infection are fungal, says Linda Stein Gold, MD, director of dermatology at Henry Ford Hospital in Detroit. At their root are fungi, not the bacteria or viruses that cause other infections.

Technically speaking, "ringworm is a dermatophyte," says Weinberg. A dermatophyte is simply a type of fungi that can cause skin, hair, or nail infections.

"Candida is a yeast," says Weinberg. These fungi can cause infections on many areas of the body.

These fungal infections affect some of the same body parts but also different ones, Stein Gold tells WebMD. The appearance of the infections can differ, too.

Ringworm infections don't involve worms, of course. These fungi are responsible for:

  • Athlete's foot, or tinea pedis
  • Jock itch, also called tinea cruris
  • Infections on the scalp and hair, or tinea capitis
  • Nail infections
  • Infections on the legs, arms, and trunk

You will usually notice itching. "When it starts out, it can be itchy and burning," Stein Gold says of ringworm infections. There can be a ring-shaped rash. The center might be red, also, or could be normal skin color.

If on the scalp, this fungus can cause hair loss.

There can be scaly patches and inflammation.

Fungal infections sometimes attack the feet, between the toes. It can look ''mushy,'' says Weinberg. Or, it can live on the side of the feet, giving the foot a moccasin type look, he says. Weinberg reports formerly serving as an investigator for Ortho Dermatologics.

The infection can be spread from another infected person, an object with fungi on it (such as a towel), or even your household pet.

Yeast infections, commonly caused by a group of fungi from the species Candida, can also affect many body parts. These organisms can cause infections when there is overgrowth. These infections can occur at many sites, including:

  • The vagina
  • The mouth, called oral thrush
  • Skin, especially under skin folds such as under the breasts
  • Nail beds
  • Warm moist areas, such as the underarms

Women with a vaginal yeast infection often report a white, cheesy discharge. In the mouth, the infection shows up as thick, white lacy patches on the tongue.

On the skin, the infections are often a red, flat rash with scalloped edges. There are ''satellite" lesions nearby, Weinberg says. There can be pustules.

Men can be affected with yeast infections in the scrotum, Weinberg says. This infection often shows up as bumps.

Topical antifungal creams and lotions are often used, say Stein Gold and Weinberg. Some are over the counter, such as:

Often the same topical medicine will work for ringworm and yeast, Stein Gold tells WebMD. There's usually no harm in trying over-the-counter remedies first for uncomplicated skin infections, she says. "If you use one of these OTC products for a few weeks and it's not better, I'd certainly have it looked at," Stein Gold says.

If the infection is extensive or persistent, you may need prescription medicines to treat it. Among these are prescription topicals such as ciclopirox (Loprox, Penlac), ketoconazole (Nizoral), and oxiconazole (Oxistat).

Oral antifungal medicines that may be prescribed include:

How long you take these medicines depends in part on how bad the infection is. Often, it is just a matter of weeks, Stein Gold says.

Nail infections may take longer to clear up than infections elsewhere, she says. For toenails, she says, three months of treatment is common. For fingernails, six weeks may be needed.

Prompt treatment is always a good idea, Stein Gold says. "Try to treat it early so it doesn't spread," she says. "Pay attention if you have burning, itching."

If you have an underlying chronic medical condition, especially one that involves a suppressed immune system, it's crucial to treat earlier than later.

You can follow some simple steps to reduce the risk of these fungal infections -- or avoid a repeat, doctors say. Here are some prevention tips from the National Athletic Trainers' Association:

  • Keep the skin dry. "That really helps," says Stein Gold. Fungi love warm, moist areas.
  • Take your own instruments (available at beauty supply stores) to the nail salon. Be sure to sterilize the instruments between manicures and pedicures.
  • Protect your nails. Doctors warn against cutting the cuticle or pushing it back too much. "It's there to protect the nail from outside invasion," Stein Gold says.
  • Baby your feet. Wear white cotton socks. Some socks are made of ''wicking'' material to reduce moisture.
  • Start fresh. If you've had a bad athlete’s foot infection, toss your flip flops or shower shoes and replace them with a new, clean pair.
  • Use foot powders if the fungi love your feet. "Keep your feet dry and cool," Weinberg says.

Wash your workout clothes. Repeat wearing invites fungus. The same goes for socks, swimsuits, and sweaty T-shirts. Wear once, wash, repeat.