Things that look the same but aren’t: Jam and jelly. Sugar and salt. Isla Fisher and Amy Adams. All the Hallmark Christmas movies. Psoriasis and ringworm. Wait… what?
Psoriasis and ringworm may look similar on the surface, but they’re actually totally different. They may have similar-looking rashes, but each condition has unique symptoms, causes, and treatments.
What’s the difference?
Psoriasis is a chronic disorder resulting from immune dysregulation that causes the life cycle of skin cells to speed up, making them build up rapidly on the skin.
This leads to red, scaly plaques that are sometimes very itchy and uncomfortable. Psoriasis is not contagious.
Ringworm, aka tinea corporis (the name for ringworm on the trunk or extremities, if you want to get technical), is a highly contagious fungal infection that has nothing to do with actual worms. (You’re welcome.)
It’s named after the circular rash it forms, which looks like a worm in the shape of a ring under the skin. Ringworm is easily treated with antifungal medications.
Symptoms of psoriasis
The symptoms of psoriasis can vary from person to person.
Along with red, silvery, scaly plaques, symptoms may include:
- skin soreness
- joint pain
- nails that are pitted or have other changes
Psoriasis is a chronic condition that has no cure. Fortunately, many people who have psoriasis go through periods of remission in which they have few or no symptoms.
Symptoms of ringworm
Ringworm typically appears as round pink or red plaques on your skin that look clear in the center. It’s very contagious and can grow if left untreated.
Some common symptoms of ringworm include:
- a raised, scaly border
- scaly areas that expand and form a circle
- a red “ring” with a clear center
Other key differences
Psoriasis and ringworm can form in the same places, like the scalp, arms, legs, genitals, and feet.
Psoriasis is not at all contagious. The cause is unknown, but you can probably thank mom, dad, or Great-Great Aunt Esther since genetics are thought to play a role. Psoriasis flare-ups can be triggered by a variety of factors, like stress, alcohol, or diet.
Ringworm, on the other hand, is VERY contagious. This fungal infection can spread faster than the latest celebrity tea — and is not so entertaining.
It’s spread in four different ways:
- human-to-human skin contact
- animal-to-human contact (blame Fido)
- object-to-human contact (don’t share towels)
- soil-to-human contact (less common, but it happens)
Other key distinctions include:
Both psoriasis and ringworm can cause red, scaly rashes. A ringworm rash is usually round and looks like a little worm curled up under your skin (so cute, right?).
An individual lesion in guttate psoriasis can look similar to ringworm, but the lesions usually don’t have clear centers like ringworm patches do. Other forms of psoriasis are usually not mistaken for ringworm.
Risk factors for ringworm include:
- living in a warm climate
- having close contact with infected people or animals
- sharing clothing or towels with someone who has ringworm
- participating in team sports that involve skin-to-skin contact
- having a weakened immune system
Your chances of contracting ringworm increase whenever you’re in close contact with people, like at the gym or when working with children.
Psoriasis can affect almost anyone, but it isn’t contagious, so there’s no need to worry about catching it from someone else.
If left untreated, ringworm rashes can potentially grow and spread.
Psoriasis can also spread, showing up on different areas of the body at different times or at once.
While ringworm rashes may grow larger, their appearance will stay pretty much the same.
Plaque psoriasis lesions may appear in new areas or change in size, but they will probably always look like well-defined pink plaques with silvery scaling (unless they’re treated).
How the rash feels
One word: ITCHY. Ringworm may have a more intense itch, while psoriasis is not usually described as being very itchy.
There’s no cure for psoriasis (yet!), but there are several types of treatment to manage the symptoms. Based on the type and severity of psoriasis, your doctor may prescribe a combination of treatments.
Some treatments include:
For mild to moderate cases of psoriasis, your doctor might prescribe a medicated ointment, cream, or topical solution. These medications are applied directly to the rash and generally include corticosteroids, vitamin D analogs, retinoids, or salicylic acid.
Light therapy, such as narrow-band UVB therapy, improves psoriasis lesions by interfering with the immune system on the skin. It can be used to target a specific area or your entire body.
It’s important to work with a doctor to determine the right treatment plan for you.
Oral or injectable medications
For moderate to severe cases of psoriasis where other treatments don’t work, your doctor may prescribe an oral or injected medication. These medications reduce inflammation and slow or stop skin cell growth by altering your immune system.
Options include oral medications like methotrexate, cyclosporine, acitretin, and Otezla or injectable biologics like Humira, among others.
Some non-biologics that your doctor may prescribe are:
Biologics are administered through injection or IV and target specific parts of your immune system.
Popular prescription biologic drugs include:
- ustekinumab (Stelara)
- ixekizumab (Taltz)
- adalimumab (Humira)
- secukinumab (Cosentyx)
- etanercept (Enbrel)
- infliximab (Remicade)
As with any treatment, there are possible side effects you should be aware of. It’s important to talk to a doctor to determine the best course of treatment for you. They’ll also keep an eye on your overall health for any signs of potentially dangerous side effects.
Because ringworm is a fungal infection, it’s primarily treated with antifungal medications. Some of these medications can be purchased just about anywhere, while others will need to be prescribed by your doctor.
Over-the-counter topical treatments work well on common ringworm cases like athlete’s foot or jock itch. These non-prescription treatments will clear up your ringworm in 2 to 4 weeks. They include creams, lotions, and powders that are applied directly to the skin.
- terbinafine (Lamisil)
- clotrimazole (Lotrimin, Mycelex)
- ketoconazole (Xolegel)
- miconazole (DermaFungal, Podactin)
Ringworm on the scalp doesn’t respond to topical medications — you’ll likely need a prescription antifungal medication to treat it. Prescription antifungals must be taken orally for 1 to 3 months.
- griseofulvin (Grifulvin V, Gris-PEG)
- terbinafine (Lamisil)
If your infection doesn’t go away or gets worse after treatment, consult your doctor.
Eczema, also known as atopic dermatitis, is a chronic condition that causes dry, scaly, itchy patches on the skin. Eczema is often confused with psoriasis. Eczema rashes don’t usually have the silvery appearance that psoriasis rashes do.
Eczema has a genetic basis, but it’s not clear exactly why it happens to some people and not others. It can flare up with weather changes or irritation to the skin, such as when you use scented products.
The easiest ways to tell the difference between psoriasis and eczema may be by considering your family history and by looking at the lesions. Plaque psoriasis lesions are usually not as itchy, and they have well-defined edges and thick, silvery scales.
The dry, scaly appearance of psoriasis may seem like dry skin. This is a common misconception. Dry skin comes with its own fun effects, such as cracking, bleeding, and peeling, but it won’t look pink or be raised with silvery plaques like psoriasis.
When to see a doctor
If you think you have either psoriasis or ringworm, it’s a good idea to visit your doctor. They can do a skin exam to find out which condition you have and decide on the appropriate course of treatment.
Be sure to let your doctor know if skin conditions like psoriasis run in your family, if there’s a chance you’ve come into contact with someone who has ringworm, or if you’ve experienced any abnormalities with your symptoms.
Any info you can provide will help your doctor make a proper diagnosis and treatment plan.
Talk to your doctor ASAP if your condition worsens or you experience any of the following:
- joint pain or swelling, especially if it affects your ability to bend your joints properly
- rashes that aren’t responding to treatment
- difficulty or inability to perform basic or routine tasks
- concerns about the appearance of your skin or rash
Because ringworm is so contagious and very common (you can even get it from infected puppies!), it can be difficult to prevent. Thankfully, there are several ways you can reduce your risk of infection:
- Educate yourself on the signs of ringworm and how to avoid infection. Share what you know with others — spread knowledge, not ringworm!
- Be sure to wash your hands often and keep common areas clean to avoid the spread of infection.
- Keep cool and dry by not wearing thick clothing in warm or humid weather, and avoid excessive sweating.
- Keep your personal items to yourself — sharing is NOT caring when it comes to personal items, like brushes, towels, clothes, or anything else that has direct contact with another person.
- Stay away from infected animals. It’s hard to resist our furry friends, but make sure to avoid contact if you notice any signs of infection. Be sure to practice regular ringworm prevention with your pets.
Psoriasis and ringworm my look similar at first glance, but they are very different.
Psoriasis is a chronic disorder caused by immune dysregulation, and it can come and go. There’s no cure, but treatment can help you manage its symptoms.
Ringworm is a contagious fungal infection that can be cleared up with either OTC or prescription medications.
See a dermatologist to properly diagnose your condition. Through a thorough skin exam, they can help determine what’s going on and how to treat it in a way that will work with your lifestyle.
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