Ringworm: symptoms, types and treatments in children and adults

When people notice unusual changes, they often immediately think of something contagious or dangerous. In reality, lichen is not a single disease but a whole group of dermatological conditions that can have different origins: fungal, viral, or inflammatory.

That is why it is important not to self-medicate but to understand which type of lichen has appeared, how it manifests, and which treatment methods are truly effective in adults and children.

What is lichen?

Lichen is a general term for several skin diseases that manifest as spots, scaling, rash, or itching. Lesions can appear on the torso, arms, legs, face, scalp, and sometimes even on nails.

In everyday life, people often call any skin spots “lichen,” but similar symptoms can also occur with allergies, eczema, or psoriasis. Therefore, the main task is to correctly determine the cause of the rash.

Lichen in children: what is important to know?

Lichen occurs more often in children than in adults due to close contacts in children’s groups and frequent contact with animals. The most common form in childhood is ringworm, which is easily transmitted to other children.

Features of lichen in children:

• The rash can spread quickly
• The scalp is more often affected
• Hair may break and “bald spots” can appear
• Mandatory treatment is needed to prevent infection of family and peers

If spots, scaling, or itching appear, it is important not to wait but to consult a dermatologist. Early treatment helps stop the infection faster and avoid complications.

It is also recommended to temporarily limit the use of shared towels, combs, and hats until an exact diagnosis is established.

How is lichen transmitted?

The mode of transmission depends on its type, as different forms have different origins.

Most often, fungal forms (for example, ringworm) are contagious. They can be transmitted:

• Through close contact with an infected person
• Through shared items — towels, clothing, bedding, combs, hats
• From animals, especially cats and dogs, including stray animals

These types of lichen often spread in children’s groups, so it is important to start treatment promptly.

At the same time, there are forms that are not contagious in everyday life. These include:

• Pityriasis rosea — often occurs after viral infections or during decreased immunity
• Lichen planus — associated with inflammatory and immune responses of the body

That is why it is important to consult a dermatologist when a rash appears to determine the type of lichen and whether there is a risk of infection for others.

How to recognize lichen?

Lichen usually begins with a spot or rash on the skin that does not disappear within a few days. Typical manifestations may include itching, scaling, dryness, or irritation of the affected area.

Warning signs include:

• Gradually enlarging spots
• New elements of the rash
• Lesions on the scalp, where hair breakage or loss may occur

In such situations, it is important to consult a dermatologist to clarify the diagnosis and select the correct treatment.

What does lichen look like?

Lichen can appear differently. For some, it is pink dry spots on the torso, for others, light patches of skin after tanning, and sometimes painful blisters like in shingles.

The appearance of the rash, its location, and associated symptoms help the doctor determine the type of disease.

Types of lichen

There are several main forms of lichen, each with its characteristic manifestations:

• Pityriasis rosea (Gibert’s disease)
  Often starts with a single large spot, followed by smaller rashes on the torso. Usually occurs after a cold or in the context of reduced immunity and may resolve on its own in a few weeks.
• Tinea versicolor (pityriasis versicolor)
  Fungal disease manifested as light or brown spots on the back, chest, and shoulders. Affected areas do not tan, so they become more noticeable after sun exposure.
• Ringworm (trichophytia)
  One of the most contagious types, especially common in children. Causes round patches with scaling; on the scalp, it can lead to hair breakage and bald spots.
• Lichen planus
  Inflammatory disease manifested as small reddish-purple rashes, often itchy. May be associated with immune disorders.
• Shingles (herpes zoster)
  Viral form associated with the varicella-zoster virus. Appears as painful blisters arranged in a strip on the torso and accompanied by severe pain.
• White lichen
  More common in children, appears as light patches on the face or hands. Usually not dangerous but requires proper skin care.

How lichen differs from psoriasis

Spots and scaling on the skin do not always mean lichen. Often, these manifestations are confused with psoriasis because both conditions may look similar at first glance. The causes, course, and treatment approaches are significantly different, so it is important to distinguish between them.

Important: A dermatologist’s examination (and if needed, scraping or Wood’s lamp test) helps to definitively distinguish lichen from psoriasis.

How is lichen diagnosed?

Diagnosis begins with a dermatologist’s examination, since different forms can look similar but require very different treatments. The doctor evaluates the rash’s characteristics, location, presence of itching, scaling, and possible infection factors (contact with animals or sick people).

Additional tests may include:

• Skin scraping for fungal infection — helps confirm ringworm or tinea versicolor
• Examination under Wood’s lamp — used to detect certain fungal lesions that fluoresce under UV light
• Dermoscopy — allows a detailed assessment of the rash’s structure
• Tests for suspected viral origin — relevant for shingles
• Additional studies in complex cases to rule out other skin diseases (psoriasis, eczema, allergic dermatitis)

Accurate diagnosis is crucial, as incorrect treatment can prolong the disease or cause complications.

How is lichen treated?

Treatment depends on the cause of the rash — fungal infection, virus, or inflammatory process. There is no universal “cure for lichen.”

Main approaches:

• Fungal forms
  Treated with antifungal creams, ointments, or shampoos. In some cases, especially with scalp involvement, systemic medications may be required.
• Viral forms (shingles)
  Require antiviral therapy and agents to reduce pain and inflammation. Early treatment is important.
• Inflammatory and immune forms
  For pityriasis rosea or lichen planus, treatment aims to reduce itching, irritation, and support the skin. Anti-inflammatory creams and soothing care may be used.

Additionally recommended:

• Avoid scratching affected areas
• Use gentle hygiene products
• Wear natural clothing that does not irritate the skin
• Do not use hormonal ointments without a doctor’s prescription

Self-medicating can worsen the condition, especially if fungal infections are treated improperly.

Can lichen be washed?

In most cases, showers are allowed, but skin care should be very gentle. Avoid soaking affected areas, taking hot baths, or staying long in water as it can worsen irritation and itching.

During hygiene:

• Do not scrub rash with a washcloth
• Avoid harsh scrubs or scented soaps
• Pat skin dry with a towel instead of rubbing

For fungal forms, also avoid excess moisture and overheating to prevent creating favorable conditions for infection.

How to avoid getting lichen?

Prevention depends on the type, but basic hygiene rules significantly reduce the risk, especially for fungal forms.

Recommendations:

• Use only your own towels, combs, and hats
• Avoid contact with stray animals or wash hands thoroughly after contact
• Regularly check your child’s skin after attending groups or school
• Consult a doctor promptly if suspicious spots or scaling appear

Following these simple measures helps prevent infection spread in families and groups.

Conclusions

Lichen is a group of skin diseases with different causes and manifestations. For effective treatment, it is important to correctly identify the type of lichen and choose appropriate therapy. If the rash does not resolve or spreads, consult a dermatologist.

At ZDRAVO clinic, patients can undergo a dermatologist’s examination and necessary skin tests to clarify the cause of the rash.