We often see dermatology patients in the clinic who say that they have ringworm and that the so-called “ringworm creams” they buy on their own are not effective and have worsened before they come to the doctor. At this point, the dermatologist must be helpless, because the patient is not suffering from the so-called “ringworm” at all, so how can a topical “ringworm cream” be effective? First of all, let’s clarify what ringworm is. Ringworm as we know it is a disease of the skin, hair or finger (toe) nails caused by a superficial fungal infection, such as ringworm of the head, ringworm of the body, ringworm of the femur, ringworm of the hands and feet, ringworm of the flowers, ringworm of the nails, etc. This type of ringworm can often be effectively controlled or even cured with the use of topical or oral antifungal medications (i.e. ringworm medications). Tinea corporis In addition to this type of disease, there are other diseases that we usually hear called “ringworm”, such as ringworm of the breast, ringworm of the peach, psoriasis, ringworm of the armpit, lichen planus, and so on. Although these are called “ringworm”, they are not caused by fungal infections, so the use of ringworm medication is ineffective and can lead to aggravation of the disease. Let’s take a look at what are these types of ringworm that are not really “ringworm”. Ringworm is a common folk name in China and is roughly equivalent to baby eczema. It usually starts to appear 2 to 3 months after birth, mostly on the cheeks, forehead, scalp and, in severe cases, on the trunk and limbs. In addition to baby eczema, many adult eczema is also the most likely to be mistaken for “ringworm” and the indiscriminate use of “ringworm cream”. The most common type of eczema is ringworm, which occurs in the spring. This is the common name for some facial scaly skin disease. The scientific name is white pityriasis also known as simple pityriasis, adolescent spring rash, seasonal contact dermatitis and other diseases. This is because the spring is warm, the sun is bright, the ultraviolet content increases, the air is suspended with pollen, willow and other particles, for adolescents and some people with high skin sensitivity, the exposed facial skin will appear a series of inflammatory reactions, manifested as white spots, flaking, etc.. There is usually no abnormal sensation. Most of the disease starts in spring. Psoriasis is actually the common name for psoriasis, which is a common chronic inflammatory skin disease that is stubborn and recurrent. Typical skin lesions can be summarized in sixteen words: “red rash, silvery white scales, film phenomenon, and punctate bleeding.” Many psoriasis patients are afraid to go to public places to participate in activities for fear of being eyed by others, in fact, no one has been able to culture fungi or detect the presence of bacteria in psoriasis skin lesions, and psoriasis is not contagious. As for the cause of its pathogenesis is still not very clear, it may be related to polygenic inheritance. In addition, the occurrence, aggravation, remission and cure of psoriasis are closely related to mental tension and psychological stress, and belong to the category of physical and mental diseases. Mental tension and make the body metabolic imbalance, the body immune function disorder. All of these factors are influencing the changes of the disease in different ways. 4. Axillary ringworm is also not ringworm, but is caused by a bacterial infection, which is caused by a pathogenic bacterium called Corynebacterium ciliatum and does not usually invade the hair roots or the skin. Patients may notice a yellow, black, or red coating around the hair shaft of their armpit or pubic hair in the summer, with yellow being the most common. These wrappings can be hard or soft, small nodular or diffuse, making the hair shaft brittle and easily broken. The skin of the affected area is normal, but usually sweaty. The sweat may be yellow, black or red due to the color of the encrustations. There are usually no conscious symptoms, and patients are often found unintentionally. 5. Lichen planus Lichen planus, known as “purpura” in Chinese medicine, is not rare clinically, and its incidence has increased in recent years. It is often misdiagnosed because of its varied lesion manifestations. The most typical damage is a flat papule slightly above the skin surface, the size of a small rice grain to green bean, in a well-defined polygonal or round shape. The color is mostly purplish red or purplish blue, but can also be dark red, reddish brown or dirty gray. From the above, we know that ringworm is not always caused by fungal infections and ringworm medication cannot solve all ringworm diseases. If you have a skin problem, do not use ringworm medication indiscriminately, but go to a dermatologist first and ask for a clear diagnosis and then undergo targeted treatment under the guidance of your doctor.