At Metro, both at our practices and at our tournaments, we take mat hygiene very seriously, and always have. We scrupulously clean the mats before every practice. Street shoes are never permitted on the mats. We change into wrestling or other suitable athletic shoes before walking on the mats. A towel is provided at the edge of the mats to wipe these shoes off as well. Anyone with a skin infection should cover it thoroughly before wrestling, or otherwise wait till it has gone away.As a result of this policy, as of 2012 there are no known cases of ringworm or other skin infections transmitted during Metro practices, and we've been holding practices since the early 1990's. These are also good practices to follow for those using home mats or setting up their own wrestling event. From about 2001-2004 there was an issue at some of the "away" tournaments and events where ringworm was transmitted because some wrestlers were unaware of what it looks like and how it is transmitted. By 2005-6 these events began following good hygiene practices similar to those noted above, in some cases even cleaning the mats between each match, and not permitting anyone with a visible skin infection to wrestle, and the result is that I've not heard of cases of ringworm or other skin infections at those events since then. So I would say that these measures are highly effective.
The following information on treatment of ringworm has been well-received and is being provided for reference, as it is easy to treat if one knows what one is doing. However, please keep in mind that the first defence is prevention: good mat hygiene both at practice and at other events may mean you'll never need to treat a case. Also, particularly at summer events, it is possible that a bump seen after a match could simply be a mosquito bite (or a fire ant bite if in Texas), whereas ringworm and other infections have a minimum incubation period of a few days.
It should be noted that the terbinafine cream noted in the article has since gone generic, and is available as such in all the chains like Walgreen's, CVS, Rite Aid, etc. The generics are significantly cheaper and sometimes come in larger, more economical sizes than the brand-name cream.
I sent this information out via e-mail after getting ringworm at a tournament in March 2004, after wrestling someone who thought he had eczema (non-contagious) but actually had ringworm (contagious). I informed the wrestler I got it from, and those whom he and I had wrestled. I'm putting it up to share my experience with other wrestling teams and wrestlers, or anyone interested in the treatment of tinea.
I am not a doctor, and this is not medical advice -- please see a doctor if you want medical advice. I am just speaking from my experience and that of a number of other wrestlers who successfully and quickly got rid of their ringworm in this way. If not treated, ringworm easily spreads at tournaments and practices so it is important to hit it hard and aggressively. Also, on the subject of disclaimers, I assume that both Lamisil and Selsun Blue are trademarks of their respective owners, and this is not intended to be a commercial for them or an endorsement, but these products do seem to work very well against ringworm.
The incubation period for ringworm is about 4-7 days; my ringworm appeared on Wednesday (March 17, 2004) as suspicious zits which turned into rings on Thursday-Friday; my first match with the wrestler who had ringworm was on the preceding Friday.
If you are exposed to ringworm at a tournament or practice, you may or may not get it; often, if there is no irritated or broken skin, and you keep the mats clean and shower quickly after wrestling, no ringworm will develop. I've wrestled a guy at practice and afterwards saw the rings on his arm, but I never got it from him.
However, to be safe, to avoid spreading it elsewhere on your body, or to others you wrestle with (or to a partner), it's a good idea to check your skin during the week after exposure to see if anything pops up. If you never got it before, it usually starts looking like a pimple but sometimes will itch (a distinctive itch which you recognize if you get it again). Then the "zit" expands to form a ring, thus the name (it is not a worm but the tinea fungus which causes it, same as the athletes foot and jock itch organisms). As the ring expands (if untreated), the middle will appear to clear up, and the red border will expand outward, sometimes merging with neighboring rings.
It is spread by skin-to-skin contact. The Lehigh University wrestling team (according to an article found several years ago on a website) studied the various treatments and concluded that the most effective treatment is as follows. As soon as a suspicious zit or ring is found, wash it thoroughly and remove any crust. Or take a shower. The washing will also help the medication penetrate. If there is a crust, you remove the crust and apply the medication to the exposed skin. Sometimes, if you scratch it after a shower, it will appear to ooze lymph; wipe this away before applying any cream. Ed likes to use acetone to increase penetration as well, which probably helps a lot but I've only tried that a few times (a liquid mixture of acetone and tolnaftate by the trade name Fungi-Clear is sold for treatment of nail fungus but reportedly is also effective against ringworm, and I've used it to prep the ringworm area before applying Lamisil so that both the tolnaftate and the terbinafine can act on the fungus). Acetone is also the active ingredient in nail polish remover and tolnaftate is found in other athletes foot products as well.
Lehigh swears by Selsun Blue (the shampoo) for cleaning and prepping the ringworm; it is said to kill and reduce the spread of the fungus even though it is labeled for dandruff use -- the menthol is also tingly and antiseptic. You can use that shampoo like soap. I've also tried iodine shampoo (which says it kills ringworm on the label), but that's not as easily available. If you don't wash the ringworm before applying the cream, penetration will be poor and the ringworm will persist for much longer, and itching may increase. Also, the washing helps to remove the dead upper layers of skin on which the organism feasts.
After washing, dry the area with something disposable, like a tissue, or if a large area, use a towel which will be washed in hot water and dried in the drier after use (along with singlets and other wrestling gear that were exposed to the organism).
Then apply terbinafine hydrochloride cream (Lamisil AT 1% cream, with a picture of a foot on the package, not the weaker jock itch spray) at least twice a day. It is very effective to place a band-aid on the area so the cream doesn't rub off and is concentrated on the area, if it is practical to do so. Applying the cream as soon as the ringworm pops up will usually get rid of it in 3-8 days; if treatment is delayed it could take much longer.
According to the labeling on the package, treatment should be continued for one week. If you let the ringworm grow and spread awhile before starting treatment, it will take longer to get rid of -- you should continue treatment until all the ringworm is gone. If you stop too early it will come back, and may be harder to get rid of. Sometimes the skin will still be a little shiny even after the ringworm itself is gone; it is OK to stop treatment at this time, but the safest course is to keep treating each area until a few days after the last symptoms are present (i.e. no itching, no rings, no pimples). If I get ringworm on the forearm, I have found that for some reason this takes longer to get rid of, but it will go away quicker if I shave off the hair in the immediate vicinity of the ringworm, then apply the Lamisil and cover with a a small bandage.
If it gets into the beard or nails, it is said to be much harder to get rid of, and may require a trip to a doctor for a prescription of an oral medication (oral Lamisil, griseofulvin or some other pill). I never got it there; the first time I got ringworm was in June 2001 on my leg; I made an appointment to see the doctor but while I was waiting the two weeks I scraped off some skin from the lesion area and looked at it under my home microscope; I saw the same hyphae which are seen in web and encyclopedia articles on ringworm. Then I experimented with various over-the-counter athletes foot, jock itch and ringworm products, including the Lotrimin (no butenafine) which the doctor prescribed (she took one look at the sketch I made from the microscope and said I had already diagnosed it). None of these medications was particularly effective; the Lotrimin was making the ringworm gradually fade but after a few weeks of this I went back to the web and found that Lehigh University article which noted, among other things, that the Lamisil is fungicidal (kills the fungus), while the other preparations they tested were only fungistats (they stop it from reproducing but don't kill it). The wrestler I got ringworm from in March 2004 was also using a fungistat, and it was not rendered non-contagious since I caught it from him; while after 48 hours of treatment with Lamisil a lesion is supposedly rendered non-contagious (but should still be covered when wrestling). When I switched to the Lamisil, the result was dramatic, which is why I've used that treatment ever since. I applied it for the first time late in the afternoon, and the following morning I removed the bandage, and much of the ringworm had already flaked off, and the rest of it was gone in 3-5 days, just in time for Hillside.
Some References:
Vasily DB, Foley JJ.: More on Tinea Corporis Gladiatorum. J Am Acad
Dermatol 2002, Mar
Skin Disease in Wrestling, by Rob Lawton ATC
The following is a composite photograph showing the results of an experiment I performed after wrestling at Hillside in the summer of 2003. I tried a newly-released cream which was designed to compete with Lamisil. The new cream, generically called butenafine and sold under the trade name Lotrimin (though not all Lotrimin creams contain butenafine), performed favorably in studies. The ringworm had appeared in late July, caught from a wrestler at Hillside the previous week and appearing after the incubation period had elapsed. I first treated it as usual with Lamisil and caused it to fade a little. On August 1st I switched to Lotrimin, but then on August 2nd I switched back to Lamisil because the itching returned. The photos show the fading from the Lamisil treatment from July 28-31. There was little or no fading during the butenafine treatment on August 1-2, then the remaining ringworm faded over the next ten days after the Lamisil was resumed, though it likely took longer because I continued to alternate between terbinafine and butenafine, with the latter cream not being very effective (I wanted to finish up the tube of butenafine, but kept returning to the terbinafine in order to keep the ringworm shrinking and keep away the itching). The upper left photograph shows a typical appearance of a new ringworm lesion; the red areas look like large and small pimples, while in the upper right photo, the large "pimple" has morphed into a ring shape (but also has started fading due to treatment). The smaller "pimples" are already eliminated in the upper right photo. The bottom two photographs show the progress of the ringworm on my wrist -- since I knew it could be hard to eliminate, I shaved it and aggressively treated it, and already on August 2nd, one of the lesions have disappeared and the other is faded, on its way out.
Hillside 2004 update: No ringworm, as of August 10 (Hillside was July 21-25 this year). Noticed the following two red, slightly itchy areas on left forearm on the Monday after the event; applied Lamisil as a precaution but it was totally gone in two days. I think it was probably just from a mosquito or similar insect. I showered with iodine shampoo this time, which may have contributed to the absence of ringworm and other skin infections, or perhaps there was just no one on the mats with ringworm this time.
For more information, please email Metro at mgwa@metrowrestling.org