Ringworm (buni): symptoms, causes and treatment

Ringworm is a common skin infection caused by a fungus. In Tagalog it is called buni. Despite the name, no worm is involved. The name comes from the ring shape of the rash.

On the body, ringworm usually looks like this:

• it starts as a small patch of red, raised spots
• it slowly grows into a ring, with a raised, scaly edge and clearer skin in the middle
• there may be one ring or several, and rings can join into a bigger patch

On brown skin, the rash may look darker than the skin around it instead of red, and the color can be harder to see. It may be scaly, dry, swollen or itchy. Ringworm on the face, neck or scalp often does not look like a neat ring. The medical name for ringworm on the body is tinea corporis.

The same kind of fungus can infect different parts of the body. Each has its own name.

• Ringworm on the face (tinea faciei): the patch may be less ring-shaped and can look like other face rashes. It can cause patchy hair loss, and in men it can affect the beard.
• Scalp ringworm (tinea capitis): itchy, scaly patches where hair breaks off and leaves bald spots, sometimes with small black dots. It is most common in children. There may be a mild fever or swollen glands in the neck. Some children get swollen, pus-filled sores on the scalp called a kerion, which needs treatment quickly because it can leave scars and permanent hair loss. Scalp ringworm needs a doctor, because creams and shampoos alone do not cure it.
• Jock itch (tinea cruris, often called hadhad): an itchy, red rash in the folds of the upper thighs and groin. It is more common in men and teenage boys.
• Athlete's foot (tinea pedis, often called alipunga): itchy, white, peeling or cracked skin between the toes. It can spread to the toenails.

A fungus on the feet can spread to the groin when you pull up underwear or pants, so treat both at the same time.

Many skin problems look like ringworm, even to doctors.

• An-an (pityriasis versicolor, also called tinea versicolor) is a different fungal infection. It causes flat, round patches, usually on the chest, upper back, upper arms, neck or tummy. On brown skin the patches are usually lighter than the skin around them. It does not spread from person to person and is not caused by not washing.
• Eczema and psoriasis can also cause round, red, scaly patches.

An antifungal cream will not help a rash that is not fungal, and the wrong cream can make a fungal rash worse.

If the rash looks unusual or does not get better, a doctor may ask for a simple KOH test. A little skin is gently scraped from the rash and checked under a microscope for fungus.

Ringworm is caused by fungi called dermatophytes. They live on the outer layer of the skin, hair and nails. They grow best in warm, moist places, so keeping skin dry matters in our hot, humid weather.

Ringworm spreads through:

• touching the rash of another person
• sharing towels, clothes, combs, bedsheets or hats
• damp floors, such as shared bathrooms and changing rooms
• touching an infected pet or other animal (cats are common carriers)
• soil, though this is less common

You are more likely to get it if your skin stays wet with sweat for a long time, if you have small cuts or scrapes, if you do not bathe often, or if you play contact sports such as wrestling. If you have diabetes or a weak immune system, ringworm is more likely to need a doctor's care.

Ringworm is common in children, but anyone of any age can get it.

Most ringworm on the body, groin and feet gets better with an antifungal cream. Common creams contain clotrimazole, miconazole, ketoconazole or terbinafine. You can buy some antifungal creams at a pharmacy without a prescription. A pharmacist can look at the rash and help you choose. Not every product suits everyone, and some are only for adults, so check the box or ask the pharmacist, especially for a child.

To use the cream:

1. Wash the area and dry it well.
2. Spread the cream on the rash and a little past its edge. Start outside the rash and move toward the center.
3. Wash your hands afterward.
4. Do not cover the rash with a bandage.
5. Follow the label or your pharmacist about how often to use it.

Keep using the cream for as long as the label or your health worker says, even after the rash fades. Treatment can take up to 4 weeks. Stopping too early can let the buni come back.

If there is no clear improvement after about 2 weeks, see a doctor. You may need a test, a different medicine, or tablets.

Some ringworm needs prescription medicine, which a doctor chooses for you:

• scalp ringworm, which needs antifungal tablets, often with a medicated shampoo
• ringworm that covers a large area, or that creams have not cleared
• infections in people with a weak immune system
• fungal nail infections

Do not use leftover or borrowed antifungal tablets. Some newer types of fungus around the world no longer respond well to the usual medicines, which is one more reason to get checked when a rash does not heal.

Not sure what your rash is? Ask our AI symptom guide, send a photo, or book a call with a nurse.

Some creams sold for itchy skin contain a steroid (a medicine that calms swelling and itch), such as betamethasone. Some "all-in-one" creams mix a steroid with an antifungal.

A steroid cream can make ringworm look better for a while because the itch and redness fade. But the steroid does not kill the fungus, and it can make the infection worse. The rash can spread, change shape and stop looking like ringworm, so it may be mistaken for eczema or psoriasis. Doctors call this tinea incognito. In one large study from Korea, more than half of the people with it had treated themselves or been treated by a doctor who was not a skin specialist, and the infection had lasted more than a year on average.

Family doctors' guidance advises avoiding combination antifungal and steroid creams for ringworm. It also notes that a rash that gets worse after a steroid cream may be a fungal infection.

• Check the ingredients on the box before you buy a cream for buni.
• Do not put a steroid cream on buni unless a doctor has checked the rash and prescribed it.
• Be extra careful with creams on the face, one of the places where the Korean study most often found tinea incognito.
• If you have been using a steroid cream on a rash that keeps spreading, stop and see a health worker. Tell them what you used.

Akapulko (Senna alata) is a traditional medicinal plant in the Philippines, used for buni and other skin problems. Lab studies show that extracts of the plant have antifungal activity.

Research in people is still small. In one study by Philippine General Hospital dermatologists, 20 people with a type of ringworm common among the T'boli in the southern Philippines applied a leaf decoction prepared in their community for 4 weeks. Most had less itching and none had side effects, but only 4 in 10 had no fungus left on the skin test. There was no comparison group, so we do not know how well it works compared with antifungal creams. The researchers called for larger trials.

If you choose to try akapulko, stop if your skin becomes more irritated. See a pharmacist or health worker about an antifungal cream if the rash is not clearly better within 2 weeks, or sooner if it spreads.

Try not to scratch. Scratching can spread the fungus to other parts of your body and can lead to a bacterial skin infection.

You can start at a pharmacy, your barangay health station or the rural health unit (RHU) or city health center. Find a health center near you.

If you are registered with PhilHealth YAKAP, check-ups at your YAKAP clinic are free. As of July 2025, a private YAKAP clinic may charge up to ₱900 per patient for a whole year.

Under PhilHealth GAMOT, the outpatient medicine benefit, the list of free medicines includes clotrimazole cream, ketoconazole cream and ketoconazole shampoo, as of the 2025 circular. To get them free:

• your YAKAP doctor must prescribe them through the GAMOT app
• you get them from a PhilHealth-accredited GAMOT pharmacy, showing the prescription or its code and a government-issued ID
• antifungal creams are in the circular's anti-infective group, which should be claimed within 2 days of the prescription
• each member and each dependent has up to ₱20,000 of free medicines a year

Branded medicines priced above PhilHealth's set fee are not covered unless the pharmacy sells them at that fee. Ask your YAKAP clinic which GAMOT pharmacies near you are accredited. See our PhilHealth YAKAP guide to register.

These habits help keep buni away and protect your family:

• Start treatment early, before the rash spreads.
• Keep skin clean and dry, especially skin folds, the groin and between the toes. Dry off well after bathing and after sweating.
• Change into dry clothes after work, sports or a hot commute. Wear loose clothes, and clean underwear and socks (cotton is best) every day.
• Do not share towels, clothes, combs, hats or bedsheets.
• Wash towels and bedsheets often, in hot soapy water if you can, and dry them well.
• Wear slippers in shared bathrooms and changing rooms.
• Shower soon after contact sports.
• Check your pets. A cat or dog with patches of missing fur may have ringworm and should see a vet.
• Wash your hands after touching animals or soil, and check your skin if someone at home has ringworm.

Children with ringworm can go back to school once treatment has started. Let the teacher know.