Why do I get ringworm frequently?

Monday March 11 2019

 

By Dr Vincent Karuhanga

I am sick of getting ringworm on and off. What is the cause?
Shiru

Dear Shiru,
Ringworm (tinea) is a contagious fungus infection of the skin involving especially the scalp, torso (body including the groins), the feet and nails. It is not caused by worms as the name goes rather the fungus that causes it eats in whorls hence the infected skin showing rings. Different fungi that may live on humans and animals (sometimes soil) may cause infection to the different body parts.

People can get ringworm by direct skin-to-skin contact with an infected person or pet or surfaces touched by the infected pet or person including bed sheets, hats or combs. Anyone can get ringworm though children in schools (boarding) are most affected.

Though ringworm is difficult to prevent, treatment of all infected persons and pets reduces the likelihood of re-infection. Avoiding contact with infected persons and pets, not sharing personal items with others (jerseys, combs, hats or socks), keeping publicly used areas clean can also help. In rare cases, ringworm can be spread to humans by contact with infected soil requiring thorough washing after contact with soil.

Ringworm can be treated with creams but in severe cases tablets can be added. If the fungus persists or recurs then drug treatment (usually for six weeks) has not been completed or the preventive measures above have not been effected. Showering immediately after exercise, to avoid having sweat staying on the skin and drying yourself, thoroughly, before dressing may be necessary. Also, the fungus may be resistant to the used drug requiring its review.

Many skin conditions may look like ringworm and treated so when they are entirely different may not get cured requiring a skin specialist if treatment has failed.

Also, some people, especially those with a weakened immune system, (diabetics, those with HIV infection or on long term steroid treatment) as well as those with an inherited skin condition called atopic dermatitis, (characterized by itchy, inflamed skin), or those genetically prone may be more susceptible to ringworm. These people may easily get the fungus including when they have been successfully treated.

My son’s hair started greying at 22. He also has patches of vitiligo on his pelvic area. Can this be stopped?
Gladys

Dear Gladys,
Vitiligo is a skin condition where the skin looses its black pigment usually creating “white” skin patches. Its mysterious occurrence has led to a local belief that it happens because the skin is burnt in response to not properly performing rituals related to the birth of twins in the family.

However, vitiligo is thought to be due to the destruction of skin cells that give both hair and skin their black colour (melanocytes) by our immune system and may therefore coexist with some other autoimmune conditions such as thyroid disease which should be ruled out.

Environmental triggers may also start this condition that may run in families, affect sun exposed areas or around human “holes” including the mouth, vulva or penis. This could be the reason your son’s vitiligo started in the pelvic are but has progressed to affect the scalp causing premature greying of hair.

Vitiligo can start at any age, though it usually begins at 20, and may start in one area and either progress to other areas or even stop by itself.

Vitiligo affecting hair can cause lots of distress, loss of self-esteem and confidence, requiring addressing properly which is usually difficult since the affected hair never usually repigments as required. Use of head caps, shaolin haircuts and dyeing the hair may however help out but not permanently.

A skin specialist may be required to help prescribe some drugs but usually these may not help as required. Carrying out hair transplants may be the last expensive resort but in many even this usually fails to yield the best results.

I have heard rumours that my brother was having an affair with my wife. I now believe that all our children are his because they bear a resemblance to him and share his blood group (O-) yet I am O+. What can I do?
Anonymous

Dear Anonymous
Although rumours can be true, they can also be false. The unfortunate thing about rumours is that there is a common belief that there cannot be smoke without fire and many people will do all they can to find the truth as you are trying to do.

If you and your brother share a mother and father, then your children can resemble your brother and may carry an identical blood group.

Unfortunately, you have not indicated your wife’s blood group to help rule out the possibility that you could still be the father of the children. Anyhow, you can do DNA tests on the children and you first because this will show that the children do or do not belong to you.

If the children are not yours, you may require doing your brother’s DNA profile as well. It is possible to extract DNA from almost any human sample, including nails, blood, sperm, and items that contain saliva, such as his toothbrush or chewing gum.

Most DNA requests are usually from blood, hair or the inside of the cheek (buccal) but these may require your brother’s permission.
You have to be careful to keep the tests a secret from your wife and children because in case the children are yours, you may have everlasting family tensions.

I am an ex-footballer and generally feel pain when it is cold. Why?

Ssekamate

Dear Ssekamate,
Whenever one feels joint pains, the body is reporting an injury, inflammation or infection of the joints or the joint’s surrounding tissues. Sometimes, one can feel joint pains due to problems of the nerves serving the affected joints.

When it is cold, the blood vessels supplying the peripheral areas of the body such as the legs and arms narrow to conserve heat and with less blood flow, the arm and leg joints will get colder and stiffer resulting in joint discomfort and pain.

Sometimes, even before coldness (or rain) sets in, people with chronic joint or nerve pains may even predict the weather change with the pains worsening because of the associated fall in barometric pressure (the pressure of air around us).

A fall in Barometric pressure results in less pressure of air against the body, allowing tissues to expand and press against the joints or even nerves leading to pain. Here people who have had football knocks, shingles (Herpes Zoster) scars, or chronic joint pains due to diseases such as psoriasis and rheumatoid arthritis, may all have pains that get noticeably worse with colder temperatures.

Therefore, you need a proper diagnosis to manage your pains because they may not necessarily be due to your previous injuries during your football career but another disease requiring proper diagnosis and management.

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