Psoriasis vs. Ringworm

The rashes may look similar, but occur in different places

Medically reviewed by Leah Ansell, MD

Both plaque psoriasis and ringworm cause red, scaly skin rashes, but there are some differences that can help differentiate them.

Ringworm is intensely itchy and often looks like a circular rash with a raised, scaly border on places like the feet or palms. Plaque psoriasis is less itchy and appears as patches of raised, red skin covered in silvery scales on, for example, the elbows or knees.

There are differences in the causes and treatments of psoriasis vs. those of ringworm, too. While ringworm is a temporary rash due to a fungal infection (dermatophytosis), psoriasis is an autoimmune condition that can be managed, but never cured.

This article details the similarities and differences between psoriasis and ringworm, as well as how they are diagnosed and treated.

Symptoms of Psoriasis vs. Ringworm

Telling the difference between psoriasis and ringworm can be tricky. Both conditions cause a red, scaly rash to appear on the skin, often in just one area of the body. Psoriasis and ringworm can also both be itchy and irritating.

But there are some ways the rashes distinguish themselves.

Location

The location of the rash can help tell the difference between psoriasis and ringworm.

• Ringworm most often appears in moist areas of the skin, including the feet (athlete's foot), groin (jock itch), and around the beard area (barber’s itch).

• Psoriasis typically appears on the knees, elbows, scalp, and back.

How Raised the Skin Is

Skin plaques are the primary symptom of psoriasis. These are areas of thick, raised skin that often appear silvery and scaly. Ringworm causes round plaques of dry red skin.

With psoriasis, the plaque and the area around it, which is often red, are usually raised. In contrast, the edge of a ringworm rash might be scaly and raised, but the inside is generally flat with smaller scales.

Other Differentiating Symptoms

Psoriasis can also cause dry, cracked skin, and thick, ridged nails on the hands and feet. Plaques may itch or burn.

Ringworm plaques are intensely itchy, especially as they spread to cover a larger area of the skin.

Ringworm can also cause:

• Blisters

• Mushy, white areas of skin

• Foul odor

• Hair loss
  

Symptom Recurrence

Psoriasis symptoms can come and go, with flare-ups followed by periods of remission.

Ringworm, if successfully treated, may never return.

Plaque Psoriasis

• Rash is characterized by thick, raised skin (plaques) that often appear silvery and scaly

• Itching and burning pain

• Common on the elbows, knees, scalp, and lower back
  

• Other symptoms of psoriasis include dry, cracked skin, and thick, ridged nails on the hands and feet

• Not Contagious

Ringworm

• Rash is characterized by red, round patches that have a raised, scaly border
  

• Severe itching
  

• Common on the feet, palms, groin, scalp, and beard area

• Other symptoms of ringworm may include blisters, hair loss, mushy white areas of skin, foul odor
  

• Contagious

Differing Causes

Psoriasis is a lifelong condition that is caused by an autoimmune response. Ringworm, on the other hand, is a temporary infection caused by a fungus.

Ringworm can be eliminated for good with treatment, but psoriasis will need to be managed throughout your lifetime.

Why Some People Get Psoriasis

Psoriasis is linked to an overactive immune system. This causes the skin to grow new cells every few days, rather than every few weeks. This rapid growth and buildup of cells are what cause the plaques that characterize psoriasis.

Unfortunately, experts don’t yet know what triggers the immune system to become overactive, but there appears to be a genetic component since psoriasis often runs in families.

Other additional risk factors put you at increased risk for developing psoriasis, including:

• Obesity

• Smoking

• Certain environmental toxins

• Some medications

• Specific infections

• Excessive mental stress

Why Some People Get Ringworm

Ringworm is caused by a fungus. Despite its name, there is no worm involved.

The fungus that causes ringworm thrives in warm, moist environments, and passes through skin-to-skin contact. Because of this, the condition is especially common in athletes, including those who play contact sports, swim in indoor pools, and use locker rooms.

Other risk factors for ringworm include:

• Obesity

• Diabetes

• Living in a tropical climate

• Sharing towels or shaving equipment

• Living in communal settings like dorms

How Do You Know If It's Psoriasis or Ringworm?

Most often, psoriasis and ringworm are diagnosed with a physical exam from a healthcare provider. Most can tell the difference between the two conditions and set you on the right path for treatment.

Occasionally, they might take a small skin, hair, or nail sample (biopsy) to examine under a microscope:

• Skin cells affected by psoriasis look thick and compressed.

• If you have ringworm, the fungus will be visible in the biopsy sample.

This will provide a definitive diagnosis.

Treatment and Prevention

Ringworm can be treated and cured with a few weeks of antifungal treatment. Psoriasis, on the other hand, requires a lifetime of management.

Psoriasis Management

Psoriasis treatments can help keep symptoms at bay. Your healthcare provider might recommend treating psoriasis outbreaks with:

• Over-the-counter steroid creams like hydrocortisone cream

• Prescription topical medications to help control and prevent outbreaks

• Phototherapy, which uses UV light to slow skin growth

• Biologic injectables, which help to mediate the autoimmune response that can cause flare-ups

Establishing a daily bathing and moisturizing routine that works for you is also important. Using special soaps, shampoos, and lotions to keep your skin well-hydrated will reduce the itching that you experience from psoriasis.

Psoriasis can't be prevented. But if you have it, flare-ups can be reduced by learning and avoiding your triggers, which might include certain foods, seasonal changes, or injuries.

Ringworm Medication and Avoidance

Ringworm is treated using antifungal medications. Most often, these are applied directly to the affected skin for two to four weeks.

If that doesn’t work, or if your infection is widespread, your doctor might recommend using oral antifungal medications.

Continue to take your medication for as long as it's prescribed, even if your symptoms disappear. Doing so ensures that the fungus that causes ringworm is completely out of your system.

Ringworm can be prevented by minimizing your risk of exposure, especially in sports settings. Prevention strategies include:

• Not sharing towels or shaving equipment

• Wearing sandals in locker rooms and pool areas

• Drying your feet thoroughly before putting on socks and shoes

• Wearing loose-fitting clothing

Summary

Although they may appear similar, there are ways to tell the difference between symptoms of psoriasis vs. those of ringworm.

Psoriasis is characterized by thick, raised skin (plaques) that often appear silvery and affect places like your elbows, knees, or scalp. Ringworm presents as red, round patches that have a raised, scaly border and appear on areas like the feet, groin, or face.

Ringworm, a type of fungal infection, can be cured using antifungal medications. Psoriasis is an autoimmune condition requires lifelong use of medications and other treatments.