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Having a circular rash can spark fears that you’ve picked up ringworm. After all, the fungal infection is notorious for causing a ring-shaped rash. But there are a lot of other circular rashes that aren’t ringworm, and dermatologists say it’s important to at least be aware that they exist before slapping OTC antifungal medication on your rash. And looking at skin rash pictures can help you identify the condition behind it, some deceive the eye.
“Circular rashes are very common. There are so many,” says Lauren Cutler, M.D., dermatologist at Santa Monica Dermatology Group in Santa Monica, CA. But the right treatment for each depends on what’s causing your rash in the first place, she points out.
Meet the experts: Gary Goldenberg. M.D., assistant clinical professor of dermatology at Icahn School of Medicine at Mount Sinai Hospital; Lauren Cutler, M.D., dermatologist at Santa Monica Dermatology Group in Santa Monica, CA; Cindy Wassef, M.D., associate professor at the Rutgers Center for Dermatology
That’s why it’s so crucial to figure out what’s behind your circular rash, Dr. Cutler says. There’s no need to panic if you develop one, but it is a good thing to get evaluated by a physician if it doesn’t go away after a week or two, says Cindy Wassef, M.D., associate professor at the Rutgers Center for Dermatology.
Circular rashes aren’t the most common type of rash dermatologists usually see, but they show up more often than most people realize, says Gary Goldenberg, M.D, assistant clinical professor of dermatology at Icahn School of Medicine at Mount Sinai Hospital. Here’s what could be behind your rash (ringworm aside) and corresponding images of each condition.
Atopic dermatitis
Also known as eczema, “it can present in a circular pattern,” Dr. Cutler says. Atopic dermatitis is a chronic skin condition that usually develops in childhood, according to the American Academy of Dermatology (AAD). It can be lifelong or it may go away with time.
Atopic dermatitis can cause the skin to become extremely itchy, according to the National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS). It also can cause dry patches of skin, rashes that can ooze, weep clear fluid, or bleed when scratched, and thickening and hardening of the skin, per NIAMS.
Atopic dermatitis may have periods of flares, where symptoms get worse, followed by periods of remission. It may be aggravated by irritants like certain soaps, fabrics, and lotions, stress, and allergens like certain foods, pollen, and animals, according to the U.S. National Library of Medicine.
Pityriasis rosea
This skin rash is considered harmless, but it can last for six to eight weeks before it disappears, according to the AAD. Pityriasis rosea usually starts with one large patch called a “herald patch” and then is followed by a widespread rash.
The rash is usually “more oval-round,” Dr. Wassef says, and it can be mistaken for ringworm, psoriasis, and eczema. Most people only get pityriasis rosea once, and it’s usually not clear what causes it, according to the AAD. The rash may itch, and it can even come along with flu-like symptoms like a sore throat, swollen lymph nodes, or fatigue, per the AAD.
Granuloma annulare
Granuloma annulare causes a rash that’s easily mistaken for ringworm. This rash forms a clear circle with small, firm, reddish bumps, and it can feel slightly itchy, according to the U.S. National Library of Medicine. These bumps usually show up on the backs of forearms, hands, or feet.
Granuloma annulare is a chronic skin disease and bumps usually return in the same spot, according to the Mayo Clinic. But granuloma annulare looks so much like ringworm that doctors will often take a biopsy to give you a proper diagnosis. The condition usually shows up in otherwise healthy people, although it can be linked with diabetes or thyroid disease.
Seborrheic dermatitis
This common skin condition causes a scaly rash on oily areas of the body, like the scalp and face, according to the AAD. Seborrheic dermatitis doesn’t always appear as a circular rash, but it can take this shape, Dr. Wassef says.
The rash usually looks pink, slightly purple, or lighter than the skin around it on darker skin tones, per the AAD. It typically is red and raised in those with lighter skin tones. This rash can be dry or greasy, and it may itch. Seborrheic dermatitis is not contagious.
Contact dermatitis
This is a condition where the skin becomes red, sore, or inflamed after coming into contact with a substance, according to the U.S. National Library of Medicine. That can be an allergen, like certain fragrances, nickel, poison ivy, or rubber, or an irritant, like hair dyes, certain shampoos, or pesticides.
Contact dermatitis doesn’t always show up in a ring shape, but it can, Dr. Cutler says. Along with the rash, you may have symptoms like itching, swelling, bumps or blisters, and skin that feels hot or tender to the touch, according to the American College of Allergy, Asthma, & Immunology (ACAAI).
Hives
About 20% of people will have hives, a.k.a. urticaria, at some point in their lives, according to the ACAAI. These are raised, itchy bumps that are either red or skin colored. They also may “blanch” or turn white in the center when you press them.
Hives can go away quickly or be chronic and last a long time, per the Cleveland Clinic. Hives can feel like a burning or stinging sensation, and they can be small or as large as a dinner plate. There’s a huge range of potential causes of hives, including certain foods, medications, insect stings, pollen, and pet dander.
Psoriasis
Psoriasis is an autoimmune disease that happens when skin cells multiply too quickly, per NIAMS. That causes patches of skin to become scaly and inflamed, usually on the scalp, elbows, or knees.
Psoriasis can go through periods of flares and remission. While there are different types of psoriasis, up to 90% of people with the condition have plaque psoriasis, which causes patches of thick, raised skin, along with a silvery-white coating called scale, according to the AAD. The plaques tend to be itchy, but scratching them can cause the skin to thicken. Psoriasis patches can appear circular, but aren’t always that shape, Dr. Wassef says.
Tinea versicolor
This infection is caused by a type of fungus called Malassezia, according to the U.S. National Library of Medicine. The fungus interferes with the skin’s normal pigmentation, leading to small, discolored patches that may be round, per the Mayo Clinic.
The patches may be lighter or darker than the surrounding skin and they tend to show up on the trunk and shoulders. The rash may be itchy and appear scaly, according to the Mayo Clinic. It’s usually sparked by hot, humid weather, having oily skin, hormonal changes, and a weakened immune system.
Lupus
Lupus, aka systemic lupus erythematosus or SLE, is a chronic autoimmune disease. It happens when the immune system attacks healthy cells and tissues by mistake, causing inflammation, according to the U.S. National Library of Medicine. Lupus can damage several parts of the body, including the skin, kidneys, heart, and joints, and it can cause a red rash.
While lupus is best known for its “butterfly” rash that appears across the nose and cheeks, the disease can also cause scaly rashes all over the body, per NIAMS. “The rash can present as circular,” Dr. Cutler says. The symptoms of lupus vary, but can include fatigue, hair loss, swollen glands, swelling in the legs, and painful breathing, according to NIAMS.
Lyme disease
Lyme disease is a bacterial infection caused by the bite of an infected blacklegged tick. It can cause a rash, fever, headache, and fatigue, according to the U.S. National Library of Medicine.
More than 70% of people with Lyme disease will develop a erythema migrans rash, which is also known as a “bullseye rash.” This can look like an actual bullseye, an expanding rash with a central crust, a red, oval plaque, or a blueish-hued rash, according to the Centers for Disease Control and Prevention (CDC). “The bullseye rash of Lyme disease is often circular and more common when the weather is warmer and people are spending more time in wooded areas,” Dr. Wassef says.
How to treat circular rashes
Circular rashes are caused by a range of different things, including fungi, bacteria, and autoimmune conditions. As a result, the right treatment usually depends on the underlying cause of the rash.
If you happen to spot a circular rash but you have no other symptoms, Dr. Wassef recommends moisturizing the area and seeing what happens. (If you suspect it may be due to Lyme disease, though, see your general practitioner right away.)
You can also try wearing loose clothing, applying over-the-counter hydrocortisone cream to help with itching, and using a cool compress on the area.
If you’re diagnosed with a particular condition, your doctor may prescribe certain medications and treatments to target the illness, like antibiotics for Lyme disease or anti-fungal medications for tinea versicolor. But getting a proper diagnosis first is crucial.
When to see your doctor
You can try OTC remedies to see if it clears up your rash. “But if the rash isn’t improving with over-the-counter medications and creams, see your dermatologist right away,” Dr. Goldenberg says.
If you’re having symptoms like a fever or aches and pains along with your rash, Dr. Cohen says it’s a good idea to see a physician sooner.
What does ringworm look like?
Ringworm creates a circular rash, but Dr. Wassef says it has a unique look. “It’s round with raised borders and is scaly,” she says. “As the ring gets bigger, the central part clears or seems to fade.”
Is ringworm an actual worm?
No, ringworm is not an actual worm or parasite. Instead, it’s an infection that’s most commonly caused by the fungi Trichophyton, Microsporum, andEpidermophyton, according to the CDC.
Is ringworm contagious?
Yes, ringworm is highly contagious. It can be spread a number of ways, including through skin-to-skin contact with an infected person or animal, sharing towels and sheets with someone who is infected, or touching a contaminated surface, like a locker room floor, per the CDC.
Bottom line
While most people assume ringworm is to blame when a circular rash appears, there are many possible causes. The only way to know what’s behind your rash is to get it checked out by a doctor. They can give a proper diagnosis and recommend next steps from there.
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