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Ringworm: Hygiene, Care And Pictures

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Wiebke

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Overview
1 What is ringworm and how is it treated?
- Ringworm facts
- Available treatments (UK-US-worldwide available products)
- Your customer rights with new guinea pigs
2 Ringworm hygiene during and at the end of treatment
- When to quarantine
- Recommended disinfectants (UK-US-worldwide available brands)
- Disinfection (plastic/hard surfaces, fabrics, wood/toys)

3 Ringworm hygiene/prevention and treatment in humans and other pet species
- Handling ringworm piggies and human hygiene/prevention
- Ringworm/tinea in humans (incl. children/babies) and other pets (with information links)
4 Ringworm progress pictures and post-treatment measures
- Pictures illustrating the onset and the typical progress of a ringworm infection
- Post-treatment bath and quarantine

5 Further information links



Ringworm/tinea is one of the very few things that can cross over from guinea pigs to other species. It is a fungal skin complaint that can affect other mammalian pets like dogs, cats, rabbits, small furries and humans; it can also affect reptilian pets.


Of all the transmittable problems between pets and humans, ringworm is the most common.

If you suspect ringworm or have got a diagnosis from the vet that you are dealing with tinea/ringworm, you have to make absolutely sure that it doesn’t spread. Your hygiene at home is every bit as important as any fungal treatment itself!

Please do not home treat or treat on spec, but seek vet advice unless you know exactly what you are doing. Mange mites and ringworm can often look very similar in the initial stages, especially if they are appearing in atypical locations. The wrong treatment for the wrong complaint can make things a lot worse instead of better!


More information on common new guinea pig problems: What to check and look out for in new guinea pigs (vet checks, sexing, parasites&illness)


1 What is ringworm and how is it treated?

Ringworm facts
Ringworm is the most aggressive and transmittable form of a fungal skin infection. It is most common in young pet shop or breeder guinea pigs or in guinea pigs rehomed privately or from shelters and rescues with no medical care and quarantine. It can also be transmitted from you and other species pets to your guinea pigs.

Any animal or human affected with ringworm is shedding lots of spores that can happily survive in the tiniest of cracks. The spores can stay active for around 18 months or even over 2 years.
The incubation period is about 10-14 days between infection and outbreak.

The human form of ringworm is called tinea. It does also affect babies and children; children often get it worst. It is not painful but very itchy and highly infectious.

Ringworm has characteristically a painfully itchy reddish ring on the outside of a developing bald, often roughly round patch, hence the name; this will not be visible on piggies with darker skin, but you may notice that the rim of the bald patch is often scratched bloody. Ringworm can look like a scratch or bite that is scabbing over at first. Ringworm often affects the head and ear area, but it can also appear in other areas like the sides, belly or the genital area if ringworm spores are picked up from the cage floor during sleeping, scent marking or humping.

Ringworm is an easily transmitted opportunistic health issue. It often affects highly stressed animals with a lowered, not yet fully developed or overloaded immune system, like shop piggies or newly rehomed piggies, which is one of the reasons why we recommend to quarantine any newly arrived piggies that haven’t undergone a mandatory quarantine at a good rescue. It can also hit a guinea pig that is struggling with underlying health issues or that is recovering from an illness/major operation as well as hit pregnant and nursing sows and their babies hard.
Ringworm can also appear out of the blue without any obvious course or source. It can be carried into the house by other pets.


Available treatments

Oral treatment

It is by far the most effective and least stressful treatment for your piggies with the least risk of infection for yourself but may not work in all cases or be available from/prescribed by all vets.


Oral systemic fungal treatment with itrafungol(UK)/sporonox(US) (active ingredient: itraconazole) or ketaconazole (US) is now more widely prescribed by exotics vets and general vets with access to an exotic consultant vet.
It has the advantage that it gets to all places of the body, especially in very sensitive areas like eyes, ears and mouth and it can also be used to treat for candida infections. It is prescription-only in the UK and not cheap but well worth it, especially when you have a number of guinea pigs or are dealing with frail or very skittish piggies.

What oral treatment cannot reach are shed or picked up spores that sit loosely in the fur coat, which is why it is necessary to bathe all guinea pigs on oral treatment and their companions twice in combination with a deep clean: once at the start of treatment and once at the end of it to prevent the risk of reinfections.
If you have it already at home, nizoral or other generic anti-dandruff (i.e. antifungal) shampoos can be safely used for those two baths to prevent any further outbreaks in ringworm piggies and their companions. It is rather harsh on the skin but one or two uses are fine and will do the trick. It is also cheaper than any other medicated anti-fungal shampoos.

Topical (i.e. on the skin) dips and shampoos in order of effectiveness
- imaverol/enilconazole dip is in our own experience the most effective and the mildest when it comes to sensitive areas and skin, as well as very young guinea pigs.
Please ask your vet for it if they won't/can't prescribe oral treatment. A dip needs to dry on the skin and should not be rinsed off for full effectiveness. Follow the advice on the bottle.

There are other dips and shampoo products that can also do the job, but they can be harsh on the skin and can cause an eye to swell painfully for a while if applied right next to it or they may have been overtaken by more effective new products.
Medicated topical products prescribed by a general UK vet may also include:
- malaseb (still very useful for fungal/bacterial/microbial skin infections, especially when the nature is not clear. It does work for ringworm)
- surolan (is still prescribed by vets but we would rather not recommend it because it contains a steroid; it is in our own experience not as effective as imaverol)

Recommended ONLY if you not have access to any decent vet care at all as it very harsh on the skin for a full course of treatment.
- nizoral or any generic human dandruff shampoos (over the counter 1%, prescription only: 2% - the efficiency of the shampoo depends on the concentration). Bathe every third day for at least three times. If crusts are still forming and hair loss continues please treat for longer at this interval.
Nizoral/human dandruff shampoo can be safely used for guinea pigs on oral treament if you have it at home for yourself.

Fungal skin/athletes foot creams as the only treatment - NOT RECOMMENDED

Please NEVER cream on spec before you have seen a vet for a diagnosis!
Creaming does not reach the whole affected area in a ringworm outbreak, which is always much wider than visible. It does not prevent spores from spreading and infecting other parts of the body and transmitting the infection further.
A thick layer of cream can also be problematic, especially in warm weather.
We strongly recommend to not use creaming for ringworm treatment. It is now a very outdated way of treating from a time when knowledge and available safe options for guinea pigs were extremely limited.

Topical fungal treatment, especially in warm weather or in tropical areas, may not be enough.There are other, less aggressive and transmittable fungal skin diseases.
A mild fungal infection (like a fungal nose strip or a mild fungal ear spot) are often treated by your vet with a cream; they are much less infectious and do come with a high risk of reinfection so creaming is efficient in these cases. Please always apply a very thin layer only.

Information on bathing and further ringworm links
- Our illustrated safe bathing guide: Bathing (including cleaning grease glands)
- More information on ringworm and fungal medications can be found here: Guinea Lynx :: Fungus


Your customer rights with new guinea pigs
Ringworm is typically a problem in newly bought guinea pigs. Exposure to spores or acute ringworm usually happens at the pet shop or breeder although the outbreak at home may happen only days into your ownership due to the 10-14 days gap between infection and acute outbreak. Spores sitting loosely in the coat of an unaffected piggy can fall onto the bedding, from where they are picked up and cause an infection even a bit later.

Any vet fees relating to a diagnosed outbreak of ringworm can be reclaimed by presenting the sales receipt together with the vet bill as part of your customer right for having in effect been sold damaged ware
- if your guinea pig is seen by a vet within 2-3 weeks of purchase in the UK
- within a month in the USA and Canada

Please do not let yourself be fobbed off by staff and insist on seeing the manager in the meantime. Do not let yourself being bullied into re-selling your guinea pig to the shop during treatment - it means that you lose your customer rights; this is very much malpractice by the shop. Your stance re. reimbursement is a lot weaker if you buy from a for sale breeder and even more so if you buy online. You can report any seller to their local council over trading standards, though.

More information on common New Owner problems and pitfalls in this link here: New guinea pigs: Sexing, vet checks&customer rights, URI, ringworm and parasites
 
2 Ringworm hygiene

Quarantine

Bonded pairs
It is generally less upsetting and easier for you to not split well bonded pairs and just treat both guinea pigs for fungal. With prompt treatment during the period between infection and outbreak, you can prevent an actual outbreak in the companion.

The not affected companion will require three fungal baths in all: one at the onset in order to prevent an outbreak from an infection caught before treatment, one once the acute phase of the affected companion is over (1-2 weeks) to prevent an outbreak from any infection caught during treatment and - if you want to be absolutely on the safe side - once at the end of the post-fungal observation period; in the latter two cases to make sure that no ringworm spores are carried across in the fur coat that can fall off or transmit and cause a later outbreak.

I would strongly recommend to give these latter two baths to the affected guinea pig, too, if it is only treated with cream on the affected spot (which may not prevent other patches from coming up and running their cause; a dip will prevent more affected areas from coming up) or - most effectively - with an oral medication (UK brand itrafungol). Oral medication cannot reach any spores sitting in the coat.

Groups or more than one pair
Ideally, you separate and quarantine any affected group piggy/bonded pair in another room or well away from any other pets. You may want to give all your other piggies and any pets in direct or indirect contact with piggies an antifungal bath to prevent further outbreaks and deep clean the room, but by removing the affected guinea pigs, you only have to do this once to all not affected guinea pigs.

If a single piggy is struggling badly on its own (including loss of appetite), you will need to give any piggy that joins as a companion an antifungal bath every third day for three times (three baths in all).

I would also recommend a final bath before your ringworm piggy/piggies are joining a group or go back into a room that is used by other pets, too, so you can be sure that they are not accidentally carrying any spores back in.

Please always keep any pets with ringworm well away not just from other guinea pigs but also other species animals and any children, as well as any frail or older people or people whose immune system is suppressed.


Recommended disinfectants
Vinegar and normal antibacterial pet shop disinfectants are NOT enough to cope with fungal issues!

Recommended effective vet grade antifungal disinfectants
UK:
We strongly recommend to get an antifungal disinfectant like F10 or Virkon.
Both products are internationally available online; you can find them on ebay or amazon, for instance, but also on sites that sell veterinary supplies. They come either as a concentrate or a spray. F10 is also available as a hand gel.
Unlike Virkon, F10 disinfectant is also able to kill off fungal spores, which is why it is our forum preference.
US and Canada: In addition to F10, LD disinfectant is also being recommended on some sites as a new product.
Worldwide: Virkon (and F10 - but you may have to check postage and availability)

NOT recommended disinfectants
- bleach: Leave at least 15 minutes standing. Can be used as a first measure when having to wait for more than 2 days for any online order to arrive, but cannot completely protect against ringworm.
- normal disinfectants: antibacterial, but not antifungal and cannot kill ringworm and ringworm spores
- vinegar: no protection whatsoever against ringworm

From my own experiences, investing in a good antifungal and antimicrobial vet grade disinfectant is well worth the money as its protection can prevent the risk of reinfection and save you much more expensive vet and medication cost down the line!
The same goes for ringworm hygiene - skimping can quickly become a very costly shortcut.


As far as ringworm hygiene is concerned:
Do it properly, spend your money in the right place and you have to do it only once!


Disinfection

In over a decade on this forum, we have had plenty of opportunity to work out what works and what not - and also to discover all the ways you can infect and re-infect yourself and your guinea pigs without noticing.
Our recommended measures are very comprehensive but if you follow them, you can get through a ringworm infection for good in one go and with minimal hassle!

Hard surfaces and plastic
Please disinfect very thoroughly any cages, hutches and any areas in your house that have been in contact with your infected piggy.
Make sure that you really reach all corners and cracks, even more so when dealing with a wooden hutch!
If your cage is on carpet, please move it to a washable area that disinfected easily during and after treatment.
If you can't, get some DIY plastic protection sheet to stand your cage on. Hoover/clean your carpet thoroughly in the area around your cage.

Fabrics
Wash any fabrics at least at 60 C / 140 F in order to kill off any spores.

This includes any of your own clothing in contact with a ringworm piggy, as well as any fleece bedding, fabric underlay, cosies, lap rugs and the towels needed for treatment and dips etc.

Toys and wooden furnishings
Please throw away any wooden hideys and chewing toys
and rather buy fresh ones after the end of the treatment or soak them wholly submerged in strong F10 for a few hours and then let dry.


3 Ringworm prevention and treatment in humans and other pet species

Handling ringworm piggies and preventing catching ringworm yourself
Please always feed, clean and handle a fungal piggy last, so you are not accidentally carrying any spores back to your other piggies/pets by accident.

Wash your hands thoroughly before and after handling an affected piggy.
You may want to get an antifungal hand gel (like F10 handgel) to prevent transmission, especially infecting yourself by accident when unthinkingly touching or scratching an area of skin.

We strongly recommend wearing disposable gloves when handling and treating a ringworm piggy.
You may also want to use an old piece of clothing or a dedicated apron when treating a ringworm piggy.
Please wash any clothes in contact with ringworm regularly at the recommended high temperature, so you are not re-infecting anything via your clothing.

We have also found that a regular every 3 day whole body wash with nizoral or another generic dandruff shampoo (1% ketaconazole) can help protect you from those unthinking scratches or gestures during any treatment, especially after a deep clean, piggy bath or when you catch yourself touching an exposed body part while wearing gloves. The most common spots for transmitted ringworm in humans turn up in the neck, face or on your arms.
PS: If you are treating your guinea pigs orally, you can also use the nizoral shampoo for a one-off piggy bath at the end of the treatment to wash any ringworm spores out of the coat before they return to their deep cleaned cage and their not infected companions.
Use a basin on a towel for grip on the floor of your shower or your bathtub for the piggy bath, then have your own last nizoral bath, hose the area carefully down and disinfect.


Ringworm (tinea) in human adults and children/babies
The infection becomes transmittable the moment a fungal spot appears and spores are shed. Many people will instinctively touch the area when they notice it for the first time, so please wash your hands throughly, first and foremost before touching anything!

The form of ringworm that you catch from your pets is called tinea corporis (ringworm on the body); it is less common than althlete's foot, groin itch or in the hair and can be therefore more misdiagnosed with similar looking skin problems. Not every busy gp/doctor or pharmacist may pick up on the link to you treating pets with ringworm, as forum members have experienced over the years.

Adults information links
More information on tinea corporis with pictures and treatment information in humans.
Ringworm (NHS information)
Ringworm of the Body (Tinea Corporis)

Children and babies information links
Please speak to a gp/doctor if you have small children that have handled an infected guinea pig if creaming is not enough. Children are more likely to get ringworm seriously and will need an antibiotic more often than adult with acute ringworm.
Children
Ringworm (Tinea Corporis): Diagnosis, Treatment and Prevention (tinea corporis in children)
Ringworm or tinea
Babies
Ringworm in Babies: Treatment and Prevention

Ringworm in other pets
Ringworm can affect most pet species, any mammals (including rabbits and small rodents - please follow the advice for guinea pigs) but also reptiles. It is however rarely seen in birds and doesn't affect aquarium fish.
Ringworm in dogs | Blue Cross
Ringworm in cats
Fungal Diseases in Reptiles & Snakes
 
4 Ringworm pictures and post-treatment measures

Pictures illustrating the onset and the typical progress of a ringworm infection
When dealing with ringworm, you have to be aware that it is going to get worse before it is getting better!

The area affected by ringworm is much wider than initially visible. Ringworm is sitting on the hair, especially the hair roots. This means that all the affected hair has to come out before the acute stage is over.

A ringworm attack when treated typically takes about a week or two to run its course; longer in a more advanced or severe case.
It is over when all affected hair and crusts have come off and there is no new exudate forming. The hair will grow back quickly within a month from the inside out.

Onset
Onset with bloody scratch scab looking initially like an injury
IMG_8819.JPG
Picture from day 2 as the bald area is starting to grow away from the scabbed-over scratch towards the eye
IMG_1137_edited-1.JPG

Onset with scaly bald area around the eye
IMG_0073_edited-1.jpg

While ringworm typically starts on the face, ears or neck, it can start elsewhere; especially in guinea pigs that have previously had ringworm or have been in contact with an acute ringworm piggy shedding spores. Advanced ringworm will also come up further down on the body in new places as spores spread or are picked up via the bedding.

Here is a picture of a ringworm outbreak at the back end in a guinea pig that had been referred and surrendered to rescue with an advanced wrongly treated care of ringworm by a vet earlier in the year. Unfortunately in this case the rescue didn't give a final bath at the end of successful oral treatment.
Thankfully with prompt treatment and strict hygiene this piggy remained the only affected guinea pig in a room of 30 other piggies. He was immediately quarantined with his companion in another room, put on another course of oral treatment and only required one bath after the end of the acute phase. Meanwhile the piggy room was completely deep cleaned from top to bottom.
IMG_6089_edited-1.jpg

Onset in a skinny pig on the belly (caused by picking up a ringworm spore that was shed by an infected companion from the floor or a cosy) (picture by @TillyTrueman)
1601677324797.png


When treating topically (skin treatments)
Acute phase between first and second imaverol dip; crusty fungal exudate still forming and clearly visible
IMG_0096.JPG

After a dip; you can see that the affected area by the ear is quite large in this case. Because of a lowered immune system (irregular heartbeat), imaverol dips were ultimately unable to stop the spread and the piggy in question was put on a then (2012) pioneering course of oral itrafungol, which stopped the ringworm completely within a week.
IMG_8040_edited-2.jpg


Furthest extent and end of the acute phase
(no more hair loss and exudate/new scales forming).

You can see the bloody areas where a scab from scratching has come off.
IMG_1332_edited-1.JPG


Recovery
(hair growing back, starting with the initially affected area at the centre of the ring)
IMG_1515_edited-1.JPG


Hair fully grown back
5 weeks after the outbreak; the hair is pretty much grown back.
IMG_0363_edited-1.jpg


Post ringworm bath and quarantine

It is advisable to give all guinea pigs a bath and the hutch/cage and all furnishings a last deep clean to make sure that no spores are carried across; especially from guinea pigs that have been exposed to, but not affected by ringworm, so you can be sure that you have a totally clean start after the end of the quarantine period.
If you have a fungal dip or shampoo at home then please use it, but this time you make sure that you carefully and gently rinse as much of the body surface as possible in order to wash out any ringworm spores sitting in the coat.
Otherwise, any other guinea pig shampoo or even plain water will help with the mechanical removal of loose spores from your piggy's body at the end of the treatment.
Please follow our bathing tips to prevent injuries from blind jumps and panic.
Bathing (including cleaning grease glands)

Please wait another two weeks after the end of the acute ringworm phase before lifting any quarantine to make sure that the fungal has disappeared and is not coming back for those guinea pigs that you have separated from a larger group or other nearby cages (see incubation period of 10-14 days). This makes sure that your treated piggies are totally free of ringworm and are not carrying anything back into a group or a guinea pig room.
Guinea pigs you have treated together for ringworm where there are no other guinea pigs or pets, simply go through a two weeks observation phase.

You are most welcome to open a thread in our Health&Illness section and ask for further ongoing support during treatment.


5 Further information links
Ringworm in guinea pigs:
Guinea Lynx :: Fungus

Ringworm in humans:
Ringworm
 
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