Ringworm Disease

Published Date : Aug 2023
Category : Infectious Diseases
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Scrutinize the Industry Surges of the Ringworm Disease with DiseaseLandscape Insights (DLI)

Ringworm is a prevalent fungal infection that can affect people at all stages of life. It is typically a circular, itchy rash that looks like a worm; however, the disease is not related to a worm. Ringworm is a fungal infection that affects the skin, scalp & nails. It is caused by keratolytic fungi called dermatophytes and hence is also known as dermatophytosis or tinea. In the lesion wind circle, the centre of the lesion is clear & surrounded by the inflammatory sensation. The lesions are the circular red, itchy & scaly patches on the skin. Dermatophytosis is a superficial skin infection caused by dermatophytes which are classified as Trichophyton, Epidermophyton & Microsporum genera. Almost 40 fungus species from the above class can cause ringworm. Although the condition looks easy to cure, it may however cause serious illness in people having weak immune systems. This poses a health concern as well as an opportunity for the industry to pioneer innovative ringworm treatments.

The market for ringworm disease is captured by various market players offering efficient antifungal medications across the globe. Additionally, some innovative products are in the development phase which will hold a strong position in the market. For instance, Blueberry Therapeutics is now in Phase 2 development of Terbinafine Hydrochloride, a potentially game-changing therapy for ringworm. This breakthrough has the potential to treat the ailment with exceptional efficacy and to open new pathways for improved patient care.

Furthermore, Viamet Pharmaceuticals is also forging a trial with osteoseconzole, which is currently in phase 2 clinical trials for the treatment of onychomycosis. The improvement seen in these trials not only demonstrates but also emphasizes the industry's dedication to improving patient outcomes.

According to the World Health Organization (WHO), 25% of the world population has Dermatophytosis, while 30 to 70% of individuals have asymptomatic conditions. Around 20-25% of the people worldwide are affected by the ringworm. The major prevalence reported is due to the increased migration, tourism & interaction with ringworm-infected animals.

Underdeveloped and low-income nations pose a high risk of ringworm disease because of insufficient healthcare facilities, poor hygiene, and the exchange of clothing and grooming equipment in public use, etc. High temperature, humidity, and tropical and subtropical climates are also major concerns to develop ringworm.

Diagnostic Analysis:

The ringworm affects different parts of the body and thus the diagnosis area of the body are as follows -

  1. Feet (Tinea pedis, commonly called “athlete’s foot”)
  2. Groin, inner thighs, or buttocks (Tinea cruris, also known as “jock itch”)
  3. Scalp (Tinea capitis)
  4. Beard (Tinea barbae)
  5. Hands (Tinea manuum)
  6. Toenails or fingernails (Tinea unguium, also known as “onychomycosis”)
  7. Other parts of the body such as arms or legs (Tinea corporis)

The conventional diagnostic techniques used to diagnose the type of disease & its severity are as follows -

  1. Histopathological Examination (Skin and nails biopsy)

Skin scrapping & nail clipping with a Period Acid Schiff (PAS) stain is a technique used to diagnose & confirm ringworm disease. The fungal nail infection (Onychomycosis) is confirmed by this technique.

  1. Potassium Hydroxide (KOH) Microscopy (Wet mount preparation)

The skin scraping or nail clippings are kept in potassium hydroxide (KOH) for the diagnosis of ringworm. This test is performed by experienced clinicians for accurate results. This test is also known as Wet mount preparation. The skin scraping is observed under the microscope.

  1. Fungal Culture

The ringworm is diagnosed by the fungal culture technique. This technique is more specific than the wet mount preparation method. However, this technique requires several weeks for results.

  1. Wood’s Lamp Examination (Ultraviolet light, Blacklight)

A Wood's Lamp examination is a simple diagnostic technique that detects certain skin, scalp, and hair disorders. It is frequently used to aid in the diagnosis of fungal, bacterial, and parasitic infections. The lamp emits long-wave ultraviolet (UV) light, which causes certain cells to glow.

Cutting-Edge Solutions for Dermatophytosis: Pioneering a New Era of Accurate Diagnosis

Recent advanced techniques are used for the fast diagnosis of the type of dermatophytosis. These are classified into five sections such as microscopic examination-dependent techniques, modified rapid culture techniques, matrix-assisted laser desorption/ionization-time of flight (MALDI-TOF) based techniques, molecular diagnostic techniques, and lateral flow-based techniques. The techniques are elaborated in short as follows -

  1. Microscopic Examination Dependent Techniques:

  • Bright-Field Light Microscope:

The dermatophytosis infection is diagnosed by microscopic examination. The clarifying agent with infected skin, scraping hair, scales, or nails is examined under the 40x power of the bright microscope. The different clarifying agents such as Potassium hydroxide (KOH), Sodium Hydroxide (NaOH), Calcofluor White, Chicago Sky Blue, and Lactophenol Cotton Blue (LPCB) are used to achieve a clear microscopic view.

  • Phase-Contrast Light Microscope:

A bright field microscopic view is enhanced using contrast and clearance adjustment by different knobs. The light intensity is adjusted to get a clear view. The dermatophytosis fungal infection in skin and nail samples is examined by the 40x phase contrast microscope objective lens.

  • Fluorescence Microscope:

The fluorescence microscope technique is used to examine the dermatophytes which produce fluorescence. The infected skin lesion or tissue is stained with a Hematoxylin/ eosin (H & E) stain or exposed to UV light.


  1. Modified Rapid Culturing Techniques:

The modified rapid culturing technique involves a Dermatophytes Test Medium (DTM), Dermatophytes Identification Medium (DIM), and Multi-chromogenic media-dependent protocol used to diagnose various types of dermatophytosis. The modified rapid culturing technique identifies accurate and specific types of infection in the skin.


  1. Matrix-Assisted Laser Desorption/ Ionization-Time of Flight Mass Spectrometry (MALDI-TOF) Based Techniques:

The MALDI-TOF technique identifies a wide range of bacteria, yeast and fungi species. The MALDI-TOF is an evolutionary and spectrum generation technique that is highly reliable, accurate, and easy to handle. The major drawback of this technique is the higher cost of analysis.


  1. Molecular Diagnostic Techniques:

The PCR technique is capable of diagnosing dermatophyte primers or specific primers. The detection of the dermatophyte by this technique is highly accurate and sensitive. Several types of modified PCR capable of detecting the different types of dermatophyte infection are Conventional PCR, Quantitative/real-time PCR (qPCR), Nested PCR, PCR-ELISA, PCR-Restriction fragment length polymorphism (PCR-RFLP), and Lateral flow-based techniques.


Diagnostic Techniques Market Player


Microscopic Technique

Modified Rapid Culturing Techniques

Molecular Diagnostic Techniques

Thermo Fisher Scientific Inc

Bio Fire Diagnostic

ACON Laboratories

Leica Microsystems

Accelarate Diagnostic system

Bio-Rad Laboratories Ltd.

Nikon Corporation


Thermo Fisher Scientific Inc

Carl Zeiss Microscopy

Thermo Fisher Scientific Inc



AES Chemunex


Celesteron LLC



Euromex Microscopen BV





Diagnostic Products


Microscopic Products

Modified Rapid Culturing Products

Molecular Diagnostic Products

EVOS M5000 & M7000

Film Array system

Promotor® 960

EVOS XL Core Imaging System

Accelarate Pheno system

CFX Opus

Leica DM 6000

BacT/Aert Virtuo Microbial detection

SeqStudio Genetic Analyzer

Eclipse Ti2

Thermo Scientific SureTect PCR system

SeqStudio Flex Genetic Analyzers


D-count Rapid Microbiology enumeration system


Levenhuk 320



Novex R3M





Therapeutic Analysis:

Ringworm is treated with different topical and systemic antifungal drugs. Treatment is given depending on the severity of the disease symptoms. For instance, localized and mild dermatophyte infections are cured by topical therapeutics. Whereas chronic infections are treated by systemic biological therapy. The medication for the disease is available in the form of creams, gels, ointment, sprays, shampoos, solutions, suspensions, dusting powder and infusions in the market.

Additionally, the growing demand for natural products developing novel areas of formulations such as herbal natural products. Manufacturers are offering herbal natural products containing topical and oral therapy that are capable to treat mild and moderate symptoms of ringworm. The treatment of ringworm is typically involving antifungal medications and hygiene practices. Several types of medications are prescribed for treatment of dermatophytosis as follows:

  1. Topical Antifungal Products:

Topical drug therapy is the most utilized treatment for ringworm. Some of the topical products that are majorly dispensed Over the Counter for treatment of the ringworm are Clotrimazole (Lotrimin® or Mycelex®), Miconazole (Desenex®), Terbinafine (Lamisil AT®), Tolnaftate (Tinactin®) and selenium sulfide. These are capable to eliminating the fungal infections and relieving the inflammatory symptoms.

  1. Oral Antifungal Products:

The orally active therapeutics are majorly prescribed for severe infections. Some of the most popular orally active therapeutics are Terbinafine, Itraconazole, Fluconazole, etc. These active components inhibit the synthesis of the sterol in fungi. Thus, fungi are eliminated from the body.

The treatment also depends on the type of ringworm infection. Thus, several types of therapeutics are available and approved by the FDA as follows:

  • Tinea pedis:

Tinea pedis, also known as Athlete’s foot, is usually treated with topical antifungal products. Severe or chronic tinea pedis requires biologically active therapeutic agents such as Terbinafine, Itraconazole, or Fluconazole.

  • Tinea Capitis:

Majorly, tinea capitis treated with systemic intervention involves griseofulvin and terbinafine. The griseofulvin and terbinafine are FDA-approved systemic therapeutics for the tinea capitis. The Selenium Sulfide shampoo is also used as a combination therapy with biological products to treat this type of ringworm.

  • Tinea Corporis & Cruris:

Usually, Tinea corporis and cruris are treated with topical antifungal products. The severe, chronic or recurrent infection is majorly treated with systemic therapeutics.

Cutting-edge therapies that revolutionized the medical landscape with diverse mechanisms of action, typical dosing regimens, formulation and side effects are elaborated below table:


Mode of Action

Typical Dosing


Side Effects

Imidazole (Ketoconazole)

Block lanosterol 14‑α demethylase

by inhibition of synthesis

of ergosterol




Ketocip Tablet orally; Ketoford 2% Cream 15gm Topical; Ketocip 2% Shampoo Topical; Seboclear Lotion Topical; K2-Zole Solution Topical 


Adrenal insufficiency,

Jaundice, kidney problems

Triazoles (Fluconazole)

Block lanosterol 14‑α demethylase



Fluka 150 Tablet Oral, Flucos Dusting Powder Topical, Fluneon 200mg Infusion I.V.

Jaundice, kidney problems



Inhibiting the enzyme squalene

Monooxygenase or sterol synthesis inhibition in fungi 

250 mg/day

Terbinaforce Cream 1% Topical; Zimig 250mg Tablet Oral; Tyza M Gel Topical, Terbicip Spray Topical

Burning sensation, Skin exfoliation, Abnormal liver function



Disruption of the mitotic spindle and

inhibition of fungal mitosis

500 mg/day

Zorbax 500mg Tablet Oral, Zorbax Oral Suspension

Diarrhoea, Abnormal liver function



Treatment Market Players

Topical Therapy

Orally Active Therapy

Biological Products

Bakson's Homeopathy

Himalaya Drug Company

Neon Laboratories Ltd

Allen Homoeo & Herbal Products Ltd

Adven Biotech Pvt Ltd

Torrent Pharmaceuticals Ltd

German Homoeo Care and Cure Pvt. Ltd.

Maharishi Ayurveda Products Pvt Ltd

Cipla Ltd

SBL Pvt Ltd

JRT Organics

Fresenius Kabi India Pvt Ltd

Shree Baidyanath Ayurved Bhawan Pvt Ltd

Technopark Pvt Ltd

Wockhardt Ltd

B-Tex Ointment Mfg Co

Alba Lifesciences


Mark India

Mankind pharma ltd

Stermed India

Suncare Formulations Pvt Ltd

Novartis india ltd

Sipra Remedies

Dupen Laboratories Pvt Ltd

Intas laboratories ltd

Rapid Life Drugs & Healthcare

Transced Therapeutics

Connote healthcare


Kairali Ayurvedic Products Pvt Ltd

Alna Biotech



Pharmaceutical Titans Unite to Conquer Ringworm: Leading the Charge in Innovative Solutions for Effective Treatment

Treatment Products

Topical Therapy

Orally Active Therapy

Immunological Therapy

Ring Guard Cream

Talekt Tablet

Fluneon 200 MG Injection

Bakson's Chrysarobinum Ointment

Adven Homoeo Derm Tablet

Syscan 200mg Infusion

Derma Plus Cream

Maharishi Ayurveda Organic Tulsi Tablet

Forcan 200mg Infusion

German's Acid Chyrso Antifungal Cream

GBF 6 Tablet

Fresocan 200mg Infusion

SBL Acid Chryso Ointment

Tecliv DS Tablet

Funaz 200mg Infusion

Baidyanath Charmrogari Ointment

Albin Plus Tablet

Zocon Inf 200mg Infusion

RVP B-Tex Ointment White

Terbinaforce Tablet IP

Fluster 200mg Infusion

Dadurin Lotion


Stofun 200mg Infusion

Mark Psora Lotion

Tebina-125 Dt Tablet

Fungirap 200mg Infusion

Saltex Lotion

Ecocon 250 mg Tablet


Dango Shampoo

Alnabin Tablet 250MG tablet


Glocid Soap

Acbro Tablet


Kairali Neem Soap




Clinical Trail Assessment:

Synthetic new medicines for the treatment of dermatophytes are currently being developed. DiseaseLandscape Insights makes it simpler to establish and carry out clinical trials for innovative therapies and drugs, assuring favourable trial outcomes. The study names of the presently active clinical trials, as well as the phases in which they are being conducted, are included in the table below.

DiseaseLandscape Insights plays a vital role in simplifying the process of conducting clinical trials for new treatments and medications. DLI aids in various aspects, such as devising patient recruitment strategies & ensuring compliance with regulatory requirements, ultimately leading to positive trial outcomes. The current clinical trials are listed below-


(Human Pharmacology)


(Therapeutic Exploratory Trail)


(Therapeutic Confirmatory Trial)


(Post Marketing Surveillance)

An Open Label, Parallel Group Comparison Study to Evaluate the Safety Tolerability and Pharmacokinetics of UHE-103 Cream Versus Naftin Cream in Subjects with Tinea Cruris and/or Tinea Pedis Under Maximal Use Conditions

An Open-Label Phase 2a Study to Evaluate the Efficacy, Safety, Tolerability, and Pharmacokinetics of Hallux Terbinafine Subungual Gel Administered to the Toenail Bed of Patients with Distal-Lateral Subungual Onychomycosis

A Multi-center, Double-blind, Randomized, Vehicle-controlled Study of Efficacy and Safety of Topical MOB015B in the Treatment of Mild to Moderate Distal Subungual Onychomycosis (DSO)


Pilot Study to Determine the Safety and Efficacy of Regimen Frequencies Using the Swift Microwave Device for Mild to Moderate Toenail Onychomycosis Caused by Dermatophytes

Pilot Study to Determine the Safety and Efficacy of Regimen Frequencies Using the Swift Microwave Device for Mild to Moderate Toenail Onychomycosis Caused by Dermatophytes



A Phase 1, First in Human, Randomized, Double-Blind, Placebo-Controlled Multiple Ascending Dose Study to Assess the Safety, Tolerability, and Pharmacokinetics of ATB1651 in Adults with Mild to Moderate Onychomycosis





Why DLI?

DiseaseLandscape Insights plays a vital role in simplifying the process of conducting clinical trials for new treatments & medications. DLI services aid in various aspects, such as devising patient recruitment strategies & ensuring compliance with regulatory requirements, ultimately leading to positive trial outcomes.

DiseaseLandscape Insights keeps market participants updated about developing trends in the Ringworm Disease Industry, giving manufacturers essential information as they develop and execute effective treatments to combat ringworm epidemics. Our experts identify the target market and devise a strategic business plan to help healthcare professionals achieve success.

Companies in the healthcare industry benefit greatly from DiseaseLandscape Insights services as we provide the foremost, up-to-date research and development in the industry by conducting focused research on contract manufacturing organizations and raw material suppliers and ensuring legal compliance for their business.

Vishal SawantBusiness Development

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