Month: June 2023

The first thing to know about ringworm is that there are no worms involved.

This generally harmless skin infection is caused by a fungus. The fungus causes a raised rash usually shaped like a ring, almost as if a worm was curled up under the skin (but again: no worms are involved).

The medical name for ringworm is tinea corporis.

Are there other types of tinea infections?

There are many different kinds of tinea skin infections, named in Latin for the part of the body they affect, such as the

• scalp (tinea capitis)
• groin (tinea cruris)
• feet (tinea pedis)
• body (tinea corporis).

Tinea infections can look a bit different depending on what part of the body they affect, but they are usually pink or red and scaly.

How do you get ringworm?

Tinea infections, particularly ringworm (tinea corporis), are very common. People catch them from other infected people and also from infected animals, particularly dogs and cats. They can also spread from one part of the body to another.

What does ringworm look like?

It usually starts as a pink scaly patch that then spreads out into a ring. The ring (which is not necessarily perfectly round) usually spreads wider with time. It can sometimes be itchy, but most of the time doesn’t cause any discomfort.

There are other rashes that can have a ringlike shape, so it’s always important to check in with your doctor, especially if the ring isn’t scaly. But most ringlike rashes are tinea.

How is ringworm treated?

Luckily, tinea corporis and the other kinds of tinea are very treatable. Most of the time, an antifungal cream does the trick.

When the rash is extensive (which is rare) or doesn’t respond to an antifungal cream (also rare), an antifungal medication can be taken by mouth.

As is the case with many other germs these days, there are some drug-resistant cases of tinea related to overuse of antifungal medications. But the vast majority of fungal infections go away with medication.

What should you do if you think a family member — or a pet — has ringworm?

If you think someone in your family has ringworm, call your doctor. The sooner you get started on treatment, the better.

If someone in the family has been diagnosed with ringworm, make sure that others don’t share clothing, towels, or sheets. Have everyone wash their hands frequently and well.

If your pet has a scaly rash, call the vet. Vacuum the areas your pet frequents, and have everyone wash their hands after touching the pet.

Can you prevent ringworm?

To prevent tinea corporis and other kinds of tinea:

• Keep skin clean and dry.
• Change clothes (particularly socks and underwear) regularly.
• Wash your hands regularly (this helps prevent all sorts of infections).
• If your child plays contact sports, make sure they shower after practice, keep their uniform and gear clean, and don’t share gear with other players.

To learn more about ringworm, visit the website of the Centers for Disease and Prevention.

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About the Author

Claire McCarthy, MD, Senior Faculty Editor, Harvard Health Publishing

Claire McCarthy, MD, is a primary care pediatrician at Boston Children’s Hospital, and an assistant professor of pediatrics at Harvard Medical School. In addition to being a senior faculty editor for Harvard Health Publishing, Dr. McCarthy … See Full Bio View all posts by Claire McCarthy, MD

Summer is an ideal time to take a hike, especially if you have the opportunity to explore one of our country’s many state and national parks. But if you venture far from home, it’s essential to make sure you’re prepared for the local climate and other conditions you may encounter on the trail, especially if you’re not an experienced hiker. Higher temperatures than you’re accustomed to or other extreme weather can be deadly.

“If you’re taking a hike in mid-July in the Arizona desert, there’s a very different list of considerations than if you’re in the mountains of Montana or the forests of North Carolina,” says Dr. N. Stuart Harris, chief of the Division of Wilderness Medicine at Harvard-affiliated Massachusetts General Hospital. Here’s a run-down of what to consider before you hit the trail.

Traveling companions, safety notifications, and orientation

First, it’s safer to travel in pairs or a group of people. But always tell someone not on your hike where you’re going, your anticipated route, and when you expect to return. National parks often require reservations or permits for overnight stays or treks to certain locales, and keep a record of day-hikers, so sign up as requested. If you end up getting injured or lost, the information can make a huge difference in locating you more quickly.

Remember to bring a map and know how to orient yourself. In many wilderness areas, cell service may be spotty or nonexistent, so don’t count on using your phone’s GPS.

In the desert, you may be able to see for 50 miles in the distance. But if you’re in a steep, wooded area, you might not be able to see 100 yards ahead and it’s much easier to become disoriented, says Dr. Harris.

Be ready for heat, humidity, and other weather hazards

Check forecasts first. Always check the forecast so you can be prepared for weather changes. Temperatures may drop and wind may increase as you climb higher. If you’re in an area prone to thunderstorms, lightning injury should definitely be on your radar, says Dr. Harris. Learn these lightning safety tips from the Centers for Disease Control and Prevention. Because these storms usually strike in the afternoon, you can minimize your risk by hiking in the earlier part of the day.

Hydrate well. During any type of exercise — especially hiking, which often demands a fair bit of exertion — be sure to drink extra water to replace the fluid you lose from sweating. On a warm day, you might not notice you’re sweating if it’s breezy. Pay attention to any signs or alerts advising hikers on how much water is best to carry.

Consider humidity. Temperature isn’t the only consideration, however. “If you’re in Arizona and the temperature is over 100° F, your body may be better able to release heat by sweating than if you’re in a very humid area,” says Dr. Harris. In the Great Smoky Mountains, for example, the temperature in July may be only in the high 80s. But humidity levels usually hover around 75% or higher. That means your sweat will evaporate more slowly, so your body’s natural cooling mechanism doesn’t work as efficiently. Be sure to rest and hydrate if you start feeling overheated.

What to wear and bring

Many park websites offer detailed safety tips specific to the terrain and weather you may encounter on a hike, so check before you go. Five basics to consider are as follows:

• If your hike involves rocky or uneven terrain, hiking boots will offer more support than tennis shoes.
• You’ll be more comfortable in lightweight, moisture-wicking clothing, but bring extra layers and rain gear, if the weather forecast suggests this is appropriate. Temperature drops can be surprising in some places when the sun wanes, so be prepared to layer up as needed if you’re out longer than expected.
• Wear a wide-brimmed hat and sunglasses to shield you from the sun’s glare — and don’t forget to apply sunscreen to all exposed skin before you set off.
• Along with plenty of fluids, bring high-energy snacks. If you get off course or encounter a problem, you’ll be glad you did.

Additionally, depending on where you’re hiking, you may need to dodge rash-inducing plants, including stinging nettles, poison oak, or poison ivy. Bring insect repellent to fend off biting insects and follow prevention strategies for ticks, which may harbor bacteria responsible for Lyme disease and other illnesses. Finally, carry a first aid kit with bandages for cuts and scrapes and moleskin for blisters.

About the Author

Julie Corliss, Executive Editor, Harvard Heart Letter

Julie Corliss is the executive editor of the Harvard Heart Letter. Before working at Harvard, she was a medical writer and editor at HealthNews, a consumer newsletter affiliated with The New England Journal of Medicine. She … See Full Bio View all posts by Julie Corliss

About the Reviewer

Howard E. LeWine, MD, Chief Medical Editor, Harvard Health Publishing

Dr. Howard LeWine is a practicing internist at Brigham and Women’s Hospital in Boston, Chief Medical Editor at Harvard Health Publishing, and editor in chief of Harvard Men’s Health Watch. See Full Bio View all posts by Howard E. LeWine, MD

Experiencing discrimination in the workplace — where many adults spend one-third of their time, on average — may be harmful to your heart health.

A 2023 study in the Journal of the American Heart Association found that people who reported high levels of discrimination on the job were more likely to develop high blood pressure than those who reported low levels of workplace discrimination.

Workplace discrimination refers to unfair conditions or unpleasant treatment because of personal characteristics — particularly race, sex, or age.

How can discrimination affect our health?

“The daily hassles and indignities people experience from discrimination are a specific type of stress that is not always included in traditional measures of stress and adversity,” says sociologist David R. Williams, professor of public health at the Harvard T.H. Chan School of Public Health.

Yet multiple studies have documented that experiencing discrimination increases risk for developing a broad range of factors linked to heart disease. Along with high blood pressure, this can also include chronic low-grade inflammation, obesity, and type 2 diabetes.

More than 25 years ago, Williams created the Everyday Discrimination Scale. This is the most widely used measure of discrimination’s effects on health.

Who participated in the study of workplace discrimination?

The study followed a nationwide sample of 1,246 adults across a broad range of occupations and education levels, with roughly equal numbers of men and women.

Most were middle-aged, white, and married. They were mostly nonsmokers, drank low to moderate amounts of alcohol, and did moderate to high levels of exercise. None had high blood pressure at the baseline measurements.

How was discrimination measured and what did the study find?

The study is the first to show that discrimination in the workplace can raise blood pressure.

To measure discrimination levels, researchers used a test that included these six questions:

• How often do you think you are unfairly given tasks that no one else wanted to do?
• How often are you watched more closely than other workers?
• How often does your supervisor or boss use ethnic, racial, or sexual slurs or jokes?
• How often do your coworkers use ethnic, racial, or sexual slurs or jokes?
• How often do you feel that you are ignored or not taken seriously by your boss?
• How often has a coworker with less experience and qualifications gotten promoted before you?

Based on the responses, researchers calculated discrimination scores and divided participants into groups with low, intermediate, and high scores.

• After a follow-up of roughly eight years, about 26% of all participants reported developing high blood pressure.
• Compared to people who scored low on workplace discrimination at the start of the study, those with intermediate or high scores were 22% and 54% more likely, respectively, to report high blood pressure during the follow-up.

How could discrimination affect blood pressure?

Discrimination can cause emotional stress, which activates the body’s fight-or-flight response. The resulting surge of hormones makes the heart beat faster and blood vessels narrow, which causes blood pressure to rise temporarily. But if the stress response is triggered repeatedly, blood pressure may remain consistently high.

Discrimination may arise from unfair treatment based on a range of factors, including race, gender, religious affiliation, or sexual orientation. The specific attribution doesn’t seem to matter, says Williams. “Broadly speaking, the effects of discrimination on health are similar, regardless of the attribution,” he says, noting that the Everyday Discrimination Scale was specifically designed to capture a range of different forms of discrimination.

What are the limitations of this study?

One limitation of this recent study is that only 6% of the participants were nonwhite, and these individuals were less likely to take part in the follow-up session of the study. As a result, the study may not have fully or accurately captured workplace discrimination among people from different racial groups. In addition, blood pressure was self-reported, which may be less reliable than measurements directly documented by medical professionals.

What may limit the health impact of workplace discrimination?

At the organizational level, no studies have directly addressed this issue. Preliminary evidence suggests that improving working conditions, such as decreasing job demands and increasing job control, may help lower blood pressure, according to the study authors. In addition, the American Heart Association recently released a report, Driving Health Equity in the Workplace, that aims to address drivers of health inequities in the workplace.

Encouraging greater awareness of implicit bias may be one way to help reduce discrimination in the workplace. Implicit bias refers to the unconscious assumptions and prejudgments people have about groups of people that may underlie some discriminatory behaviors. You can explore implicit biases with these tests, which were developed at Harvard and other universities.

On an individual level, stress management training can reduce blood pressure. A range of stress-relieving strategies may offer similar benefits. Regularly practicing relaxation techniques or brief mindfulness reflections, learning ways to cope with negative thoughts, and getting sufficient exercise can help.

About the Author

Julie Corliss, Executive Editor, Harvard Heart Letter

Julie Corliss is the executive editor of the Harvard Heart Letter. Before working at Harvard, she was a medical writer and editor at HealthNews, a consumer newsletter affiliated with The New England Journal of Medicine. She … See Full Bio View all posts by Julie Corliss

About the Reviewer

Howard E. LeWine, MD, Chief Medical Editor, Harvard Health Publishing

Dr. Howard LeWine is a practicing internist at Brigham and Women’s Hospital in Boston, Chief Medical Editor at Harvard Health Publishing, and editor in chief of Harvard Men’s Health Watch. See Full Bio View all posts by Howard E. LeWine, MD