Category: HEALTH

In this increasingly digital world, it’s not surprising that children are spending more and more of their time on some sort of device. And while there is certainly much to be learned, explored, and created using devices, there are skills that devices can’t always teach — and that children need to learn.

Play bolsters executive function and mood regulation skills

Executive function, emotional regulation, and general physical skills are important for children to learn — and practice — as they grow. The best way for children to learn these skills is through play; that’s why we say that play is the work of a child. As devices become more pervasive, and as many children become more scheduled with lessons and organized activities, making time for device-free play can become forgotten.

I think that also, parents and children are literally forgetting how to play. Parents used to bring toys to entertain their children while they waited to see me; now they just hand their child their phone. Devices are so ubiquitous and easy, it can take real effort to put them aside and find something else to do.

Play is essential to healthy development

Harvard’s Center on the Developing Child has developed excellent handouts for parents (note: automatic download) on different age-based games and activities to help support their child’s development. I particularly like those that involve the parent too — because that not only helps your child, it helps your relationship.

Great games to play with younger children: Ages 4 to 7

In the first three years of life, play is about literally building brain connections and basic skills. As kids grow, play builds on those skills and gives them opportunities to think, be creative, cooperate with one another, and use their bodies.

Here are some ideas for 4-to 7-year-olds (note: automatic download):

• Freeze Dance, Red Light Green Light, Simon Says, or Duck Duck Goose are all games that get kids active while reinforcing self-regulation and cooperation.
• I Spy, Bingo (or Opposites Bingo, where families make their own picture boards and kids have to match the opposite to what is said), and other matching games are great for building memory and cognitive skills.
• Try starting a story and having others add to it to see what plot twists emerge! It’s a great way to encourage creativity. You can do something similar with a drawing: start with something simple, like a house or a boat, and take turns embellishing this, narrating as you do.

Great games to play with older children: Ages 8 to 12

The 8-to 12-year-olds (note: automatic download) are capable of more complicated activities, like:

• Doing jigsaw puzzles, or solving crosswords or other puzzles together.
• Playing games like chess, Battleship, Go, or Clue that involve memory and planning.
• Playing a sport — play basketball together, go skating, practice yoga, or go for a run together. Being active together is not only healthy for both of you, it sets a good lifelong example.
• Learning an instrument — learn together!
• Making things. Teach them to cook, build, sew, crochet, grow a garden. This, too, can be play.

Opportunities to play help teens, as well

As kids grow into teens (automatic download), they naturally seek more independence and time with their peers. Opportunities for play take different forms depending on personal interests. Sports, cooking, music, theater, and even (within moderation) video games can encourage creativity, life skills, and fun.

For more information about how parents can build and encourage important life skills in their children, visit the Harvard Center on the Developing Child website.

Follow me on Twitter @drClaire

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

I recently saw a car vanity plate that read “LBODOC” (as in elbow doc). The driver — probably an orthopedic doctor or arthritis specialist — was clearly a fan of the elbow, an unassuming joint and a surprisingly central player in many daily tasks. I could relate: throughout my medical career, the elbow has been my favorite joint.

Here’s why we should give praise to elbows and do all we can to protect them.

What if we didn’t have elbows?

Let’s face it: the human experience would be quite different without elbows.

Imagine your arm without a joint that bends at the elbow. You’d be unable to easily feed yourself, put on makeup, shave your face, or brush your teeth. It’d be tough to get dressed or throw a ball without elbows. And, importantly, wiping yourself after using the bathroom would be nearly impossible.

Yet, when it comes to joints and joint disease, we hear little about elbows; hips and knees get most of the attention. So, let’s consider for a moment what the lowly elbow does and why it deserves more credit.

How do your elbows work?

Three bones come together at the elbow joint: the humerus, which is in the upper arm, and two long bones called the ulna and radius in the lower arm.

Your elbow has two main motions:

• Flexing and straightening. Flexing your arm allows you to bring your hand toward your body (flexion), which you do when bringing food to your mouth or putting your hands on your hips. Straightening your arm (extension) allows such motions as putting your arm in a shirt sleeve or reaching your toes.
• Turning up and down. You can also flip your palms from facing the ceiling (supination) to facing the floor (pronation). These motions are important for many common movements, such as turning a key or a doorknob.

Bumping your elbow: Why is it called the funny bone?

Probably for two reasons:

• The humerus in the upper arm sounds just like the word humorous, meaning funny.
• Bumping your elbow often puts pressure on the ulnar nerve, since it’s located between the bones of the joint. Pressure on this nerve can cause a funny tingling sensation that runs down your arm.

Elbow trouble: Four well-known problems — and a surprising fifth

Like so many overlooked and underappreciated things, most people think little about their elbows until something goes wrong. Here are some of the most common elbow problems:

• Arthritis. Several types of arthritis can affect the elbow, including rheumatoid arthritis, psoriatic arthritis, and gout. Interestingly, the most common type of arthritis, osteoarthritis, doesn’t usually affect the elbow unless there’s been prior damage to the joint.
• Bursitis. The bursa is a saclike structure that surrounds the tip of the elbow. Bursitis develops when it becomes swollen or inflamed, due to infection, gout, or bleeding.
• Tendonitis. Tendon inflammation (tendonitis) may develop on the inside part of the elbow (called “golfer’s elbow”) or the outside (called “tennis elbow”). Despite these names, you don’t have to play any particular sport to develop elbow tendonitis.
• Trauma. Everyday activities and athletic pursuits put the elbow at risk. A bike accident, falling off a skateboard, or just tripping on a curb and falling onto your arm can cause significant elbow injuries. These include ligament damage, broken bones, or bursitis.

And the surprising fifth problem? Cell phone-induced nerve irritation: holding your elbow bent for a long time can lead to “cell phone elbow” due to pressure on the ulnar nerve. This can cause numbness and pain down the arm. The solution? Put the phone down — or at least go hands-free.

How can you protect your elbows?

Considering all our elbows do for us, we need to do our best to protect them. That means:

• Wear elbow protectors when engaging in activities likely to injure the elbows (like skateboarding or roller blading).
• Learn proper technique for activities that can stress the elbow like racquet sports, baseball, weight training, or repetitive motions in carpentry and other types of work. For example, a trainer or coach can help you improve your tennis stroke to avoid overstressing the elbow joint and its tendons or ligaments.
• Use appropriate equipment. For example, avoid using a tennis racquet that’s too heavy for you.
• Train well. Strengthening forearm muscles and stretching can help avoid golfer’s elbow.

The bottom line

As the junction between hand and shoulder, our elbows play a pivotal role in everyday function. It’s high time we recognized them for what they do for us. Even if the elbow isn’t your favorite joint — as it is for me — perhaps it should be in your top five. After all, think of all the things you couldn’t do without them.

About the Author

Robert H. Shmerling, MD, Senior Faculty Editor, Harvard Health Publishing; Editorial Advisory Board Member, Harvard Health Publishing

Dr. Robert H. Shmerling is the former clinical chief of the division of rheumatology at Beth Israel Deaconess Medical Center (BIDMC), and is a current member of the corresponding faculty in medicine at Harvard Medical School. … See Full Bio View all posts by Robert H. Shmerling, MD

Everyone who lives with inflammatory bowel disease (IBD) knows their illness has a major impact on daily life. Many people are diagnosed in their 20s or 30s, a time when we might hope for few health challenges.

Medications, and sometimes surgery, may be used to treat IBD. If you identify as LGBTQ+, you might wonder how all of this may affect you — your physical health, of course, but also your sexual health and pleasure. Below are a few things to understand and consider.

What is inflammatory bowel disease?

IBD is a condition that causes inflammation along the gastrointestinal (GI) tract. The two main types are Crohn's disease and ulcerative colitis:

• Crohn's disease: inflammation can occur anywhere along the GI tract (from the mouth to the anus)
• Ulcerative colitis: typically affects the large intestine (colon) only.

IBD can cause diarrhea, bloody stool, weight loss, and abdominal pain, and is typically diagnosed with blood and stool tests, imaging, and colonoscopy. A diagnosis of IBD may increase the risk of developing anxiety or depression, and can also have an impact on sexual health. People with IBD may require long-term medical treatment or surgery for their condition.

The starting point: Talking to your doctor

Talking to your medical team about IBD and sexual health may not be easy. This may depend on how comfortable you feel disclosing your LGBTQ+ identity with your health care providers. Ideally, you should feel comfortable discussing sexuality with your medical team, including what types of sexual partners and activities you participate in and how IBD may affect this part of your life.

Be aware that health care providers may not be able to address all LGBTQ+-specific concerns. Optimal care for people with IBD who identify as LGBTQ+ is not fully understood. However, this is an active area of research.

How might medicines for IBD affect sexual health?

Many effective IBD medications subdue the immune system to decrease inflammation. These immunosuppressive medicines may raise your risk for sexually transmitted infections (STIs) such as HIV, chlamydia, syphilis, and gonorrhea.

What you can do: Discuss these concerns with your doctor so you can take appropriate protective measures. This might include:

• ensuring that your vaccinations, such as hepatitis B and HPV, are up to date.
• engaging in sex using barrier protection to prevent STI transmission.
• taking pre-exposure prophylaxis (PrEP). This safe and effective medicine helps prevent the spread of HIV. Ask your primary care doctor or gastroenterologist if PrEP is appropriate for you.

How might surgery for IBD affect sexual health?

For some people with IBD, gut inflammation is severe enough to require surgery to remove part of the intestine. For example:

• Abscesses or fistulas (abnormal connections between two body parts) sometimes form when someone has Crohn's disease around the anus. This may require surgical treatment.
• Active inflammation in the rectum or anus may make sex painful, particularly for people who engage in anal receptive sex.
• We don't yet know whether anal receptive sex is safe for people who have had surgery to remove the colon and create a J-pouch, which is formed from small intestine to create an internal pouch that enables normal bowel movements.

What you can do: Discuss your concerns with your gastroenterologist and colorectal surgeon.

If you engage in anal sex, you may be confused about whether it is safe to do so. While you may feel uncomfortable discussing this concern and others with your doctor, try to be as honest and open as you can. That way, you'll receive the best information on how to engage in safe and enjoyable sex after an IBD diagnosis or surgery.

What else to consider if you are transgender

People with IBD who are transgender may have additional concerns to address.

For example, there may be a risk for sexual side effects from gender-affirming surgery. These procedures may include vaginoplasty (surgical creation of a vagina) for transgender females, or phalloplasty (surgical creation of a penis) for transgender males. The safety of these procedures in people with IBD is not currently well understood.

What you can do: If you identify as transgender, ask your doctor if any gender-affirming surgeries you've had or medicines you take, such as hormones, might affect your IBD, recommended treatments, or sexual health.

If you're considering gender-affirming surgery, discuss your options with your medical team. Be aware that gender-affirming surgery may be more challenging, or may not be advisable, for people with complex or active IBD. It's important to discuss your specific risks with your doctor when pursuing gender-affirming care. Having access to a team of physicians, including a surgeon and a gastroenterologist, may improve outcomes.

The bottom line

Try to talk to your gastroenterologist about how your sexual practices and gender identity may affect — and be affected by — your IBD. A conversation like this may feel uncomfortable, but being candid about your symptoms and concerns will help you receive the best possible care.

Often, a multidisciplinary approach to care is helpful. Your health care providers, including your gastroenterologist and surgeon, may suggest seeing additional specialists.

Much remains unknown about sexual health and practices in LGBTQ+ people with IBD. While more research is needed, open communication on the impact of medications, surgery, and other aspects of living with IBD can do a lot to improve your quality of life.

About the Authors

Andrew Eidelberg, MD, Contributor

Dr. Andrew Eidelberg is a third-year internal medicine resident at Beth Israel Deaconess Medical Center. After graduating from the University of Miami and Weill Cornell Medical College, he decided to pursue a career in gastroenterology, specifically … See Full Bio View all posts by Andrew Eidelberg, MD

Loren Rabinowitz, MD, Contributor

Dr. Loren Rabinowitz is an instructor in medicine Beth Israel Deaconess Medical Center and Harvard Medical School, and an attending physician in the Inflammatory Bowel Disease Center at BIDMC. Her clinical research is focused on the … See Full Bio View all posts by Loren Rabinowitz, MD

Prostate cancer is generally viewed as a disease of older men. Yet about 10% of new diagnoses occur in men age 55 or younger, and these early-onset cancers often have a worse prognosis. Biological differences partially explain the discrepancy. For instance, early-onset prostate cancers contain certain genetic abnormalities that don’t appear as often in older men with the disease.

But socioeconomic factors also play an important role, according to new research by investigators at Jacksonville College of Medicine (JCM) in Florida. The fact that poverty, educational status, and other factors governing socioeconomic status (SES) influence cancer survival is well established.

This is the first study to investigate how SES affects survival in early-onset prostate cancer specifically. The findings show that men with lower SES don’t live as long as the higher-SES patients do. “They’re more likely to be diagnosed at advanced stages,” says Dr. Carlos Riveros, a physician and research associate at JCM and the paper’s first author.

What the research found

During the investigation, Dr. Riveros and his colleagues evaluated data from the National Cancer Database (NCD), which is sponsored by the American College of Surgeons and the National Cancer Institute. The NCD captures data from over 1,500 hospitals in the United States. Dr. Riveros’s team focused specifically on long-term outcome data for 112,563 men diagnosed with early-onset prostate cancer between 2004 and 2018.

The researchers were able to determine the zip codes where each of these patients lived. Then they looked at per-capita income for those zip codes, as well as the percentage of people living within them who had not yet earned a high school diploma. Taken together, the income and educational data served as a composite SES measure for each zip code’s population. In a final step, the team looked at how the survival of early-onset prostate cancer patients across the zip codes compares.

The results were remarkable: Compared to high-SES patients, the low-SES men were far more likely to be African American, and less likely to have health insurance. More of the low-SES men lived in rural neighborhoods and had stage IV prostate cancer at diagnosis. Fewer low-SES patients were treated at state-of-the-art cancer centers, and less of them had surgical treatment.

After adjusting for age, race, ethnicity, cancer stage, treatment, and other variables, the lower-SES men were 1.5 times more likely than the higher SES men to have died over a median follow-up of 79 months.

Observations and comments

According to Dr. Riveros, the findings are consistent with evidence showing that social determinants of health — the conditions in places where people work and spend their lives — have broad impacts on cancer risk. “Many people in lower-SES areas have had poor diets since birth,” he says.

Lower-SES individuals may be limited in their ability to find, understand, or use health-related information, and therefore “might not know what advanced prostate cancer feels like, or when it’s time to go to a doctor,” Dr. Riveros says. He and his co-authors concluded that SES should be considered when implementing programs to improve the management of patients with early-onset prostate cancer.

“This paper underscores the importance of addressing issues related to diversity, equity, and inclusion when it comes to optimizing outcomes for men with prostate cancer,” says Dr. Marc B. Garnick, the Gorman Brothers Professor of Medicine at Harvard Medical School and Beth Israel Deaconess Medical Center.

Dr. Heidi Rayala, a urologist affiliated with Beth Israel Deaconess Medical Center in Boston, and a member of the Harvard Medical School Annual Report on Prostate Diseases editorial board, agrees, but adds that evaluating individual sociodemographic factors is challenging because many of them are coupled with disparities in insurance coverage. “What remains to be answered is whether there are unique underlying SES factors that would benefit from targeted cancer prevention strategies, or whether this all boils down to the 10% of the US population that remains uninsured,” she says.

About the Author

Charlie Schmidt, Editor, Harvard Medical School Annual Report on Prostate Diseases

Charlie Schmidt is an award-winning freelance science writer based in Portland, Maine. In addition to writing for Harvard Health Publishing, Charlie has written for Science magazine, the Journal of the National Cancer Institute, Environmental Health Perspectives, … See Full Bio View all posts by Charlie Schmidt

About the Reviewer

Marc B. Garnick, MD, Editor in Chief, Harvard Medical School Annual Report on Prostate Diseases; Editorial Advisory Board Member, Harvard Health Publishing

Dr. Marc B. Garnick is an internationally renowned expert in medical oncology and urologic cancer. A clinical professor of medicine at Harvard Medical School, he also maintains an active clinical practice at Beth Israel Deaconess Medical … See Full Bio View all posts by Marc B. Garnick, MD

It’s hard to care about anything when you feel exhausted, burned out, or ragged around the edges. Your once-fiery enthusiasm may seem more like charred rubble due to overwhelming family responsibilities, a job that drains you, or financial struggles. Or maybe an illness, the uncertainty and disruptions of the age we live in, or a combination of factors has left you feeling as if you have precious little to give.

“What you’re experiencing is burnout. It’s real and it can lead to depression, anxiety, relationship damage, and an inability to function at home or at work,” says Dr. Marni Chanoff, an integrative psychiatrist with Harvard-affiliated McLean Hospital.

Take heart: With time and effort, you can refill your cup, slowly adding back a bit of the energy and joie de vivre you’ve been missing. Here are three ways to start.

1. Carve out time for yourself

Taking time for yourself isn’t a luxury; it’s essential to self-care. “You need to slow down and give yourself the opportunity to rest and rejuvenate,” Dr. Chanoff says, “Schedule it if you have to, starting with 10 or 15 minutes, a couple of times a day.”

How can you reclaim precious minutes in an overly full schedule? “Look at your day, week, or month, and be discerning about how many things you say ‘yes’ to in one period of time. Give yourself permission to say ‘no thank you’ to things that deplete you or don’t serve you,” Dr. Chanoff says.

Make small moments count: choose what makes you feel at peace. For example, have a cup of tea, or simply lay a blanket or mat on the floor at home or work and lie on your back. Don’t look at your phone or email. “You want to tell your body to take a break. It helps you reset and back away when stress draws you in,” Dr. Chanoff explains.

2. Commit to better health

A strong body helps balance the stressful situations that have caused your burnout. The basic recipe for good health includes:

• Exercise. Moderate intensity exercise, the kind that works the heart and lungs, releases important chemicals that help regulate mood, sleep, and many body systems. Aim for at least 150 minutes of exercise per week, which amounts to about 22 minutes a day. Start with just a few minutes a day if it’s all you can do. It doesn’t have to be fancy. “It can be any movement that brings you joy, like dancing, yoga, or brisk walking,” Dr. Chanoff suggests.
• A good diet. Eating lots of junk food (typically full of sugar, salt, and unhealthy saturated fat) fuels chronic stress, fatigue, depression, and anxiety. Choose more unprocessed foods such as vegetables, fruits, whole grains, legumes, lean proteins (fish or poultry), and unsaturated fats (such as avocados or olive oil). If time is an issue, Chanoff suggests batch-cooking simple, healthy foods you can have several days of the week. (Lentil or bean soup is a good one-pot meal. Throw in as many vegetables as you can.)
• Sleep. Insufficient sleep affects overall health, concentration, and mood. Try to sleep seven to nine hours per night. “It helps to wind down an hour or two before you fall asleep. And practice good sleep hygiene: turn off your phone, keep your room cool and dark, and go to sleep and wake up at the same time each day,” Dr. Chanoff advises.

3. Surround yourself with comfort

Hygge (pronounced HOO-ga) is the Danish concept of cozy comfort that brings happiness and contentment. Folks in Denmark know a thing or two about finding sunshine in cold dark months.

To practice hygge, surround yourself with people, activities, and things that make you feel cozy, loved, happy, or content. Go simple: spend time with your favorite people, add a small vase of flowers to your space, don fuzzy slippers once home, eat a treasured comfort food, or listen to a favorite song.

More ideas to try:

• Light a candle.
• Get under a heated blanket.
• Frame a photo of a happy time.
• Have breakfast in bed.
• Use pretty table linens.
• Indulge in art (check out various works at museums online).
• Stand still outside to listen to the sounds of nature.
• Curl up in a cozy chair.
• Window-shop in your favorite store.
• Wear a soft sweater that feels good on your skin.
• Use a silk or satin pillowcase on your bed pillow.
• Take a warm bath.
• Get an oil diffuser with a scent that reminds you of a place you love, like the beach or a pine forest.

Turn up the effect by savoring cozy comfort. How does it feel, taste, smell, or sound? “Engaging the senses with soothing stimulation can be nourishing. It counteracts ongoing stress that the nervous system endures, and may help to elicit the relaxation response — the opposite of the fight or flight [stress] response,” Dr. Chanoff explains. Breathing deeply will help, too.

Eventually, these bits of hygge, health, and personal time will give you something you probably haven’t allowed yourself in a while, and that’s compassion. Be gentle with yourself. Pamper your soul and replenish your cup, so you can continue being there for the important people and tasks in your life.

About the Author

Heidi Godman, Executive Editor, Harvard Health Letter

Heidi Godman is the executive editor of the Harvard Health Letter. Before coming to the Health Letter, she was an award-winning television news anchor and medical reporter for 25 years. Heidi was named a journalism fellow … See Full Bio View all posts by Heidi Godman

Editor’s note: in honor of Pride Month, we’re re-publishing a 2019 post by Dr. Cecil Webster.

Generally speaking, discussing what happens in our bedrooms outside of the bedroom can be anxiety-provoking. Let’s try to make your doctor’s office an exception. Why is this important? People in the LGBTQ+ community contend not only with a full range of health needs, but also with environments that may lead to unique mental and physical health challenges. Whether or not you have come out in general, doing so with your doctor may prove critical in managing your health. Sexual experiences, with their impact on identity, varied emotional significance, and disease risk, are a keystone for helping your doctor understand how to personalize your healthcare.

Admittedly, talking about your intimate sexual experiences or your gender identity may feel uncomfortable. Many LGBTQ+ patients worry that their clinicians may not be knowledgeable about their needs, or that they’ll to have to educate them. Finding a LGBTQ+ adept doctor, preparing ahead of time for your next appointment, and courageously asking tough questions can give you and your health the best shot.

Finding a skilled clinician who is LGBTQ+ adept

Many large cities have healthcare institutions whose mission centers on care for LGBTQ+ peoples. However, these organizations may prove inaccessible to many for a variety of reasons. Regardless of your location, asking friends, family, or others to recommend a clinician may be a game changer. If your trans friend had a relatively painless experience visiting an area gynecologist, perhaps your Pap smear may go smoothly there as well. If your coworker has a psychiatrist who regularly asks him about his Grindr use, perhaps it may be easier to navigate your gay relationship questions with her.

Word of mouth is often an undervalued method of finding someone skilled and attentive to the needs of LGBTQ+ individuals. Online, many clinicians offer a short bio with their areas of expertise, and there are provider directories featuring trusted clinicians. Further, some doctors regularly write articles and give talks that may offer clues about desired knowledge. A simple Google search of your provider may yield a bounty.

Next, give your doctor or healthcare organization a call. Don’t be shy about requesting someone whose practice matches your specific needs. Your health information is protected, and generally, physicians hold your clinical privacy dear. Keep in mind that not all clinics will know or share whether or not your doctor is, for example, also a lesbian, but they may pair you with someone well suited to your request or point you in the right direction.

Preparing for your appointment

Let’s say you are nervous about coming out to your doctor. A little preparation may ease this burden. Here are some quick tips:

• Let them know you’re nervous at the start of the conversation.
• Be as bold as you can tolerate.
• Write down what you are excited about, nervous about, and/or curious about.
• Go in with a few goals and start with what’s most important.
• Maximize your comfort. If your partner is calming, bring them. If Beyoncé soothes what ails you, bring her along too.
• Lightly correct or update your clinician if they get something wrong.

Ask tough questions, give clear answers

As a psychiatrist who works with kids and adults, I often hear questions like, “I don’t know really how to say this, but I started experimenting with other guys. Does this mean I’m gay?” I may start by asking if you’ve enjoyed it. My colleagues in health care might begin with the same question.

Pleasurable experiences come in all sorts of constellations, and healthy exploration is part of being human. Additionally, clinicians need to assess and address your safety. Many LGBTQ+ people are at higher risk of intimate partner violence. We may ask about your use of condoms, how many partners you’ve had recently, your use of substances during sex, and how these experiences may shift how you see yourself. Give clear answers if possible, but don’t fret if you’re uncertain. Your doctor will not likely provide a label or pry unnecessarily. They may offer constructive information on the use of condoms, reasons to consider using PrEP (which can effectively prevent HIV), and places you can go for more guidance. Physicians enjoy giving personalized information so that you may make informed healthcare decisions.

There is no end to what is on people’s minds. Be bold. Will tucking reduce my sperm count? Maybe. Does binding my breasts come with risk? Likely. Was Shangela robbed of her RuPaul’s Drag Race: All Stars 3 crown? Utterly, but let’s get back to your cholesterol, shall we?

Remember that it is often impossible to squeeze everything into one appointment. Afterward, take time to catch your breath, reflect on what you’ve learned, and come up with more questions for next time. We’re here for that.

About the Author

Cecil R. Webster, Jr., MD, Contributor

Dr. Cecil R. Webster, Jr. is a child, adolescent, and adult psychiatrist in Boston. He is a lecturer in psychiatry at McLean Hospital and Harvard Medical School, and consultant for diversity health outreach programs at the … See Full Bio View all posts by Cecil R. Webster, Jr., MD

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.

Follow me on Twitter @drClaire

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