by Scholten A
(Ringworm of the Scalp; Fungal Infection of the Scalp)

Definition

Tinea capitis is a skin infection that affects the scalp. If not treated, it can lead to permanent hair loss and scarring.

Ringworm of the Scalp
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Causes

Tinea capitis is caused by a fungus. The fungus invades hair shafts. It is spread by:

  • Person-to-person contact
  • Contact with the fungus on:
    • Fallen hair
    • Combs, hats, and bedding
  • Contact with pets that have the fungus

Risk Factors

Tinea capitis is more common in children 3 to 7 years old. Other things that may raise the risk are:

  • Sharing combs, brushes, or hats
  • A weak immune system, such as with:
    • HIV
    • Certain long term diseases such as diabetes or cancer
  • Crowded living conditions
  • Large family size

Symptoms

Tinea capitis may cause:

  • Itching of the scalp (not always present)
  • Bald patches
  • Scales, sores, or black dots on the scalp

Diagnosis

The doctor will ask about symptoms and health history. A physical exam will be done. The person may be referred to a skin doctor.

Diagnosis is often based on a scalp exam. If the diagnosis is uncertain, the doctor may scrape the scalp or clip a few hairs for testing.

Tests on the sample may include:

  • Microscopic exam
  • Fungal culture

Treatment

The goal is to clear the infection. The main treatment for tinea capitis is antifungal medicine taken by mouth. Antifungal creams may also be added. Antifungal shampoos may help reduce the spread to others.

The condition can be difficult to treat.

Prevention

To reduce the risk of tinea capitis, do not share combs, brushes, or headgear.

RESOURCES

American Academy of Dermatology  https://www.aad.org 

Centers for Disease Control and Prevention  https://www.cdc.gov 

CANADIAN RESOURCES

Canadian Dermatology Association  https://dermatology.ca 

Dermatologists  http://dermatologists.ca 

References

Leung AKC, Hon KL, et al. Recent Pat Inflamm Allergy Drug Discov. 2020;(1):58-68.

Tinea capitis (scalp ringworm). Merck Manual Professional Version website. Available at: https://www.merckmanuals.com/professional/dermatologic-disorders/fungal-skin-infections/tinea-capitis-scalp-ringworm. Accessed April 2, 2021.

Tinea capitis. EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/tinea-capitis Accessed April 2, 2021.

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