Symptoms of tinea capitis include a dry patch of scale, a patch of hair loss, or both on the scalp.
Doctors base the diagnosis on an examination of the scalp and samples taken from the scalp.
Treatment includes antifungal drugs taken by mouth for all people and, for children, antifungal cream.
(See also Overview of Fungal Skin Infections Overview of Fungal Skin Infections Fungi usually make their homes in moist areas of the body where skin surfaces meet: between the toes, in the genital area, and under the breasts. Common fungal skin infections are caused by... read more .)
Tinea capitis is a type of dermatophytosis Overview of Dermatophytoses (Ringworm, Tinea) Dermatophytoses are fungal infections of the skin and nails caused by several different fungi and classified by the location on the body. Dermatophyte infections are also called ringworm or... read more . In the United States, tinea capitis is primarily caused by Trichophyton.
Tinea capitis is highly contagious and is common among children.
Symptoms of Scalp Ringworm
Tinea capitis may cause a dry scaly rash that may be somewhat itchy, a patch of hair loss (alopecia Alopecia (Hair Loss) Hair loss, also called alopecia, can occur on any part of the body. Hair loss that occurs on the scalp is generally called baldness. Hair loss is often of great concern to people for cosmetic... read more ), or both. One type of fungus causes "black dot" ringworm, in which hair shafts break at the scalp surface. Another type of fungus causes "gray patch" ringworm, in which hair shafts break above the surface, leaving short stubs. Tinea capitis may sometimes cause flaking that resembles dandruff.
A dermatophyte infection occasionally causes a kerion, which is a large, painful, inflamed, swollen patch on the scalp that sometimes oozes pus. A kerion may have blisters and crusting and can look like an abscess (a pocket of pus). A kerion is caused by an immune system reaction to the fungus and may result in scarring hair loss.
Diagnosis of Scalp Ringworm
A doctor's examination of the skin
Examination of plucked hairs or scale from the scalp
Sometimes a Wood light examination and sometimes culture
Tinea capitis is diagnosed by its appearance and the results of an examination of a sample of plucked hairs or of hairs and scale from the scalp. Doctors examine the samples under a microscope Scrapings Doctors can identify many skin disorders simply by looking at the skin. A full skin examination includes examination of the scalp, nails, and mucous membranes. Sometimes the doctor uses a hand-held... read more .
Sometimes a type of ultraviolet light (called a Wood light Wood light (black light) Doctors can identify many skin disorders simply by looking at the skin. A full skin examination includes examination of the scalp, nails, and mucous membranes. Sometimes the doctor uses a hand-held... read more ) is shined on the scalp to distinguish the type of fungus.
Doctors may also do a culture Culture Doctors can identify many skin disorders simply by looking at the skin. A full skin examination includes examination of the scalp, nails, and mucous membranes. Sometimes the doctor uses a hand-held... read more (the process of growing an organism in a laboratory for identification) of the samples or of material taken from a kerion.
Treatment of Scalp Ringworm
In children and adults, antifungal drugs taken by mouth
In children, antifungal cream and selenium sulfide shampoo
In adults, sometimes selenium sulfide shampoo
In children, treatment of tinea capitis involves an antifungal drug called terbinafine taken by mouth for 4 weeks. Griseofulvin is an alternative drug for children.
An antifungal cream can be applied to the scalp to prevent spread, especially to other children, until the tinea capitis is cured. Prescription-strength selenium sulfide shampoo should also be used at least twice a week. Children may attend school during treatment. (See also table Some Antifungal Drugs Applied to the Skin (Topical Drugs) Some Antifungal Drugs Applied to the Skin (Topical Drugs) .)
In adults, tinea capitis treatment is with the antifungal drug terbinafine or itraconazole taken by mouth. How long treatment is needed depends on the drug used. Selenium sulfide shampoo is also sometimes used in adults.
For severely inflamed areas and for a kerion, doctors may prescribe a short course of a corticosteroid such as prednisone taken by mouth to lessen symptoms and perhaps reduce the chance of scarring.