Ringworm of the Scalp

Tinea Capitis is also called scalp ringworm. It is a fungal infection of the skin on the scalp seen mainly in children.

CAUSES

Scalp ringworm spreads from:

  • Other people.

  • Pets (cats and dogs) and animals.

  • Bedding, hats, combs or brushes shared with an infected person

  • Theater seats that an infected person sat in.

SYMPTOMS

Scalp ringworm causes the following symptoms:

  • Flaky scales that look like dandruff.

  • Circles of thick, raised red skin.

  • Hair loss.

  • Red pimples or pustules.

  • Swollen glands in the back of the neck.

  • Itching.

DIAGNOSIS

A skin scraping or infected hairs will be sent to test for fungus. Testing can be done either by looking under the microscope (KOH examination) or by doing a culture (test to try to grow the fungus). A culture can take up to 2 weeks to come back.

TREATMENT

  • Scalp ringworm must be treated with medicine by mouth to kill the fungus for 6 to 8 weeks.

  • Medicated shampoos (ketoconazole or selenium sulfide shampoo) may be used to decrease the shedding of fungal spores from the scalp.

  • Steroid medicines are used for severe cases that are very inflamed in conjunction with antifungal medication.

  • It is important that any family members or pets that have the fungus be treated.

HOME CARE INSTRUCTIONS

  • Be sure to treat the rash completely – follow your caregiver's instructions. It can take a month or more to treat. If you do not treat it long enough, the rash can come back.

  • Watch for other cases in your family or pets.

  • Do not share brushes, combs, barrettes, or hats. Do not share towels.

  • Combs, brushes, and hats should be cleaned carefully and natural bristle brushes must be thrown away.

  • It is not necessary to shave the scalp or wear a hat during treatment.

  • Children may attend school once they start treatment with the oral medicine.

  • Be sure to follow up with your caregiver as directed to be sure the infection is gone.

SEEK MEDICAL CARE IF:

  • Rash is worse.

  • Rash is spreading.

  • Rash returns after treatment is completed.

  • The rash is not better in 2 weeks with treatment. Fungal infections are slow to respond to treatment. Some redness may remain for several weeks after the fungus is gone.

SEEK IMMEDIATE MEDICAL CARE IF:

  • The area becomes red, warm, tender, and swollen.

  • Pus is oozing from the rash.

  • You or your child has an oral temperature above 102° F (38.9° C), not controlled by medicine.