Ringworm on the scalp, also called tinea capitis, is a fungal infection affecting the hair shafts and the scalp. This is a highly-contagious infection that usually affects toddlers and school-age children.
Despite its name, ringworm of the scalp isn’t ready caused by a worm, but a fungal infection. The name comes from the circular marks left on the skin, which has a flat center and raised borders.
The condition is common among children from across the globe. In the United States,
the incidence of ringworm on the scalp is unknown. However, the reported incidence is among school-aged African American males with 12.9 percent. The typical onset of the disease is between 5 and ten years old, and the condition accounts for 92.5 percent of dermatophytoses in kids that are below ten years old.
Across the globe, tinea capitis is widespread in urban areas in North America, Central America, South America, Africa and India. In Southeast Asia, the rates have dramatically declined from 1 4 percent to just 1.2 percent in the last five decades.
This is due to improved personal hygiene and sanitary conditions.
The most common signs and symptoms of a ringworm infection are itchy patches on the scalp. Due to the infection, some sections of the hair may break off near the scalp.
This would lead to red areas or bald spots. The disease is easy to treat, but if it’s left untreated, the bald spots may continue to spread and grow.
The common symptoms include:
- Painful scalp
- Inflamed lymph nodes
- Fever (low grade)
- Brittle hair
In more severe cases, there can be swellings called kerion that have pus. This condition may lead to permanent bald spots if it’s left untreated. Commonly, the patches look like severe dandruff on various places on the scalp. Sometimes, this condition may be mistaken for psoriasis. In some areas, blisters and painful boils develop on the scalp.
Various factors cause ringworm on the scalp or tinea capitis. Fungi called dermatophytes cause this condition. Fungi are microorganisms that live on dead tissue like the hair, fingernails and the outer layers of the skin. Usually, they prefer areas that are moist and warm, so sweaty skin is their favorite spot.
This condition spreads easily among kids, and you can get infected by merely touching the skin of an infected person. Moreover, using combs, beddings and other personal things of an infected person, you will have a higher risk of acquiring the infection.
There are various modes of transmission of this type of fungal infection:
Object to human
Ringworms can spread through direct contact with surfaces or objects that a person who has the infected has touched. For example, some belongings like combs, towels, and beddings may carry the fungi, making the other person who touched them, at a higher risk of infection.
Human to human
The condition can spread through direct skin-to-skin contact.
Animal to human
Cats and dogs are often carriers of this type of ringworm.
There are many factors that may increase the development of tinea capitis:
Exposure to infected children
Outbreaks of ringworm are common in child care centers and schools. This infection spreads rapidly among kids because of direct physical contact.
This type of infection is very common among toddlers and school-aged kids.
Dogs and cats are commonly affected by tinea capitis. By touching or petting the animal, you can get the infection.
Other risk factors:
- Children in daycare centers, play areas, parks, and schools, especially when a child has the condition
- Children with sweaty scalp
- Those residing in overcrowded places with poor living conditions
- Minor head injuries affecting the scalp
- Sharing items like combs and beddings
- Those with pets
- Neglecting fungal infection in other parts of the body
- Weakened immune systems
Kerion, a severe and painful inflammation of the scalp is a common complication of tinea capitis or ringworm on the scalp. This appears as raised and soft pustules that drain pus. Sometimes, it causes yellow crusting on the scalp.
The hair may break or fall out when the crust is pulled out. This may lead to permanent scars and in rare cases, hair loss.
The infection may spread to other body parts such as the limbs, torso, and groin. Sometimes, people may suffer from permanent hair loss and bald patches because of the scalp illness.
The doctor can often formulate a diagnosis of ringworm or another condition affecting the scalp based on a physical examination of the scalp. Also, a complete medical history is also needed. Tinea capitis is usually confirmed through the following tests:
Hair or scalp sample
This is a condition wherein the scalp skin cells, and hair shafts are tested and examined microscopically.
The doctor may recommend having a biopsy
Wood’s lamp test
This procedure uses ultraviolet rays to look at the fluorescent properties of the infection.
This test will examine of the cause of the condition is indeed a fungus.
The health care provider will prescribe a medicine to treat ringworm on the scalp. Usually, this is taken for 4 to 8 weeks.
There are other ways to treat the condition, and you can start at home:
- Keep the scalp clean and wash with medicating shampoo, as prescribed by the doctor.
- Pets should be cleaned regularly, and the lesions should be treated. So, all the family members and pets should undergo treatment.
- Wash towels and other personal belongings in hot and soapy water. Dry them under the sun, to kill the fungi.
The leading medical treatment for ingrown is terbinafine hydrochloride and griseofulvin. Make sure your doctor prescribes these medicines before taking them. The common side effects of griseofulvin include:
- Sensitivity to the sun
- Allergic reactions
The side effects of terbinafine hydrochloride include:
- Abdominal pain
- Change in taste
The doctor may prescribe a medicated shampoo to eradicate the fungi and stem the spread of infection. The most commonly-used shampoos contain the active antifungal ingredient ketoconazole or selenium sulfide.
Recovery and Reinfection
Shampoos like this help prevent the spread of the virus. However, these shampoos do not kill the ringworm. Normally, you need to combine treatments with oral medication.
Despite the measures to limit fungal infections brought about by tinea capitis, these organisms heal slowly. Reinfection is also common. However, you can get rid of ringworm through preventive measures and medications.
Visit the doctor regularly between 4 to 6 weeks to make sure that the measures to treat the ringworm are effective. It can be hard to eradicate ringworms and reinfection is possible. The good news is, reinfection often stops at puberty. However, there are long-term effects of this infection like scarring or bald patches on the scalp.
After treatment, ask the doctor if your child can already go back to school. Usually, kids are allowed to return to school once they start treatment for the skin condition. Pets and all family members should undergo testing and treatment for ringworm to prevent reinfection.
To make sure all belongings are clean and will not spread the infection, soak towels and caps in hot and soapy water. On the other hand, combs and hair brushes can be soaked in water with bleach. Make sure all your things are separated to prevent cross contamination of these items that can become ways to spread the hard-to-handle infection.
There are various steps to make sure the prevention of tinea capitis.
The preventive measures include the following:
- Keep the hair and scalp clean and dry. Shampoo regularly if needed.
- Ensure that children practice the proper handwashing technique especially before and after meals.
- Practice good, sanitary and hygienic condition, especially in the area of the residents.
- Avoid sharing common things like combs, beddings, and towels.
- Since the fungi can spread through cats and dogs, you need to examine your pet regularly.
- Treat fungal infections properly and immediately. This will prevent them from spreading to other regions of the body.
- Teach the children about how fungal infections spread and how to stem them.
- Teach children about fungal infections and how to recognize the early signs and symptoms.
- Educate kids on how to practice proper hygiene and how to perform the proper way to wash their hands.
- Warm kids on borrowing personal items from other people who have the infection.
The dermatophytes can cause ringworm, and they are very contagious. This makes prevention hard and time-consuming. However, children are very vulnerable to the disease. Inform the kids about the risks of sharing items like combs and brushes with others. Moreover, regular shampooing, hand washing, and other hygiene practices can help prevent the spread of the infection.
To prevent the spread of the infection in your pets, make sure that all pets are groomed properly, and if they’re infected, early treatment is important. Avoid petting any animals that show patches of skin that show their fur. Also, make sure you bring your pet to the veterinary clinic regularly.