Overview

Ringworm of the scalp (tinea capitis) is a fungal infection of the scalp and hair shafts. The signs and symptoms of ringworm of the scalp may vary, but it usually appears as itchy, scaly, bald patches on the head.

Ringworm of the scalp, a highly contagious infection, is most common in toddlers and school-age children.

Treatment for ringworm of the scalp includes medications taken by mouth to kill the fungi, as well as medicated shampoos that may lessen the spread of infection.

Some cases of ringworm of the scalp result in severe inflammation at the site of infection that may cause scarring or permanent hair loss.

Symptoms

The signs and symptoms of ringworm of the scalp include:

  • One or more round patches of scaly skin where the hair has broken off at or just above the scalp
  • Patches that slowly expand or enlarge
  • Scaly, gray or reddened areas
  • Patches that have small black dots where the hair has broken off at the scalp
  • Brittle or fragile hair that easily pulls out
  • Tender or painful areas on the scalp<

When to see a doctor

Several conditions affecting the scalp may have a similar appearance. See your child's doctor if your child has any hair loss, scaling or itchiness of the scalp, or other unusual appearance of the scalp. It's important to get an accurate diagnosis and prompt, appropriate treatment.

Causes

Ringworm of the scalp is caused by one of several varieties of mold-like fungi called dermatophytes. The fungi attack the outer layer of skin on the scalp and the hair shaft.

Ringworm isn't caused by a worm. The common name for the disorder refers to the ring-like or circular appearance of the infection on the skin.

Methods of transmission

Ringworm is contagious and can spread in the following ways:

  • Human to human. Ringworm often spreads through direct skin-to-skin contact with an infected person.
  • Object to human. Ringworm can spread through contact with objects or surfaces that an infected person or animal has touched, such as clothing, towels, bed linens, combs or brushes.
  • Animal to human. Dogs and cats, especially puppies and kittens, are often carriers of ringworm. Other animals that are often carriers of the fungi include cows, goats, pigs and horses. Your child can contract ringworm by grooming or petting an animal with ringworm.

Other types of ringworm

The fungi that cause ringworm of the scalp can cause other infections on the body. These infections are generally classified by the part of the body affected. They include:

  • Ringworm of the body (tinea corporis). This form causes a red, scaly ring or circle of rash on the top layer of your skin.
  • Athlete's foot (tinea pedis). This form of ringworm affects the moist areas between your toes and sometimes on the foot itself.
  • Jock itch (tinea cruris). This form affects your genitals, inner upper thighs and buttocks.

Risk factors

Risk factors for ringworm of the scalp include:

  • Age. Ringworm of the scalp is most common in toddlers and school-age children.
  • Exposure to other children. Outbreaks of ringworm are common in schools and child care centers where the infection easily spreads through close physical contact.
  • Exposure to pets. A pet, such as a cat or dog, can have the infection without showing any signs. Children can get the infection by touching or petting the animal.

Complications

In some cases, ringworm of the scalp causes kerion — a severe, painful inflammation of the scalp. Kerion appears as soft, raised swellings that drain pus and cause thick, yellow crusting on the scalp.

Instead of breaking, the hair falls out or can be easily pulled out. Kerion may be caused by an overly vigorous reaction to the fungus and can lead to permanent scars and hair loss.

Prevention

Ringworm is difficult to prevent because the fungi that cause it are common and highly contagious. You can help reduce the risk of ringworm by taking these steps:

  • Educate yourself and others. Be aware of the risk of ringworm from infected persons or pets. Tell your children about ringworm, what to watch for and how to avoid the infection.
  • Shampoo regularly. Be sure to wash your child's scalp regularly, especially after haircuts.
  • Keep clean. Be sure your child washes his or her hands often to avoid the spread of infection. Keep common or shared areas clean, especially in schools, child care centers, gyms and locker rooms.
  • Avoid infected animals. The infection often looks like a patch of skin where fur is missing. In some cases, though, you may not notice any signs of the disease. Ask your veterinarian to check your pets and domesticated animals for ringworm.
  • Don't share personal items. Teach your children not to let others use their clothing, towels, hairbrushes or other personal items, or to borrow such items from other children.
Nov. 05, 2016
References
  1. Allmon A, et al. Common skin rashes in children. American Family Physician. 2015;92:211.
  2. Bennett JE, et al. Dermatophytosis (ringworm) and other superficial mycoses. In: Mandell, Douglas, and Bennett's Principles and Practice of Infectious Diseases. 8th ed. Philadelphia, Pa.: Saunders Elsevier; 2015. https://www.clinicalkey.com. Accessed June 29, 2016.
  3. Kliegman RM, et al. Cutaneous fungal infections. In: Nelson Textbook of Pediatrics. 20th ed. Philadelphia, Pa.: Elsevier; 2016. http://www.clinicalkey.com. Accessed June 29, 2016.
  4. Treat JR. Tinea capitis. http://www.uptodate.com/home. Accessed June 29, 2016.
  5. Kaushik N, et al. Superficial fungal infections. Primary Care Clinics in Office Practice. 2015;42:501.
  6. Ringworm risk and prevention. Centers for Disease Control. http://www.cdc.gov/fungal/diseases/ringworm/risk-prevention.html. Accessed July 1, 2016.