Diagnosis

Your doctor will likely be able to diagnose ringworm of the scalp by looking at the affected skin and asking certain questions. To confirm the diagnosis, your doctor may take a sample of hair or skin to be tested in a lab. Testing a sample of hair or skin can show if a fungus is present.

Treatment

Treatment for ringworm of the scalp requires a prescription-strength antifungal medication taken by mouth. The first-choice medication is usually griseofulvin (Gris-Peg). Alternatives might be used if griseofulvin isn't working or your child is allergic to it. These include terbinafine, itraconazole (Spoanox, Tolsura) and fluconazole (Diflucan). Your child might need to take one of these medications for six weeks or more — until hair regrows. Typically, with successful treatment, the bald spots will grow hair again and the skin will heal without scarring.

Your doctor might recommend that you also wash your child's hair with a prescription-strength medicated shampoo. The shampoo removes fungus spores and helps prevent spreading the infection to others or to other areas of the body.

There is no need to shave the head or cut the hair as part of the treatment.

Preparing for your appointment

If your child has a condition affecting the scalp, you'll likely start by seeing your family doctor or child's pediatrician. You may be referred to a skin specialist (dermatologist).

What to expect from your doctor

Your doctor is likely to ask you a number of questions, such as:

  • When did you first notice symptoms?
  • What did the scalp look like when symptoms first appeared?
  • Is the rash painful or itchy?
  • What, if anything, makes the condition better or worse?
  • Do you have any pets at home, or has your child been around farm animals?
  • Does another family member or a pet already have ringworm?
  • Do you know of any cases of ringworm in your child's school?

Questions for your doctor

Questions you might be prepared to ask your doctor include:

  • If this is ringworm, what can we do to prevent the infection from spreading?
  • What hair care routines do you recommend while the condition heals?
  • When can my child return to school?
  • Should I schedule a follow-up appointment for my child?
  • Should I make appointments for my other children even if they aren't showing signs or symptoms right now?
Jan. 22, 2022
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  3. Kelly AP, et al., eds. Pediatrics. In: Taylor and Kelly's Dermatology for Skin of Color. 2nd ed. McGraw-Hill; 2016. https://accessmedicine.mhmedical.com. Accessed Sept. 10, 2021.
  4. Schmitt BD. Ringworm. In: Pediatric Telephone Protocols: Office Version. 16th ed. American Academy of Pediatrics; 2019.
  5. Office of Patient Education. Fungal infection: Ringworm of the scalp. Mayo Clinic; 2010.
  6. Ferri FF. Tinea capitis. In: Ferri's Clinical Advisor 2022. Elsevier; 2022. https://www.clinicalkey.com. Accessed Sept. 10, 2021.