What Is Ringworm of the Scalp?
Ringworm of the scalp is not really a worm, but a fungal
infection. It gets the name “ringworm” because the fungus makes circular marks
on the skin, often with flat centers and raised borders. Also called Tinea
capitis, this infection affects your scalp and hair shafts,
causing small patches of itchy, scaly.
Ringworm is a highly contagious infection that’s usually spread
through person-to-person contact or by sharing combs, towels, hats, or pillows.
Ringworm is most common in children, but can infect a person of any age.
Causes of Ringworm of the Scalp
Fungi called dermatophytes cause ringworm of the scalp. Fungi are
organisms that thrive on dead tissue, such as fingernails, hair, and the outer
layers of your skin.
Ringworm spreads easily, especially among children. You can get
ringworm from touching the skin of an infected person. If you use combs,
bedding, or other objects that have been used by an infected person, you’re
also at risk.
House pets, such as cats and dogs, can also spread ringworm. Farm
animals like goats, cows, horses, and pigs can be carriers too. These animals
might not show any signs of infection.
Overcrowding and poor hygiene increase the spread of ringworm. Dermatophytes
prefer warmth and moisture, so they thrive on sweaty skin.
Symptoms of Ringworm of the Scalp
The most common symptom of ringworm is itchy patches on the
scalp. Sections of hair may break off at or close to the scalp, leaving scaly,
red areas or bald spots. You may see black dots where the hair has broken off.
Left untreated, these areas gradually grow and spread.
Other symptoms include:
- brittle hair
- painful scalp
- swollen lymph nodes (glands that help the body
fight off infection)
- low-grade fever
In more severe cases, you may develop kerion, crusty swellings
that drain pus. These can lead to permanent bald spots and scarring.
Diagnosis of Ringworm of the Scalp
A visual exam is often enough for a doctor to diagnose ringworm
of the scalp. Your doctor may use a special light called a Wood’s lamp to
illuminate your scalp and determine signs of infection.
Your doctor may also take a skin or hair sample to confirm the
diagnosis. This involves taking a hair or scraping from a scaly patch of scalp
and looking at it under a microscope. The sample is then sent to a lab to
determine the presence of fungi. This process may take up to three weeks.
Treatment of Ringworm of the Scalp
Your doctor will probably prescribe fungi-killing oral medication
and medicated shampoo.
The leading antifungal medications for ringworm are griseofulvin
hydrochloride. Both are oral medications that you take for approximately
six weeks. Both have common side effects, including diarrhea and upset stomach.
Your doctor may recommend taking these medications with a high-fat food like
peanut butter or ice cream.
Other possible side effects of griseofulvin (sold as Grifulvin V,
- sun sensitivity
- faintness or dizziness
- allergic reactions (in people who are also
allergic to Penicillin)
- rash or hives
Other possible side effects of terbinafine hydrochloride (sold as Lamisil) include:
- stomach pain
- rash or hives
- loss of taste or change in taste
- allergic reaction
- in rare cases, liver problems
Your doctor may prescribe a medicated shampoo to remove fungus
and prevent the spread of infection. The shampoo will contain the active
antifungal ingredients ketoconazole or at least 2.5 percent selenium sulfide. Leave
the shampoo on for five minutes, then rinse.
Your doctor may tell you to use this shampoo a couple of times a
week for a month. Medicated shampoo helps prevent the fungus from spreading, but
doesn’t kill ringworm. You must combine this type of treatment with oral
Recovery and Prevention of Reinfection | Outlook
Ringworm heals very slowly. It can take more than a month to see
any improvement. Be patient and continue taking all medication as directed. Your
doctor may want to check you or your child in four to six weeks to make sure
the infection is clearing.
Your child can usually return to school once they start treatment
for ringworm, but ask your doctor when it’s safe for them to return.
Pets and other family members should be examined and treated if
necessary. This will help prevent reinfection. Do not share towels, combs,
hats, or other personal items with other family members. You can sterilize
combs and brushes that belong to the infected person by soaking them in bleach
It’s hard to get rid of ringworm. It’s also possible to get the
infection more than once. However, recurrences often stop at puberty. Long-term
effects include possible bald patches or scarring.
Prevention of Ringworm of the Scalp
The dermatophytes that cause ringworm are common and contagious.
This makes prevention difficult. Since children are especially susceptible,
tell your children about the risks of sharing hairbrushes and other personal
items. Regular shampooing, hand washing, and other normal hygiene routines can
help prevent the spread of infection.
It can be hard to tell if an animal has ringworm, but a common
sign of infection is bald patches. Avoid petting any animals that have patches
of skin showing through their fur. Maintain regular checkups for all pets and
ask your veterinarian to check for ringworm.