Tinea capitis

  • Definition
    • Tinea capitis is a fungal infection of the scalp. It is also called ringworm of the scalp.

      Related skin infections may be found:

  • Alternative Names
    • Fungal infection - scalp; Infection - fungal - scalp; Tinea of the scalp; Ringworm - scalp

  • Causes
    • Fungi are germs that can live on the dead tissue of the hair, nails, and outer skin layers. Tinea capitis is caused by mold-like fungi called dermatophytes.

      The fungi grow well in warm, moist areas. A tinea infection is more likely if you:

      • Have minor skin or scalp injuries
      • Do not bathe or wash your hair often
      • Have wet skin for a long time (such as from sweating)

      Tinea capitis, or ringworm, can spread easily. It most often affects children and goes away at puberty. However, it can occur at any age.

      You can catch tinea capitis if you come into direct contact with an area of ringworm on someone else's body. You can also get it if you touch items such as combs, hats, or clothing that have been used by someone with ringworm. The infection can also be spread by pets, particularly cats.

  • Symptoms
    • Tinea capitis may involve part or all of the scalp. The affected areas:

      • Are bald with small black dots, due to hair that has broken off
      • Have round, scaly areas of skin that are red or swollen (inflamed)
      • Have pus-filled sores called kerions
      • May be very itchy

      You may have a low-grade fever of around 100 to 101°F (37.8 to 38.3°C) or swollen lymph nodes in the neck.

      Tinea capitis may cause hair loss and lasting scars.

  • Exams and Tests
    • Your health care provider will look at your scalp for signs of tinea capitis. A special test that uses a lamp called a Wood's lamp can help diagnose a fungal scalp infection.

      Your health care provider may swab the area and send it for a culture. It may take up to 3 weeks to get these results.

      Rarely, a skin biopsy of the scalp will be done.

  • Treatment
    • Your health care provider will prescribe medicine you take by mouth to treat ringworm on the scalp. You will need to take the medicine for 4 to 8 weeks.

      Steps you can do at home include:

      • Keeping your scalp clean.
      • Washing with a medicated shampoo, such as one that contains ketoconazole or selenium sulfide. Shampooing may slow or stop the spread of infection, but it does not get rid of ringworm.

      Other family members and pets should be examined and treated, if necessary.

      • Other children in the home may want to use the shampoo 2 to 3 times a week for about 6 weeks.
      • Adults only need to wash with the shampoo if they have signs of tinea capitis or ringworm.

      Once the shampoo has been started:

      • Wash towels in warm, soapy water and dry them each time they are used by someone who is infected.
      • Soak combs and brushes for 1 hour a day in a mixture of one part bleach to 10 parts water. Do this for 3 days in a row.

      No one in the home should share combs, hairbrushes, hats, towels, pillowcases, or helmets with other people.

  • Outlook (Prognosis)
    • It may be hard to get rid of tinea capitis. Also, the problem may come back after it is treated. In many cases it gets better on its own after puberty.

  • Possible Complications
  • When to Contact a Medical Professional
    • Call your health care provider if you have symptoms of tinea capitis. Home care is not enough to get rid of tinea capitis.

  • References
    • Elewski BE, Hughey LC, Sobera JO, et al. Fungal diseases. In: Bolognia JL, Jorizzo JL, Schaffer JV, et al, eds. Dermatology. 3rd ed. Philadelphia, PA: Elsevier Mosby; 2012:chap 77.

      Hay RJ. Dermatophytosis and other superficial mycoses. In: Mandell GL, Bennett JE, Dolin R, eds. Mandell, Douglas, and Bennett's Principles and Practice of Infectious Diseases. 7th ed. Philadelphia, PA: Elsevier Churchill Livingstone; 2009:chap 267.