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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, incidence, and risk factors

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 only parts of the scalp, or all of it. Areas that are infected appear bald with small black dots, due to hair that has broken off.

You may have round, scaly areas of skin that are red or swollen (inflamed). You may also have pus-filled sores called kerions.

You may have a low-grade fever of around 100 - 101 °F or swollen lymph nodes in the neck.

There is almost always itching of the scalp.

Tinea capitis may cause hair loss and lasting scars.

Signs and tests

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

The 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

The health care provider will prescribe medicine you take by mouth to treat ringworm in the scalp.

  • Griseofulvin, terbinafine, and itraconazole are the types of medicine used to treat this condition.
  • You will need to take the medicine for 4 - 8 weeks.

Steps you can do at home include:

  • Keep the area clean.
  • Wash with a medicated shampoo, such as one that contains ketoconazole or selenium sulfide. Shampooing may slow or stop the spread of infection, but does not get rid of ringworm on its own.  

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

  • Other children in the home may want to use the shampoo 2 - 3 times a week for around 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 each time they are used by someone who is infected
  • Soak combs and brushes for 1 hour a day in a mixture of one-half bleach and one-half water. Do this for 3 days.

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

Expectations (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.

Calling your health care provider

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: Mosby Elsevier; 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: Churchill Livingstone Elsevier;2009:chap 267.


Review Date: 11/20/2012
Reviewed By: Kevin Berman, MD, PhD, Atlanta Center for Dermatologic Disease, Atlanta, GA. Review provided by VeriMed Healthcare Network. Also reviewed by A.D.A.M. Health Solutions, Ebix, Inc., Editorial Team: David Zieve, MD, MHA, David R. Eltz, Stephanie Slon, and Nissi Wang.
The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. © 1997- A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.
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