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Ringworm (Scalp)

Overview

Scalp ringworm, also known as tinea capitis, is a skin condition caused by a fungus. It often shows up as itchy, flaky, and sometimes bald spots on the head. The spots can be round or oval, which is why it's called "ringworm." It's important to remember that this condition has nothing to do with actual worms. The fungus lives on the scalp and causes the irritated appearance.

Symptoms

Ringworm of the scalp can show up in several ways. One common sign is a round, flaky, or red area on the head. The hair in this area may break off close to the scalp. You might also notice patches that are spreading gradually, and tiny black dots where the hair has snapped. Another symptom is hair that feels weak and easily breaks or pulls out. Finally, the affected area on the scalp may feel sore or painful.

When to see a doctor

Different scalp problems can look alike. If your child is losing hair, has a flaky or itchy scalp, or their scalp looks unusual in any way, take them to the doctor. A doctor can correctly identify the problem and give the right medicine to treat it. Over-the-counter creams, lotions, and powders won't work for scalp ringworm. You need a prescription medicine from a doctor to treat ringworm.

Causes

Scalp ringworm is a fungal infection that affects the top layer of skin and hair follicles on the scalp. This fungus can cause the hair to break and fall out.

Scalp ringworm can spread in a few ways:

  • Person-to-person: This is a common way the infection spreads. It happens when someone touches the skin of someone who already has ringworm. Close contact, like sharing hats, hairbrushes, or towels, can increase the risk.

  • Animal-to-person: Ringworm can also be passed from animals to humans. If you touch an animal with ringworm, particularly when petting or grooming, you could get it. Many animals can carry ringworm, including cats, dogs, kittens, puppies, cows, goats, pigs, and horses.

  • Object-to-person: Ringworm can live on surfaces for a while. If someone with ringworm touches an object, like a towel, comb, or brush, and you later touch the same object, you could get infected. This is why it's important to keep potentially contaminated items separate from other people and pets.

Risk factors

Scalp ringworm is a common fungal infection that often affects kids. Several things can increase the chances of getting it.

Age matters: Young children, especially toddlers and kids in school, are more likely to develop scalp ringworm. This is partly because their immune systems might not be as strong, and they're more likely to be in close contact with other children.

Sharing is caring...sometimes not: Ringworm spreads easily in places where children are close together, like schools and daycare centers. Direct contact, like sharing brushes or hats, or close play, can pass the infection.

Pets can be carriers: Even if a pet cat or dog doesn't look sick, they can still carry the fungus that causes ringworm. If a child touches an infected animal, they could get the infection. It's important to note that pets don't always show obvious signs of the infection.

Complications

Ringworm of the scalp sometimes leads to a serious reaction called kerion. Kerion is a swollen, tender area on the scalp. It often oozes pus and forms thick, yellow scabs.

Prevention

Ringworm on the scalp is tough to stop. The fungus that causes it is pretty common, and it can spread even before you see any signs. Here are some ways to lessen the chances of getting it:

1. Learn About Ringworm and Spread Awareness: Ringworm can spread from people or animals who have it. Even if they don't look sick, they can still pass it on. Talk to your kids about what ringworm is, what to watch out for (like a red, itchy spot on the scalp), and how to avoid catching it.

2. Keep Scalps Clean: Regularly washing your child's hair, especially after haircuts, helps. Some products, like shampoos with selenium sulfide or coconut oil, might also help. But remember, regular cleaning is key.

3. Keep Skin Clean and Dry: Teach kids to wash their hands often, especially after playing with pets. Keeping shared spaces clean, like schools, daycare centers, gyms, and locker rooms, is important too. Dry skin is less likely to get infected.

4. Check Your Pets: Ringworm in animals often shows up as bald patches on their skin. If you have pets, talk to your vet about checking them for ringworm. This helps prevent the spread from animals to humans.

5. Don't Share Personal Items: Emphasize to your children not to share things like clothes, towels, hairbrushes, sports equipment, or anything else that touches their skin or hair. This is a crucial way to stop the spread.

By following these steps, you can significantly reduce the risk of your child getting ringworm.

Diagnosis

A doctor can usually tell if you have ringworm of the scalp just by examining your scalp and asking you some questions. To be sure, your doctor might take a small piece of skin or hair to send to a lab for testing. This testing can determine if a fungus is causing the ringworm.

Treatment

Ringworm of the scalp needs medicine taken by mouth to get rid of the fungus. Doctors usually start with a medicine called griseofulvin. If this doesn't work or your child is allergic, other options like terbinafine, itraconazole, or fluconazole might be used. These medicines are often needed for several weeks, sometimes even six weeks or more, until the hair grows back completely. With successful treatment, the bald patches will usually grow hair again and the skin will heal without leaving a mark.

To help clear up the infection and prevent it from spreading, a medicated shampoo is often recommended. This shampoo kills the fungus spores and stops the infection from spreading to other parts of the body or to other people.

It's not necessary to shave your child's head or cut their hair as part of the treatment.

Preparing for your appointment

If your child has a problem with their scalp, you'll probably first see your family doctor or pediatrician. They might send you to a dermatologist, a doctor who specializes in skin conditions.

Your doctor will likely ask you some questions to understand the problem better. For example, they might ask:

Questions you can ask your doctor:

  • When did you first notice the problem? This helps pinpoint when the condition started.
  • What did the scalp look like when you first noticed it? Describing the appearance (redness, sores, patches, etc.) helps the doctor figure out what's going on.
  • Is the rash or irritation painful or itchy? This tells the doctor how uncomfortable your child is.
  • Does anything seem to make the condition better or worse? For example, does it get worse after a certain activity or when the weather changes?
  • Do you have pets or has your child been around farm animals lately? Some scalp conditions can be spread by animals.
  • Does another family member or a pet already have a similar condition? This helps determine if it could be contagious.
  • Have you heard of any similar cases at your child's school? This is important to know if the condition might be spreading in the community.

Questions you might ask your doctor:

  • If this is a contagious condition (like ringworm), how can we stop it from spreading to others? This is crucial for preventing the spread of infection.
  • What hair care routine should we follow to help it heal? This could include specific shampoos or ways to manage hair.
  • When can my child go back to school? Knowing when it's safe for your child to return to school is important.
  • Should we schedule a follow-up appointment? This ensures the condition is properly treated and monitored.
  • Should I have my other children checked, even if they don't seem sick? If the condition is contagious, it's a good idea to check other children in the family to prevent it from spreading.

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