Tinea Capitis

Tinea capitis is an infection of the scalp by mold-like fungi called dermatophytes.

What causes tinea capitis and who is at risk?

Tinea capitis (also called ringworm of the scalp) is a skin disorder that usually affects only children younger than age ten. It can be persistent and contagious; however, it often disappears spontaneously at puberty.

The fungi that cause tinea infections thrive in warm, moist areas. You have an increased risk for tinea infection if you have poor hygiene, prolonged wetness of the skin (such as from sweating), and minor skin or scalp injuries.

Tinea infections are contagious. You can catch it if you come into direct contact with someone who has the condition, or if you touch contaminated items such as combs, hats, clothing, or similar surfaces. The infection can enter through cut or broken skin. The infection can also be spread by pets, particularly cats.

Good general hygiene is important in the prevention and treatment of all tinea infections. The scalp should be shampooed regularly, especially after haircuts.

Avoid contact with infected pets or individuals. Headgear, combs, brushes, and similar items should not be exchanged unless they are first thoroughly cleaned and dried. Children sharing sleeping mats at daycare have contracted tinea capitis, as well.

Symptoms

Symptoms include round, scaly lesions on the scalp. These areas may be red or swollen (inflamed). The patient may also have areas that appear bald (alopecia), due to hair that has broken off. There may be small black dots on the scalp.

Itching of the scalp may be slight, or may not occur at all. Sometimes, there may be pus-filled lesions on the scalp (kerions).

Diagnosis

The diagnosis is suspected primarily based on the appearance of the scalp. A skin lesion biopsy with microscopic examination or culture may show dermatophytes. This test is often not necessary to diagnose tinea capitis. A Wood's lamp test may be performed to confirm the presence of a fungal scalp infection.

Call your doctor if:

Call for an appointment with your health care provider if you have symptoms of tinea capitis. Home care remedies do not effectively treat tinea capitis.

Treatment Options

Anti-fungal medications, taken by mouth, are used to treat the infection. Agents applied topically, like creams, are not effective, as they do not penetrate to the fungal infection in the hair shaft.

  • Griseofulvin may be used for 6 to 10 weeks of therapy. Patients should take griseofulvin with a fatty meal to enhance absorption. Griseofulvin may lead to nausea or upset stomach in children.
  • Terbinafine, itraconazole, ketoconazole, and fluconazole are other orally available anti-fungal options for tinea capitis; however, treatment periods for some of these drugs may be shorter, which may aid in compliance. Both ketoconazole and fluconazole may also cause stomach upset in children.
  • Most antifungal medications are available generically. Griseofulvin, terbinafine, itraconazole, ketoconazole, and fluconazole are all available in the generic form, and because these medications are taken for prolonged periods of time, generic substitutes may be more cost effective.

Keep the area clean. A medicated shampoo, such as one containing selenium sulfide or ketoconazole may reduce the spread of infection. Other family members and pets should be examined and treated, if necessary.

See Also:

References

  • Trovato MJ, Schwartz RA, Janniger CK. Tinea capitis: current concepts in clinical practice. Cutis. Feb 2006;77:93-9.
  • Last updated: 2012-12-21 by L. Anderson, PharmD

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