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Ringworm (scalp)

Medically reviewed by Drugs.com. Last updated on Jan 12, 2024.

Overview

Ringworm of the scalp (tinea capitis) is a rash caused by a fungal infection. It usually causes itchy, scaly, bald patches on the head. Ringworm gets its name because of its circular appearance. No worm is involved.

Ringworm of the scalp is a contagious infection. It's most common in toddlers and school-age children. Tinea capitis is related to athlete's foot (tinea pedis), jock itch (tinea cruris) and ringworm of the body (tinea corporis).

Medication taken by mouth can kill the fungus that causes ringworm of the scalp. Medicated shampoos may help keep a person from spreading the infection to others.

Ringworm of the scalp

Ringworm of the scalp appears as round patches where the hair has broken off at or just above the scalp. These bald-looking patches slowly grow larger.

Symptoms

Signs and symptoms of ringworm of the scalp may include:

Close-up of ringworm of the scalp

Up close, the scalp can look scaly and silvery with patches of broken hair. You may also see small black dots if the hair has broken off right at the scalp.

When to see a doctor

Several conditions affecting the scalp may have a similar appearance. See your child's doctor if your child has any hair loss, scaling or itchiness of the scalp, or other unusual appearance of the scalp. It's important to get an accurate diagnosis and prompt treatment with prescription medicine. Nonprescription creams, lotions and powders won't get rid of ringworm of the scalp.

Causes

Ringworm of the scalp is caused by a common fungus. The fungus attacks the outer layer of skin on the scalp and the hair. This causes those hairs to break. The condition can be spread in the following ways:

Risk factors

Risk factors for ringworm of the scalp include:

Complications

Some people with ringworm of the scalp may develop a severe inflammation called kerion. Kerion appears as soft, raised swellings that drain pus and cause thick, yellow crusting on the scalp.

With kerion, the hair falls out or can be easily pulled out. The condition may be caused by an overly vigorous reaction to the fungus and can lead to scarring and permanent hair loss.

Kerion

Ringworm of the scalp can cause kerion a severe, painful inflammation of the scalp. Kerion appears as soft, raised swellings that drain pus.

Prevention

Ringworm of the scalp is difficult to prevent. The fungus that causes it is common, and the condition is contagious even before symptoms appear. Take these steps to reduce the risk of ringworm:

Diagnosis

Your doctor will likely be able to diagnose ringworm of the scalp by looking at the affected skin and asking certain questions. To confirm the diagnosis, your doctor may take a sample of hair or skin to be tested in a lab. Testing a sample of hair or skin can show if a fungus is present.

Treatment

Treatment for ringworm of the scalp requires a prescription-strength antifungal medication taken by mouth. The first-choice medication is usually griseofulvin (Gris-Peg). Alternatives might be used if griseofulvin isn't working or your child is allergic to it. These include terbinafine, itraconazole (Spoanox, Tolsura) and fluconazole (Diflucan). Your child might need to take one of these medications for six weeks or more — until hair regrows. Typically, with successful treatment, the bald spots will grow hair again and the skin will heal without scarring.

Your doctor might recommend that you also wash your child's hair with a prescription-strength medicated shampoo. The shampoo removes fungus spores and helps prevent spreading the infection to others or to other areas of the body.

There is no need to shave the head or cut the hair as part of the treatment.

Preparing for your appointment

If your child has a condition affecting the scalp, you'll likely start by seeing your family doctor or child's pediatrician. You may be referred to a skin specialist (dermatologist).

What to expect from your doctor

Examples of questions your doctor may ask, include:

Questions for your doctor

Questions you might be prepared to ask your doctor include:

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