Ringworm of the scalp, also known as tinea capitis, is a scalp infection caused by fungus. Here’s how to treat the fungal skin infection.
Medically reviewed by Dr Juliet McGrattan (MBChB) and Based on a text by Dr Flemming Andersen and Dr Ulla Søderberg
Ringworm of the scalp, medically known as tinea capitis, is a common fungal infection characterised by itching, rashes and lesions on the scalp. Ringworm is transmitted from person to person and through contact with animals, but has nothing to do with worms. It is more common in children than adults.
To ease your itchy scalp we look at ringworm of the scalp causes, symptoms and treatment tips:
What is ringworm of the scalp?
Ringworm of the scalp is a type of fungal infection that affects the scalp and hair shafts, but there are multiple forms of ringworm that can appear anywhere on the body, including the groin, feet and toenails.
People often confuse tinea capitis with other scalp conditions so if you’re not sure, speak to your GP for a diagnosis.
Ringworm of the scalp causes
Ringworm of the scalp can be transferred from person to person through direct touch or from sharing towels, clothes and bed linen. It is also transferred through contact with animals (eg dogs, cats, cows, hamsters and guinea pigs).
Most mammals have a skin fungus with which they live in peaceful coexistence, without any symptoms for the animal, but the fungus can be transferred to humans.
Ringworm is most common among farming populations whose lifestyle involves frequent contact with animals.
Ringworm of the scalp symptoms
Common ringworm of the scalp symptoms include the following:
✔️ Hair loss and stubble
One or more sections of the scalp will show hair loss (alopecia) or give a stubbly appearance. The skin will be slightly scaly but with little or no irritation.
✔️ Scalp lesion
Alternatively, there may be dry scaly areas of scalp which itch and shed skin, giving the appearance of bad dandruff.
✔️ A kerion
Sometimes small pustules will develop on the scalp and in severe cases, a kerion (a swollen mass discharging pus) will appear. The kerion may become inflamed and fill with fluid or pus, and may also be quite painful. There may be swollen, tender neck glands and a fever if pustules or a kerion are present.
Ringworm of the scalp risk factors
While anyone can get ringworm, the following groups of people are at particular risk:
Adults can become infected, but children who come into close contact with animals are particularly susceptible to ringworm and can pass it on easily to other children.
- People who work with animals
Farmers and people who work with animals that have fur are at increased risk.
Ringworm of the scalp diagnosis
Many other skin diseases can have similar symptoms but require very different treatment. It is therefore important for the doctor to perform several tests and not to rely only on a visual diagnosis.
A scraping of the fungi can be taken for microscopic checks and cultivation to identify it.
Some fungi will appear fluorescent (glow in the dark) under ultraviolet light. This could be done by a GP or by a dermatologist (a skin specialist).
Ringworm of the scalp treatment
The most common treatment is an antifungal medicine taken by mouth, such as itraconazole, terbinafine and griseofulvin. Treatment should be started as soon as possible to avoid the fungal infection spreading further and to avoid infection of other healthy people. Antifungal tablets need to be prescribed by a doctor because they aren’t suitable for everyone and potential side effects need to be discussed.
If a large kerion has formed, the antifungal treatment may be supplemented with corticosteroids for a short period of time to reduce swelling and inflammation. With a kerion, bacteria build up in the hair follicles and can cause tumour-like swellings that ooze pus, which can lead to permanent baldness in some areas of the scalp.
Antifungal creams and shampoos might be used in addition to antifungal tablets but are unlikely to clear the infection alone.
It is difficult to avoid the fungi that cause ringworm as they are everywhere in our surroundings. However, a good preventive measure is to minimise direct contact with animals showing symptoms of ringworm, such as scaly, patchy skin. It’s important that ringworm of the scalp is treated promptly to minimise the risk of spreading it to other family members.