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Scalp Ringworm: Causes, Symptoms and Treatment

As the name rightly suggests, scalp ringworm is a fungal infection which affects the scalp and is mostly found in children.
Sonia Nair
Ringworm infection is not caused by parasitic worms, but by different species of fungi. This infection affects the skin of humans and certain types of animals.
Ringworm infection is classified into different types and the common ones are athlete's foot (Tinea pedis), jock itch (Tinea cruris), nail fungus (Tinea unguium), scalp ringworm (Tinea capitis), etc. Scalp ringworm is characterized by redness, scaling, crusting and itching of the scalp.

Who is Affected?

Scalp ringworm is common in children in the age group of 4 to 14, but adults can also get affected. It is said that lack of enough sebum on the scalp makes children prone to develop this type of fungal infection.
Sebum production increases after puberty and this is believed to be the reason why teenagers and adults are more resistant to scalp ringworm. Boys are found to be more vulnerable, as compared to girls.
Usually, most of the affected people develop symptoms within two weeks after contact, but there are some (mostly adults), who do not have any symptoms, but can spread the disease as carriers.

What Causes Scalp Ringworm?

Fungi called 'dermatophytes', which cause ringworm can be found in animals, humans, and soil. The spores of these fungi spread to humans in various ways. Close contact with infected people is the common cause.
 Sharing of personal items (like hairbrush, comb, towel, pillows, etc.) is another cause, as contact with contaminated objects too can result in this type of fungal infection.
Even infected animals (especially pets) can spread this skin condition, but the rate of such incidences are low, as compared to human to human transmission. If the infection is contracted from pets, the prominent symptoms would be redness, itching and scaling.
Mere contact may or may not cause the infection, but, if you have any cuts or injuries on the scalp, there is every chance of getting infected. Tight braiding of hair is also cited as a cause, as it becomes easier for the fungi to enter the hair shaft. They feed on the keratin, as they grow and spread the condition.
Some people do not get infected with the disease, even if they get exposed to these fungi, but they may become mere carriers. Those who live in overcrowded living areas with poor hygienic conditions are more likely to develop scalp ringworm infection.

What are the Symptoms?

As mentioned earlier, the classic symptoms of scalp ringworm are redness, scaling, crusting, hair loss and itching. The symptoms could be widespread or limited to patches.
Some may develop bald patches (with or without a raised, ring-like border) that increase in diameter, as the condition spreads. Some may also develop fever and enlarged lymph nodes on the neck. In some cases, ringworm infection may spread to the face too. The symptoms may also vary with the type of fungus that has caused the infection.
Black dot appearance: Scalp ringworm caused by fungi that belong to the genus Trichophyton is characterized by bald patches with a dotted appearance. In this case, the infection occurs within the hair shafts. The fungi feed on the keratin, thereby making the hair brittle. The infected hair break off leaving a small portion of the shaft. The black dotted appearance is due to the remains of broken hair.
Inflammatory Form: This type of scalp ringworm infection is characterized by patches that are tender and swollen (termed kerion). These patches develop pustules that may ooze pus and form abscesses. Severe itching, hair loss, pain and fever (along with swollen lymph nodes of the neck) may also occur. This type of ringworm is mostly transmitted from animals or soil and is found to be more severe than the other types.
Gray Patch Type: In some cases, scalp ringworm is characterized by round, scaly patches that are very dry. This form of scalp ringworm infection is caused by Microsporum fungi. The hair of the affected area become dull and break off easily, leaving stubs. Partial hair loss with intense itching is a common symptom of this infection. Inflammation is not usually seen.

Diagnosis and Treatment

Though the condition can be diagnosed through visual examination, it is always confirmed with laboratory tests. This is because of the close similarity of scalp ringworm infection with conditions like psoriasis and seborrhoeic dermatitis. Microscopic examination of the scrapings and microbial culture of hair are often done. Woods lamp is commonly used for diagnosis of scalp ringworm.
Once diagnosed, scalp ringworm is usually treated with antifungal medication that prevents growth and reproduction of fungi. Usually, oral medication is preferred to topical ones, for treating scalp ringworm infection as they are said to be more effective.
Use of antifungal shampoo is also said to be beneficial in relieving the symptoms. You may use it once or twice a week. It is advisable to disinfect your personal items, every few days.
This will prevent reinfection, to some extent. Since scalp ringworm is an infectious disease, and is often found to be persistent, it is necessary to maintain personal hygiene as a precautionary measure. Avoid contact with infected people or objects used by them.
In short, scalp ringworm is not a life-threatening condition. However, if left untreated, it may spread and result in hair loss and bald patches. Another possible complication is bacterial infection.
So, treat the condition as soon as you notice the symptoms. In some severe cases, hair regrowth may not happen. Otherwise, it will take around six to ten months for the hair to grow back. As a preventive measure, avoid sharing of personal items. Take your pet to the vet and get it treated at the earliest, if it has any skin infection.
Disclaimer: This story is for informational purposes only and should not be used as a replacement for expert medical advice. Visiting your physician is the safest way to diagnose and treat any health condition.