Tinea Capitis (Ringworm): Definition, Types, Symptoms, and Treatment

Types of Tinea Capitis

There are 2 types of tinea capitis, namely:

• NON-INFLAMMATORY (E.G., ECTOTHRIX INFECTIONS)
• INFLAMMATORY (E.G., ENDOTHRIX INFECTIONS)

The non-inflammatory type does not come with hair loss but can cause black dot tinea capitis and gray patches that destroy the hair shafts.

The inflammatory type can trigger an allergic reaction with pus-filled lumps, also called kerion, which can cause scarring alopecia.

Are Ringworm on the Body and Ringworm on the Scalp Different?

Although ringworm on the body is called tinea corporis and not tinea capitis, both are fungal infections caused by the same genus of dermatophytes, namely Trichophyton. The difference lies in the body parts they affect. Tinea corporis can manifest on the arms and legs, while tinea capitis typically occurs on the scalp.

Can You Have Ringworm Only on the Scalp and Nowhere Else on the Body?

Yes, that is possible. However, since it is a contagious fungal infection, untreated tinea capitis can potentially spread to other parts of the body. In this case, you will be dealing with ringworm on both the scalp and the body. Therefore, people suffering from tinea capitis should avoid touching other parts of their body if they scratch the affected area.

What are the Symptoms?

If you have tinea capitis, you will likely notice the following symptoms:

• REDNESS
• ITCHING
• HAIR LOSS
• DRY/SCALY PATCHES
• SWOLLEN LYMPH NODES
• INCREASING SIZE OF BALD PATCHES

Be aware that with inflammatory tinea capitis that can lead to kerion, you might spot pus-filled bumps on your child’s scalp. You can also watch out for black dot tinea capitis or gray patches. They appear as small black dots on hairless areas or slightly grayish areas where hair is missing.

How Long Does it Take to Improve?

For tinea capitis to be treated for good, it needs to be properly treated by a professional. Yes, “for good” because fungi tend to be quite stubborn and trick people into thinking they are going away. To treat the disease completely, antifungal treatment is essential. The treatment for tinea capitis takes about 4 to 8 weeks.

How Do You Get Tinea Capitis?

Tinea capitis is quite contagious. Even cats in Southern Europe carry the pathogen. It can spread to other people if left untreated through:

• SHARING PERSONAL ITEMS LIKE HATS, HAIRBRUSHES, COMBS, TOYS, TOWELS, PILLOWCASES, AND BEDDING
• DIRECT CONTACT WITH THE SCALP OF AN INFECTED PERSON
• INFECTED ANIMALS (INCLUDING PETS LIKE CATS, DOGS, ETC.)
• CONTACT WITH FUNGAL SPORES IN PUBLIC FACILITIES (GYMS, SWIMMING POOLS, SHOWERS, ETC.)

Tinea capitis is contagious and can be spread for 1 month through contact, contaminated items, or transmitting animals if left untreated. Once treatment begins, it is no longer contagious after 2 days.

Can Wet Hair in a Tight Ponytail Cause Tinea Capitis?

One thing fungi love is dark, warm, and moist places. Microsporum canis infection can also easily occur. So, if you wear a tight ponytail while your hair is still wet or go to bed with wet/damp hair, fungi of the trichophyton apezies can thrive, and infections become more common. Even though the disease is contagious, wet hair and a tight ponytail can worsen the situation.

Can Adults Get Tinea Capitis?

Yes, adults can also get ringworm of the scalp, but it cannot be said that it is as common as it is in children. In fact, they make up about 11% of all tinea capitis cases. Some studies show that adults who suffer from tinea capitis usually have problems that weaken the immune system, such as HIV.

Does Hair Grow Back After Tinea Capitis?

If treated thoroughly, hair grows back within 6 to 12 months after tinea capitis. However, if ignored or left untreated, scalp ringworm can lead to permanent hair loss.

How to Treat Tinea Capitis?

The treatment of choice for tinea capitis is systemic antifungal treatment. Depending on the organism that causes tinea capitis, the treatment can take 1 to 3 months. Since topical treatments are not sufficient to cure the disease, healthcare providers prescribe oral medications. Oral treatments to cure tinea capitis include:

• GRISEOFULVIN
• TERBINAFINE
• ITRACONAZOLE
• FLUCONAZOLE

For kerion, corticosteroids can help reduce inflammation and the risk of scarring alopecia.

You can combine the oral medications with a shampoo containing selenium sulfide or ciclopirox, or other medicated shampoos twice a week to help control the infection of the hairy scalp. This topical treatment with shampoo helps prevent the spread of tinea capitis and speeds up the treatment process. However, it cannot cure the disease on its own.

Can a Hair Transplant Treat Hair Loss from Tinea Capitis?

Yes, a hair transplant can certainly be considered for tinea capitis. Since ringworm can lead to permanent hair loss, a hair transplant is a good option. You can consult a reputable center to explore treatment options and plans for your specific situation.

PLEASE NOTE: A hair transplant is recommended from the age of 22.

Does Hydrogen Peroxide Kill Tinea Capitis?

No, the use of hydrogen peroxide is not recommended. Ringworm on the scalp is caused by fungi and therefore needs to be treated with antifungals. Hydrogen peroxide can cause the already damaged skin to become even more irritated and dry than it already is.

⚠️ So, if you think your child or you have the symptoms, consult your doctor or a dermatologist. They will first perform an examination of the scalp with a Wood’s lamp. Then, they can perform tests such as culture swabs, scalp scrapings, or biopsies to make an accurate diagnosis. Once the diagnosis is made, they will suggest appropriate treatment or systemic therapy depending on the causative agent.

💡 Wood’s light technique: Fungal infections are found with UV light. With this technique, tinea capitis becomes visible in a blue-greenish color.

What Does it Look Like When Ringworm is Healing?

What does it look like when ringworm is healing?

It can take some time for tinea capitis to go away, but after a few days of treatment, you will notice the effects. To ensure that the medications are working properly and are effective in highly inflammatory cases, you should keep an eye on the healing stages of ringworm, such as:

• LESS ITCHING
• DRY OR SCALY APPEARANCE OF THE SKIN
• PEELING OF THE SKIN
• SUBSIDING OF SCALING AND REDNESS
• PATCHY SKIN RASH
• SKIN DISCOLORATION

You should ensure that your child takes the prescribed medications for the entire recommended duration. This is because the fungus may appear to be gone but may not be completely healed.

It is important that you complete the therapy, stay in contact with your doctor, and have follow-up examinations after 4 to 6 weeks.

Tinea capitis can be stubborn and occur more than once, but in most cases, it stops after puberty.

Alopecia Areata vs. Tinea Capitis

Although alopecia areata and tinea capitis may seem similar at first glance, as they both affect the scalp and lead to hair loss, they are actually quite different. Simply put, alopecia areata is an autoimmune disease that can affect people of any age and gender and leads to permanent hair loss.

Tinea capitis, on the other hand, is a contagious fungal infection that is more common in children and is treatable in most cases. To determine which condition you might have, bald patches caused by tinea capitis are often itchy and scaly, while they usually feel smoother with alopecia areata.

Tinea Capitis vs. Psoriasis

Just like alopecia areata, psoriasis is an autoimmune disease that, unlike tinea capitis, can lead to irreversible hair loss regardless of the patient’s age. It can be difficult to distinguish tinea capitis from psoriasis because the symptoms, such as inflammation, itching, and scaly scalp, can look similar. However, with psoriasis, the bald patches appear as silvery-white scales that are thick and can flake off. If you think you might have either of these conditions, you should see a dermatologist. They can examine you and perform tests to determine which condition you have.