Overview

Tinea Capitis, often called ringworm of the scalp, is a fungal infection that affects the scalp and hair shafts. It's caused by tiny fungi called dermatophytes that thrive in warm, moist environments. While anyone can get it, it's most common in children, especially those between the ages of 3 and 7, but can sometimes affect adults. Yes, Tinea Capitis is contagious - and can spread through direct contact with an infected person or by sharing contaminated items like combs, hats, or pillows. Living with Tinea Capitis can be bothersome due to itching and visible changes to the hair and scalp, sometimes causing self-consciousness.

Symptoms

You might notice a few different things if Tinea Capitis is present. Remember, it can look different from person to person.

• Scaly, itchy patches - on the scalp, which can be round or irregular.
• Areas of hair loss or broken hairs - close to the scalp, sometimes appearing as black dots where the hair has broken off.
• Redness and inflammation - of the scalp.
• In some cases, small, pus-filled sores - called pustules may appear.
• A more severe form, called a kerion, can develop, which is a boggy, swollen, tender mass - that can ooze pus.
• Mild to intense itching - is very common.
• Sometimes, swollen lymph nodes - in the neck might be present.
• The patches - may slowly grow larger over time.

Diagnosis

Figuring out if it's Tinea Capitis usually starts with a close look at your scalp or your child's scalp by a healthcare professional. They'll look for the typical signs like scaling and hair loss. To confirm, they might gently scrape a small sample of skin or a few plucked hairs from the affected area to look at under a microscope for fungal elements. Sometimes, a special light called a Wood's lamp is used, as some types of fungi glow under it. A fungal culture, where the sample is sent to a lab to grow the fungus, is the most accurate way to identify the specific type of fungus causing the infection.

Management & Treatment

Dealing with tinea capitis can feel overwhelming, but the good news is that it is a treatable condition. Because the fungus lives deep within the hair follicles, treatment requires an oral medication to effectively clear the infection.

Prescription Oral Medications

The cornerstone of treating tinea capitis is an oral antifungal medication prescribed by a doctor. Topical creams and ointments that you put on the skin are not effective for this condition because they cannot reach the fungus in the hair shaft.

• Griseofulvin and Terbinafine are the most commonly prescribed medications for tinea capitis and are safe and effective for children.
• The length of treatment is very important. Your child will likely need to take the medication for six to eight weeks, or sometimes longer. It's crucial to complete the entire course of medication, even if the scalp starts to look better, to make sure the fungus is completely gone and doesn't come back.

Medicated Shampoos

Along with the oral medication, your doctor will likely recommend a medicated shampoo. These shampoos help to remove fungal spores from the surface of the scalp and hair. This is important because it reduces the risk of spreading the infection to other people or to other areas of the body.

• Shampoos containing selenium sulfide or ketoconazole are often recommended.
• These should be used two to three times a week by the person with the infection. Your doctor might also recommend that other members of the household use the shampoo as a preventive measure.

Home Care and Family Management

Because tinea capitis is contagious, taking steps at home is a key part of the treatment plan.

• Check everyone in the household: It's a good idea to check the scalps of all close family members for any signs of tinea capitis. Sometimes, people can carry the fungus without having any symptoms.
• Don't share personal items: To prevent spreading the infection, avoid sharing items that come into contact with the head. This includes combs, brushes, hats, scarves, towels, and pillowcases.
• Clean household items: Combs and brushes should be soaked in a bleach solution (1 part bleach to 10 parts water) or simply replaced. Wash all bedding, hats, and towels in hot water.

Expected Timeline for Improvement

It can take some time to see results, which can be frustrating. You can typically expect to see signs of improvement after a few weeks of starting the oral medication. Hair regrowth in any bald patches will usually begin once the fungal infection has been successfully treated and cleared. Remember, completing the full course of medication is the most important step for a full recovery.

When to Follow Up

If you don't notice any improvement in the scalp after several weeks of treatment, or if the condition seems to be getting worse, it's important to contact your doctor. They may want to re-evaluate the diagnosis or consider a different treatment approach.

We understand that managing a skin condition in your child or yourself can be a worrying experience. Please know that with consistent and proper treatment, tinea capitis can be cured. Always talk with a healthcare professional to get an accurate diagnosis and to create a treatment plan that is right for you or your child.

Duration & Outlook

With proper attention from a healthcare professional, Tinea Capitis typically resolves within several weeks to a few months. It's generally considered an acute condition, meaning it has a distinct onset and, with care, an end. For most people, the hair will grow back completely once the infection is cleared, though it can take some time. However, if a severe kerion develops and isn't managed promptly, there's a risk of permanent scarring and hair loss - in that specific area. It's important to watch for signs of the infection spreading or becoming more inflamed, as these are warning signs to seek medical advice quickly.

Prevention

Preventing Tinea Capitis mainly involves good hygiene and avoiding contact with the fungi.

• **Encourage regular hair washing.
• Teach children not to share personal items - like combs, brushes, hats, towels, or pillowcases.
• **If someone in the household has Tinea Capitis, make sure their items are kept separate and cleaned regularly.
• Check pets - (like cats and dogs) for any signs of skin infection, as they can sometimes carry the fungi and pass it to humans.
• **Keep shared spaces, especially in schools or daycare centers, clean.

Causes & Triggers

Tinea Capitis is caused by dermatophyte fungi, the same types of fungi that cause athlete's foot and jock itch. These fungi invade the outer layer of the skin on the scalp and the hair shafts.

The infection spreads through:

• Direct person-to-person contact: - Touching the scalp of an infected person.
• Contaminated objects: - Sharing items like combs, brushes, hats, bedding, or even upholstered furniture that has come into contact with an infected person or pet.
• Contact with infected animals: - Pets, especially kittens and puppies, can carry the fungus without showing signs themselves.

Children are most likely to develop Tinea Capitis, particularly those in close contact with other children, like in schools or daycare. Risk factors include living in warm, humid climates, crowded living conditions, minor scalp injuries (like from tight braiding or shaving), and having a weakened immune system, though healthy individuals get it frequently too.

When to see a doctor:

It's always best to see a doctor or dermatologist if you suspect Tinea Capitis. They can provide an accurate diagnosis and guide you.

Look for these signs:

• Any new scaly patches, bald spots, or broken hairs - on the scalp.
• Persistent itching - of the scalp.
• Redness, swelling, or sores - on the scalp.
• If your child complains of scalp discomfort - or you notice them scratching their head frequently.
• If symptoms - don't improve or seem to worsen despite home care.
• If you see signs of a kerion (a boggy, swollen, tender area) - seek medical attention promptly as this requires urgent care to prevent scarring.

A dermatologist is a specialist in skin and hair conditions and can be particularly helpful if the diagnosis is uncertain or if the condition is severe or not responding as expected.

Frequently Asked Questions (FAQs):

• Is Tinea Capitis the same as dandruff? No, they are different. Dandruff typically causes white or yellowish flakes without the distinct patches of hair loss or severe inflammation seen in Tinea Capitis. However, Tinea Capitis can sometimes be mistaken for severe dandruff initially.
• Can my child go to school with Tinea Capitis? This often depends on the school's policy and once appropriate medical care has started. It's important to inform the school and follow their guidelines, as Tinea Capitis is contagious. Your doctor can provide advice on this.
• Will the hair grow back after Tinea Capitis? In most cases, yes, the hair will grow back completely once the fungal infection is successfully cleared. However, in severe cases, especially if a kerion forms and leads to scarring, there might be permanent hair loss in the affected area. Early and proper care is key.
• Can adults get Tinea Capitis? Yes, while it's much more common in children, adults can also get Tinea Capitis. It might look slightly different in adults and can sometimes be misdiagnosed.
• If one person in the family has it, should everyone be checked? It's a good idea. Since Tinea Capitis is contagious, other family members, especially children, might also have the infection, sometimes without obvious symptoms. Your doctor can advise on who should be checked.

Remember, this information is to help you understand Tinea Capitis better. It's so important to see a healthcare professional for an accurate diagnosis and guidance. They are your best resource for managing this condition effectively. We understand this can be a stressful time, and we're here to support you with clear information.

Sources

• American Academy of Dermatology (AAD)
• Centers for Disease Control and Prevention (CDC)
• The Merck Manuals
• UpToDate