Ringworm (scalp)

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.

Signs and symptoms of ringworm of the scalp may include:

• One or more round, scaly or inflamed patches where the hair has broken off at or near the scalp
• Patches that slowly get bigger and have small, black dots where the hair has broken off
• Brittle or fragile hair that can be easily broken or pulled out
• Tender or painful areas on the scalp

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.

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:

• Human to human. Ringworm often spreads through direct skin-to-skin contact with an infected person.
• Animal to human. You can contract ringworm by touching an animal with ringworm. Ringworm can spread while petting or grooming dogs or cats with ringworm. Ringworm is fairly common in kittens, puppies, cows, goats, pigs and horses.
• Object to human. It's possible for ringworm to spread by contact with objects or surfaces that an infected person or animal has recently touched. This includes items such as clothing, towels, bedding, combs and brushes.

Risk factors for ringworm of the scalp include:

• Age. Ringworm of the scalp is most common in toddlers and school-age children.
• Exposure to other children. Outbreaks of ringworm are common in schools and child care centers where the infection easily spreads with close contact.
• Exposure to pets. A pet, such as a cat or a dog, can have the infection without showing any signs. Children can get the infection by touching the animal.

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.

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:

• Educate yourself and others. Be aware of the risk of ringworm from infected people or pets. Tell children about ringworm, what to watch for and how to avoid the infection.
• Shampoo regularly. Be sure to wash your child's scalp regularly, especially after haircuts. Some scalp conditioning products, such as coconut oil and pomades with selenium, might help prevent ringworm of the scalp.
• Keep skin clean and dry. Be sure children wash their hands, including after playing with pets. Keep shared areas clean, especially in schools, child care centers, gyms and locker rooms.
• Avoid infected animals. The infection often looks like a patch of skin where fur is missing. If you have pets or other animals that commonly carry ringworm, ask your veterinarian to check them for the infection.
• Avoid sharing personal items. Teach children not to let others use their clothing, towels, hairbrushes, sports gear or other personal items.