Tinea Capitis (Scalp Ringworm)
Symptoms
Tinea capitis causes scaly patches with hair loss, “black dots” where hairs break off, or inflamed boggy masses called kerions. Itching, tenderness, and lymph node enlargement are common. Children are most frequently affected. Untreated kerions may lead to permanent scarring alopecia. Seborrheic‑like scale can mimic dandruff.
Cause
Dermatophytes, often Trichophyton tonsurans or Microsporum species, invade hair shafts and follicles. Spread occurs via direct contact, shared hats, combs, or bedding. Crowded living conditions and poor hygiene facilitate outbreak. Asymptomatic carriers can harbor fungi without lesions. Pets may act as reservoirs for zoophilic species.
Treatment
Oral antifungals such as griseofulvin or terbinafine are required for 6‑8 weeks; topical therapies alone are ineffective. Antifungal shampoos like ketoconazole reduce surface spores and transmission. Treating household contacts and disinfecting hair tools help control spread. Early treatment prevents scarring. Kerions may need adjunctive corticosteroids to reduce inflammation.
Dr. Beth Schulz-Butulis
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