Common scalp conditions: Tinea Capitis (Scalp Ringworm)

Tinea capitis, commonly known as scalp ringworm, is a  contagious fungal infection that affects the scalp and hair. It is most common in children, although adults can also develop the infection.

Tinea capitis can cause scaling, itching, inflammation and areas of hair loss. Because it can resemble conditions such as seborrheic dermatitis, psoriasis or alopecia areata, appropriate assessment is very important. 

What Is Tinea Capitis?

Tinea capitis is caused by a group of fungi called dermatophytes, which can infect the skin and hair shaft. The infection can affect the hair itself, leading to broken hairs and patchy hair loss.

Although the name “ringworm” suggests a worm is involved, tinea capitis is not caused by a worm. It is a fungal infection and can be transmitted through close contact with an infected person or animal, or through contaminated items such as combs, brushes, hats, towels and bedding. 

Symptoms of Tinea Capitis

The appearance of scalp ringworm can vary depending on the type of fungus involved and the individual's inflammatory response.

Common symptoms can include:

• Itchy or irritated scalp
• Dry, flaky or scaly areas
• Redness or inflammation
• Patchy areas of hair loss
• Broken hairs or short hairs close to the scalp
• Black  dots where hairs have broken at the scalp surface
• Pustules  or crusting in more inflammatory cases
• Tender or swollen areas of the scalp

A more severe inflammatory reaction, known as a kerion, can cause a painful, swollen or boggy area of the scalp and may result in permanent scarring hair loss if not treated promptly. 

What Causes Tinea Capitis?

Tinea capitis is caused by fungi, and is therefore a fungus infection. Different species can be responsible, and the particular organism can vary according to geographical location.

The infection can spread through:

• Direct contact with an infected person
• Contact with an infected animal
• Shared combs, brushes or hair accessories
• Shared towels, hats, pillows or bedding
• Close household or community contact

Children are particularly susceptible to tinea capitis, although adults can also be affected. 

Tinea Capitis Treatment

Scalp ringworm requires medical assessment and treatment with an antifungal medication.  Antifungal shampoos may sometimes be recommended alongside oral and topical treatments.

Because tinea capitis is contagious, household members may also need assessment, and avoiding the sharing of combs, brushes, towels, hats and bedding can help reduce transmission. Where an animal is suspected to be the source, veterinary assessment may also be appropriate. 

If you notice unexplained patchy hair loss accompanied by scaling, itching, broken hairs or scalp inflammation, it is important to seek medical assessment. Early treatment can help clear the infection and reduce the risk of complications, including permanent scarring hair loss.