Scalp Ringworm: Symptoms, Causes, and Treatment

Scalp ringworm, or tinea capitis, is a fungal infection that is common in childhood, but can happen at any age. Unlike other scalp conditions, like dandruff or seborrheic dermatitis, it is contagious and can spread to others.

While the term ringworm isn’t one that anyone wants to hear, the good news is that it does not come from worms at all. It’s called ringworm because the fungus appears as a red ring on the skin, usually with a flat center and raised edges. Ringworm is contagious.

If you suspect that you or your child have ringworm, wash hands frequently and avoid touching the site of infection. Contact your healthcare provider, since scalp ringworm requires prescription treatment .

In this article, I’ll talk about the symptoms and causes of scalp ringworm, and how it’s diagnosed. I’ll also cover risk factors, complications, and what you need to know about treatment and prevention.

Symptoms

Ringworm is contagious, and spreads from direct contact with others, as well as by sharing objects that touch the infected area. These can include hats, combs, brushes, towels, hats, and pillows.

The most common symptoms of scalp ringworm include:

• Red, itchy, circular patches on the scalp
• Hair breakage or loss around the patch
• Pain around the infected area
• Swollen lymph nodes
• Mild elevation in temperature (between 99.5°F and 100.3°F)

If ringworm is left untreated, it can spread to other parts of the scalp or elsewhere on the body. In very serious infections, which are less common, pus-filled swellings may form (known as kerion).

If the infection progresses to this point, permanent baldness may remain in that spot, along with scars. If you have been infected with ringworm, symptoms will often show up 4-14 days after exposure to the fungus.

Causes

Ringworm is caused by a type of fungi known as dermatophytes. These types of fungus thrive in areas, like the scalp, that are warm, dark, and have dead tissue, like the small amounts of skin and hair that naturally flake off the scalp each day.

Ringworm spreads easily among younger children, but anyone can get it by touching the infected skin or an object that has touched it (like a comb or brush). If someone in your home has ringworm, objects that touch heads should be sanitized frequently, not shared, and hands should be frequently washed to minimize spread.

In some cases, infections can be spread by housepets, like dogs or cats. They may not have signs of ringworm, but can spread the infection.

Diagnosis

Doctors will be able to diagnose ringworm from a simple visual examination. If the patch is small, your doctor may use a small, fluorescent light called a Wood’s lamp to help get a better view of the scalp to make a diagnosis.

In rare cases, if it is still unclear, a doctor may test a hair sample to identify the fungus. It can take up to 3 weeks for the diagnosis to be confirmed if fungal testing is required.

Risk Factors

Some risk factors for ringworm infection include:

• Living in warm climates
• Living in close contact with an animal or person who has ringworm
• Sharing clothing, hats, towels, or bedding with a person who has ringworm
• Having a weakened immune system

Complications

In most cases, there are no long-term complications from ringworm as long as it is properly treated.

Some complications can include:

• Temporary hair loss
• Poor self-esteem or insecurity about hair loss

Oral antifungal medication can cause liver injury.  Your doctor may want to monitor your liver function while taking these medications.  

Prevention

The best way to prevent scalp ringworm is to avoid sharing objects that touch the head. This is generally a good hygiene idea for children, since it can also prevent the spread of lice. You can get ringworm more than once, even after the infection has been treated.

If you suspect that a household pet may have ringworm, ask your veterinarian to evaluate your pet.

Treatment

Tinea capitis usually requires both an oral antifungal medication and topical medicated shampoo. The shampoo may prevent ringworm from spreading, but will not treat the infection itself.

The treatment for tinea capitis usually lasts six weeks to ensure the infection is resolved. Scalp ringworm is typically treated by either oral griseofulvin (Grifulvin V) or terbinafine hydrochloride (Lamisil).

Both have similar side effects, including diarrhea and upset stomach. Less commonly, medications for ringworm may also have side effects such as sun sensitivity, vomiting, dizziness, allergic reactions, rash, or hives. Let your doctor know if you or your child experience any symptoms or side effects from ringworm treatment.

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