Ringworm of the scalp (tinea capitis)
Tinea capitis is a common infection of the scalp by mold-like fungi called dermatophytes. The body normally hosts a variety of microorganisms, including bacteria, mold-like fungi (dermatophytes) and yeast-like fungi (such as Candida). Some of these are useful to the body. Others may multiply rapidly and cause symptoms.

Tinea capitis (also called ringworm of the scalp) is a skin disorder that affects children almost exclusively. It can be persistent and contagious, almost to the point of epidemic. It does not commonly occur after puberty.

Tinea infections are contagious and can be passed by direct contact with affected individuals or by contaminated items such as combs, hats, clothing, or ANYTHING that comes into contact with the hair or scalp. They can also be transmitted by contact with pets that carry the fungus (often, cats and dogs).

Symptoms
Itching of the scalp, may be slight or absent

• Skin (scalp) lesions
• Round, scaly
• Gray or reddened
• Bald appearing patches (hair is broken off or actually missing)
• Possibly small black dots on the scalp
• Occasionally localized area of swelling, raw skin, or pus filled lesion on the scalp (kerion)

Signs and tests
The diagnosis is suspected primarily based on the appearance of the scalp. A skin lesion biopsy or skin scraping with microscopic examination or culture may show dermatophytes. Often treatment of tinea capitis is initiated before the tests results are in, if the clinical appearance is obvious.

Treatment
The goal of treatment is control of the infection. Oral antifungal medications are required for a minimum treatment length of 8 weeks. . ALL items that have been in contact with the hair or scalp should be discarded or replaced, or treated with an antifungal program so the disease is not transmitted back to the patient later (say, for example they wear the same hat containing the fungal spores, later). Also, all children in the same household should be monitored for its development. All members of the household, including the adults, should be examined and treated if necessary. All household members should use medicated shampoo for the next month to eliminate the carrier state.

Expectations (prognosis)
Tinea capitis may be extremely persistent, and may recur, but the key is to treat aggressively for 8 weeks, eliminate fomites (combs, brushes, berets, hats, pillowcases, etc) , examine and treat all affected household members, and have all household members use an antifungal shampoo for 4 weeks. Dr. Crutchfield will carefully evaluate the situation and make the appropriate treatment recommendation for you.

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For additional helpful information on this topic Dr. Crutchfield recommends these helpful links:
Medline Plus Medical Encyclopedia
Athletes foot
Nail Health
Ringworm Information