Fungus Infection of the Scalp (tinea Capitis)

There are several types of fungal infections which can infect the scalp. One of these is the ringworm commonly referred to as Tinea capitis. Ringworm infection of the scalp is extremely common world wide. It is predominantly an infection of toddlers and young children. The infection is quite obvious because it presents with constant itching, redden scalp and patches of hair loss. Despite the alarming symptoms, ringworm of the scalp is not life threatening. The most difficult problem is the treatment. When it is not adequately treated, it can be easily transmitted to friends and family.

Symptoms: Most children who have a ring worm infection will have some symptoms, but on rare occasions they will not have any. Constant and intense itching around the scalp is the most obvious sign. Other features of the infection include loss of hair in circular patches. Often the skin is red and tender. The hair loss is quite significant. Even the hair that remains can be easily pulled out without any tension. In almost all cases, ringworm infections of the scalp tend to increase in size if it is not treated. A small patch will generally infect other areas of the scalp. Besides infection of other areas of the scalp, ringworms can easily be transmitted to others: person to person transmission is quite common. Other modes of transmission include sharing personal care items, bed linen pillows and combs. Sometimes pets acquire the infection and can transmit it to humans.

Risk factors

Ringworm is most common in children who attend day care and kindergarten. Outbreaks of ringworm infections are quite common in North America and difficult to control. Even inanimate objects like pencils, door handles, chairs and tables can transmit this fungus. The risk of ringworm infection is also increased if:

– one has poor hygiene

– lives in overcrowded conditions

– has problems with excessive sweating

– shares personal care items in a large family

Once a ringworm infection of the scalp is suspected, it is important to seek help from a health care professional. This fungus is quite hardy and is easily transmitted to others in the home.


The diagnosis of tinea capitis is relatively simple. In most cases the dermatologist will be able to make a diagnosis based on the history and physical examination. If there is any doubt about the diagnosis, scrapings of the skin or hair can be examine underneath a microscope. In rare cases, the hair and skin are sent for culture.

Fungus of the scalp is not serious but can have social and health implications. If not treated, the fungus can causes a severe infection known as kerion. Kerion is basically collection of pus underneath the scalp. When the fungus has reached the stage of a kerion, most people are left with permanent hair loss and even scars.


Once the diagnosis of tinea capitis is made, treatment of scalp infection includes a variety anti fungal medications. The most common medications are Griseofulvin and Terbinafine.

Griseofulvin is available as liquid and tablet whereas terbinafine is an oral capsule. These medications have to be taken for at least 4-6 weeks. Topical medications are not useful in the treatment of tinea capitis because they are not able to penetrate deep into the scalp and enter hair follicles. There is no shampoo or gel that is useful in the treatment of tinea capitis.

The medications work slowly and changes are gradual. In most cases, the pills must be taken for several weeks to notice a change in the condition of the scalp.


Tinea capitis is best prevented, but prevention of this infection is quite difficult. The fungus is very easily transmitted. The majority of people acquire the fungus long before they have any symptoms. The only way to prevent the fungus is with the following approach:

Maintain decent hygiene. Clean or shampoos the scalp regularly. Regularly wash your hands and teach your children the same principles.

Do not share personal care items, especially in school or in any type of social gathering.

Teach your child to keep his/her personal locker/desk clean at school. After any outdoor activity, the clothes should be changed and personal items should not be shared.

Examine your child’s scalp every now and then so that you can identify the infection at an early stage.

If you have pets, examine them and if they appear sick, take them to a veterinarian. If your pet is sick, do not touch the pet with bare hands.

If you suspect that your pet or child has an infection, buy selenium sulfide shampoo and use it regularly. If the infection appears to be getting worse, go to your health care worker or veterinarian.