Tinea Capitis (Scalp Ringworm)

 

What is Tinea Capitis (Scalp Ringworm)?

Tinea capitis is a fungal infection of the skin on the scalp. It is caused by a type of fungi known as dermatophytes. These fungi tend to cause a round ring-like skin rash. Therefore tinea capitis is often referred to in common terms as scalp ringworm. This type of infection can also occur on many other parts of the body and is caused by the same fungi, or species of fungi, as tinea capitis.

Who gets Tinea Capitis?

Age

Tinea capitis can affect any person of any age but males are more susceptible to this condition as compared to females. Children aged 3 to 7 years are at the greatest risk as they are more prone to contact with others with the infection.

Risk factors

Some individuals are more susceptible to this disease. This means that they are more likely to develop tinea capitis than others in their age group. It is associated with certain risk factors which includes people who recently have had skin or scalp injuries, have poor hygiene and perspire excessively.

Warm and moist conditions are favorable for the growth of dermatophytes especially if there is an abundant supply of dead skin cells. Therefore living in a hot environment, poor personal hygiene and excessive perspiration are strong contributing factors for the causation of tinea capitis.

Spread

Individuals who come in contact with an infected person or use their belongings such as combs, clothes or other accessories can contract this disease. Touching pets like cats can also make individuals prone to tinea capitis. People with low immunity like those suffering from chronic diseases such as diabetes and HIV also have higher chances of getting this disease.

Tinea Capitis Symptoms

There are various symptoms of tinea capitis which are similar to other disease affecting the scalp and skin.

Hair loss

Hair loss is the most common complaint of tinea capitis patients as the fungi affects the scalp region, which results in loss of hair in the affected area. Strands of hair become brittle and break off easily.

Itching

The affected area of the scalp may itch due to the fungal infection. It worsens when the scalp is very dry and as the fungus spreads.

Irritation

Individuals may also experience irritation in the affected area of the skin region. This may include a slight tingling or burning sensation with redness. It is usually provoked with excessive scratching.

Lesions

The affected area of the scalp may show presence of circular pus filled lesions. It may not be easily spotted as the typical red ring lesion of a fungal (ringworm) infection until the hair falls out.

Rashes

Skin rashes are typically red with a raised border. The inner part of the rash may be red or white with crusting skin. These types of rashes may also appear in pets that have similar fungal infections which can be transmitted to humans.

Dots

The affected area of the scalp may sometimes also show presence of black dots. This occurs due to breaking of the hair at the roots. White balls attached to these remnants of the hair follicle may also be seen

Smooth skin

The affected area of the skin becomes smooth after the skin peels off. It may also be smoother than normal once the infection is treated and the skin heels.

What causes Tinea Capitis?

Tinea Capitis occurs when the fungi known as dermatophytes find the appropriate conditions for its growth and multiplication. Warm and moist conditions are the most suitable factors, and it accelerates growth of the fungi. Areas of the body that sweat excessively become breeding grounds of dermatophytes. There is usually some preceding injury to the skin that compromises its integrity. The fungus can then establish itself and grow. The most common types of dermatophytes to cause tinea capitis are the Trichophyton and Microsporum species. This can be passed on from an inanimate object to humans, from human to human, or even from animal to human.

Tinea Capitis Diagnosis

Initially observing the affected area and physical examination is carried out to confirm the presence of this disease. Once the disease is suspected, then a skin lesion biopsy is conducted where the skin and fungi can be seen with a microscope. A Wood Lamp test is performed to further confirm the fungal infection.

A swab or scrapings from the scaly skin can also be taken for examining under the microscope for presence of the fungi. This is done with a KOH test. If the microscopic test yields negative result, then the samples can be sent to the laboratory for further testing.

Additional tests may also be recommended if the infected person show no signs of improvement with the prescribed treatment. This may be to exclude other diseases of the skin or immune system disorders.

Treatment for Tinea Capitis

Tinea capitis can be treated with medicines and also with home remedies.

Tinea Capitis Treatment (Home or Natural)

  • The affected area should be kept clean as far as possible. A shampoo specifically meant for tinea capitis can be used for cleaning the affected area. These shampoos often contain substances such as selenium sulfide or ketoconazole. It should be used in order to decrease the severity of infection. The shampoo applied on the scalp should be worked into a lather and left on the scalp for at least 5 minutes before rinsing. This would allow the active ingredients present in the shampoo to effectively work on the fungi.
  • Affected children should be cautious about transmitting the infection to others. While it is not practical for a child to miss school due to a scalp ringworm, they need to be taught not to share combs or touch others after scratching their scalp.
  • Tea trea oil (melaleuca) has been clinically proven to be effective in the treatment of fungal infections. Shampoos may be available but the full strength oil should not be applied directly on the scalp. Instead it should be used as directed an only with the approval of a doctor.

Tinea Capitis Treatment (Medical)

Medical treatment should be sought even before attempting any home remedies. Oral antifungal medications are prescribed by dermatologists to treat tinea capitis. These include itraconazole, griseofulvin and terbinafine. These medications need to be taken for a period of 6 weeks or more. It is also used with topical antifungals in the forms of creams, ointments and shampoos.

Tinea Capitis Prognosis

Treating tinea capitis is a bit difficult as some cases can be persistent but complete eradication of the infection is possible. Mild infections may resolve on its own with age and after puberty, however, medical treatment is always advisable.

How to prevent Tinea Capitis?

The following measures can be taken into consideration for preventing the onset as well as spread of a scalp ringworm.

  • Maintain good hygiene and keep a safe distance from pets who are suffering from this disease.
  • Bathe regularly to wash off the fungal spores from the body. Wear clean washed and completely dried clothes and undergarments.
  • Make use of antiseptic creams on cuts and powders to keep body dry and moisture free.
  • Make use of medicated antifungal shampoo to wash hair regularly. This would help keep the scalp clean and free from infections. Shampoo hair immediately after a haircut.
  • It is best to avoid clothes and accessories of individuals who are either suffering from tinea capitis or have a past history of the infection.

Tinea Capitis Pictures

Understanding whether a scalp rash is tinea capitis or not is difficult. Therefore professional medical attention should be sought. The pictures below are a helpful guide to identify the presentation of tinea capitis but it is important to note that certain skin conditions, like seborrheic dermatitis and scalp psoriasis, may appear similar to the untrained eye.

 

Pictures sourced from Wikimedia Commons

 

References

http://www.merckmanuals.com/professional/dermatologic_disorders/fungal_skin_infections/dermatophytoses.html

http://emedicine.medscape.com/article/1091351-overview

http://www.nlm.nih.gov/medlineplus/ency/article/000878.htm

http://dermnetnz.org/fungal/tinea-capitis.html

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