Ringworm of the Scalp

Ringworm of the scalp is a fungal infection that often affects toddlers and school age children. Symptoms typically include scaly or inflamed patches of hair loss, which can be itchy and uncomfortable. 

The condition is contagious and can understandably cause concern among parents, but it’s good to know that it can usually be treated successfully with prescription medication and antifungal shampoo.

What causes ringworm of the scalp?

Despite its name, ringworm of the scalp is not in fact caused by worms, but by tiny fungal threads which grow through the outer layer of the skin and the hair follicles. This leads to an itchy rash that often causes bald patches and black dots where the hair has broken off. 

Ringworm of the scalp is also known as tinea capitis and is related to athlete’s foot (tinea pedis) and ringworm of the body (tinea corporis).

What are the symptoms of ringworm of the scalp?

The main signs and symptoms of ringworm of the scalp include the following:

• A flaking scalp that can be mistaken for dandruff or psoriasis
• Itchy, round patches of hair loss, with black or blond dots where the hair has broken off
• Scaly red areas or bald patches where hair has broken off
• Small, broken hairs that may remain in the bald patches
• In severe cases, crusty swellings called kerions, that are tender and filled with pus
• High temperature and swollen glands

Can ringworm of the scalp cause permanent hair loss?

In most cases of ringworm of the scalp, oral medication and antifungal shampoo will be effective in clearing the infection, and your child’s hair will grow back over time.

However, complications can sometimes arise if ringworm of the scalp is left untreated. A severe inflammatory infection can develop, leading to large, painful, pus-filled swellings on your child’s scalp called kerions.

Without early intervention, the infection can occasionally cause permanent scarring and hair loss. That’s why it’s essential to have any signs of ringworm of the scalp promptly examined and treated with prescription medication. 

How is ringworm of the scalp diagnosed?

Ringworm of the scalp can sometimes be mistaken for dandruff or psoriasis, and it can be one of many conditions that cause bald patches and hair loss. That’s why it’s always a good idea to seek medical advice if you’ve noticed any symptoms on your child’s scalp. 

Our team of paediatricians and Consultant Dermatologists will be able to quickly identify ringworm of the scalp through a clinical examination of your child’s head. They may also take a hair sample or a scraping of the affected skin to be sent for lab testing to confirm the diagnosis.

Is ringworm of the scalp contagious

Yes, it’s a highly contagious infection and is commonly passed on in the following ways:

• Through pets who might have ringworm
• By coming into contact with someone who has the condition, through touching their head or hair
• Through sharing brushes, towels, sheets and furniture, as the fungi can live on unwashed objects for a long time
• By touching or playing with contaminated objects or toys

The condition spreads more easily among young children. Teenagers and adults are more resistant to it, as experts believe the sebum that develops after puberty on our scalps is resistant to the fungi.

What is the treatment for ringworm of the scalp?

In most cases, ringworm of the scalp can be treated effectively with the following:

• Prescription strength, antifungal medication taken by mouth. If your child finds it difficult to swallow, the medication can be crushed and mixed with water
• Griseofulvin is usually the first choice and takes around 8-12 weeks.
• Alternatively, if griseofulvin isn’t working or your child is allergic, we may prescribe terbinafine which takes around four weeks to work
• An anti fungal shampoo or cream in addition to the medication, to remove any fungi spores on the scalp and hair, and stop the infection from spreading
• Occasionally, inflammation caused by ringworm of the scalp can lead to secondary bacterial infection, and antibiotics may be prescribed

With successful treatment, typically your child’s hair will grow back and the skin on the scalp will heal without any scarring. Our specialists do not recommend shaving or cutting your child’s hair.

How to stop ringworm of the scalp spreading

Ringworm of the scalp is highly contagious, so it’s important to follow these guidelines, to try and prevent the infection from spreading:

• Start your child’s treatment immediately
• Wash all clothes, towels and bedding at 60˚C, and carry on washing regularly
• Do not share towels, clothing, hats or bedding with someone who may have ringworm
• Wipe down objects that may be contaminated, such as toys, scissors, hair brushes or combs with a bleach solution, or throw away
• Wash your hands after touching animals or soil
• Pets should be examined by a vet and treated with antifungal medication if they have ringworm
• Other family members should be examined by a doctor
• Some experts recommend that family members should use an antifungal shampoo for four weeks regardless of whether or not they have an obvious infection

If you think your child may have ringworm, it’s a good idea to let their class teacher know, in case other pupils are also infected. They may need to be treated, to prevent re-infection. Once your child has begun treatment with oral medication and antifungal shampoo they can safely return to school.

When to see a specialist for your child’s ringworm of the scalp

Ringworm of the scalp symptoms can be slightly confusing and there are several conditions that cause hair loss or a flaky scalp, including alopecia areata, eczema and psoriasis. If you notice your child scratching their head, or if they have a flaky scalp, hair loss or any other unusual symptoms on their scalp, it’s always a good idea to have their hair and scalp checked carefully by a medical professional. 

Our specialists include leading paediatricians and Consultant Dermatologists who have many years’ experience in accurately diagnosing and treating children’s skin infections promptly and successfully. They offer tailored treatments, which are particularly important if your child has severe symptoms, such as boils, inflammation or secondary bacterial infections.

Visiting our London Clinic

We’re here to offer our care and expertise, and we have appointments with our paediatricians and Consultant Dermatologists often available at short notice. To find out more about how we can help you, please telephone 020 7244 4200 or make an appointment online.