Fungus can do a lot for us — make bread, make beer and cure infections, in the case of penicillin. But when the fungus infects us, well, that’s not nearly as much fun as beer.
From your head to your feet, groin and other parts of your body, fungal infections are an itchy, irritating annoyance that can cause a variety of symptoms. There’s no getting around it — they suck, and can get pretty gross.
Scalp fungus presents an array of unique — and crappy — symptoms too (more on those later), but the good news is that it’s almost always treatable. It’s important to take action quickly if you develop a fungal infection on your scalp to prevent it from spreading to other areas of your body and becoming more severe.
Below, we’ve explained what scalp fungus is and the factors that cause it to develop. We’ve also explained the effects scalp fungal infections can have on your hair, as well as the most effective options for treating and preventing this type of fungal infection, so you can stop feeling like an unpaid Last of Us extra.
Scalp fungus, or tinea capitis, is a type of fungal infection that affects your skin and hair. It won’t turn you into a zombie, but it can alter your appearance.
Scalp fungus is often referred to as scalp ringworm. Despite its name, there’s no worm involved — instead, this type of infection is caused entirely by contagious fungi.
As with other common fungal infections, it develops when a specific type of fungus starts to grow on the outermost layer of your skin.
A similar type of infection called tinea barbae — which develops on your face, chin and neck — can affect your beard area.
According to the Centers for Disease Control and Prevention (CDC), about 40 different species of fungi may cause tinea infections that affect your scalp, groin, feet and other parts of your body. Specifically, scalp fungal infections are often caused by fungi in the microsporum and trichophyton genera.
Scalp fungus can cause a variety of symptoms, including:
The severity of these symptoms can vary depending on a number of factors. Sometimes, scalp fungus causes gray, scaly patches of skin to develop across your scalp with a small amount of noticeable hair loss.
In more severe cases, a scalp fungal infection can cause inflammation, lesions and secondary infection with bacteria.
So if you’re not dipping your head in some sourdough starter, how does scalp fungus happen?
Like other fungal skin infections, scalp fungus develops when contagious fungi are transmitted onto your scalp and hair from other people, animals or objects.
Fungi can be found in almost every environment. When you come into contact with a fungus, it can spread onto your skin, causing an infection to develop. Often, it only takes a moment for a fungus to make its way onto your body and start growing.
Common sources of this type of fungal infection include:
People. It’s possible to develop scalp fungus after contact with other people with fungal infections. The fungi that cause this type of infection can spread from other people onto your hands, then move to your head when you touch your scalp or hair.
Animals. Ringworm infections are common in animals, including dogs, cats and many farm animals. Many fungal infections are especially common in younger animals, such as puppies and kittens.
Shared items. Items that are shared with other people, such as towels, clothing, combs, hairbrushes and other personal care products, can spread fungal infections.
The environment. Certain areas, such as damp surfaces in communal locker rooms or showers, are breeding grounds for the fungi that cause scalp ringworm and many other fungal infections.
Thankfully, the most common types of fungus that hit humans — which if we’re being honest aren’t really that common — don’t cause us to become flesh-hungry mindless drones in an apocalyptic wasteland. Zombie “jock itch” doesn’t exist.
There are, however, two predominant fungi that may mushroom up in your scalp — tinea capitis (also known as ringworm) or candida.
You likely know ringworm: the variety of fungus associated with stray animals, barefoot children who play outdoors and apparently, your scalp.
Scalp ringworm can affect anyone, but it’s most common in children and people with weak immune systems. Like other fungal infections, ringworm tends to spread more often during the warmer periods of the year, so if you’ve got it in December, you’re very special (congrats!).
A far less common cause of scalp infection, candida is a yeast infection for your dome. Typically, yeast infections are associated with wet, internal areas of the body — you know — vaginas. And while yeast also infects penises, throats, and more, it’s typically not the one you hear about in the scalp.
But a candida scalp infection is really rare, and generally only happens in people who are immunocompromised.
One thing that real-world human fungi can do, which you probably won’t see as a major plot point in a zombie movie or TV show, is cause some hair loss. If you have a fungal infection on your scalp, you may experience patchy hair loss, with small, round bald patches forming in certain parts of your scalp.
The hair in the affected area may become brittle and break off its roots easily. In some cases, scalp fungus can cause patches of small black dots to develop as strands of hair literally break off at your scalp.
Although most of the hair loss associated with scalp fungus is temporary, scalp fungal infections that cause inflammation (often referred to as kerion) can cause scar tissue to develop. This may lead to a type of permanent hair loss called scarring alopecia.
Because of the risk of permanent hair loss, it’s important to take action quickly if you notice any of the symptoms of the scalp fungal infection we mentioned above.
It's also important to understand that hair loss caused by fungus is very different from the hair loss caused by male pattern baldness. Although fungal infections can cause hair loss, they don’t have any effect on DHT or other hormones.
So how do you determine whether you’ve got a fungus or a viral or bacterial infection on your scalp? As much as you may want to see some really gross side-by-side images right now, the truth is that it can often be hard to determine on your own.
Fungal infections may have clear visual cues, like white growths or ring-like patterns to clue you in, but it’s more than likely (unless you’re a fungal scientist, or maybe a dermatologist) that you’re going to be hard-pressed to identify fungal dandruff or differentiate a scaly scalp from a fungus from that of a scaly scalp due to scarring alopecia.
The best way to tell whether you have a fungal infection — and which fungal infection you have — is to talk to a healthcare provider and let them assess your affected skin.
As a bonus, they’ll be able to start the treatment basically right away — let’s take a look at what treating scalp fungus might look like.
The earlier you take action to treat scalp fungus, the more likely you are to be able to get rid of the infection without suffering from significant hair loss. Acting fast also lowers the risk of the fungal infection spreading to other parts of your body or to other people.
Scalp fungus is treatable using antifungal medications, including:
Griseofulvin. One of the most common medications used to treat fungal infections of the scalp is griseofulvin, an oral antifungal. You may need to use griseofulvin or another medication for four to eight weeks to properly treat the infection.
Itraconazole. This antifungal agent can be used as a preventive treatment for people with weakened immune systems, like those with HIV, people undergoing chemotherapy, and people who have gotten organ transplants. But this big gun can work as a treatment for milder situations as well.
Fluconazole. This antifungal agent is the most reliable treatment for a fungus that beer and bread love, and vaginas and throats hate: yeast.
Since topical antifungal medications can’t penetrate the hair shaft, they typically aren’t used to treat scalp fungus. However, your healthcare provider may also recommend topical antifungal creams if you have inflammation or scalp lesions, or show symptoms of ringworm or another fungal infection elsewhere on your body.
It’s important to continue using your medication for the entire treatment period, even if your skin and hair improve relatively early. Stopping treatment early may increase your risk of recurring fungal infections.
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Once you’ve treated scalp fungus, it’s important to prevent the infection from coming back. Use the following tips to reduce your risk of developing scalp fungus or spreading it to others:
Wash your hair regularly. It’s important to keep your hair and scalp clean. Try to wash your hair regularly. Your healthcare provider may recommend using an antifungal or other medicated shampoo to prevent reinfection.
Keep your hair and skin clean and dry. Fungal infections tend to thrive in moist, dirty environments. After you wash your hair, dry your scalp thoroughly to prevent fungi from spreading and multiplying.
Avoid sharing clothes or personal care items. Avoid sharing towels, clothing, combs or other personal care items with other people. Because these come into contact with your skin, they can easily spread fungal infections.
Replace your hairbrush and/or comb. The fungi that cause infections can survive on combs, brushes and other products for some time, making it possible to reintroduce the infection after treatment if you reuse these items. When you start treatment for scalp fungus, it’s best to throw away your old comb or hairbrush and replace these items.
Use hot water to wash your clothes, towels and bedsheets. Make sure to wash all of these items thoroughly to kill fungi and reduce your risk of spreading the fungal infection to your partner.
Take precautions in locker rooms and public showers. Fungal infections often spread in these areas. Be careful not to touch damp or dirty surfaces, then touch your scalp or hair.
Other fungal infections, such as athlete’s foot, can spread around your body. Make sure to protect yourself by wearing sandals or flip-flops whenever you use a public shower or locker room.
If you have a pet, take it to the vet. Scalp fungus and other fungal infections are often spread through pets. Even if your pet doesn’t show any signs of infection, it’s important to take it to the vet to have it checked for infectious fungi, including ringworm.
Wash your hands with soap and water after touching animals. Make sure to wash your hands thoroughly after touching dogs, cats and other animals. This also protects you from bacteria and other non-fungal pathogens.
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Just like encountering roving bands of cannibal murderers after the apocalypse, scalp fungus is a common problem that can affect people of all ages and backgrounds. Here are some important things to remember about it:
While scalp fungus doesn’t cause male pattern baldness, it can affect your hair follicles and cause you to shed hair in certain areas of your scalp.
When a scalp fungal infection causes inflammation, it can lead to a form of permanent hair loss called scarring alopecia.
Avoiding scalp fungus is the easiest treatment. Keep your skin and hair clean and dry, be careful when sharing clothing and hats and use good hygiene around animals.
Medication can treat scalp fungus — if you find yourself with signs of an infection, see a healthcare professional for help.
If you have scalp fungus, talk to a healthcare provider. They’ll prescribe you medication to treat the infection, manage any inflammation and prevent the fungus from coming back. If you’re looking for a dandruff solution, Hims’ Dandruff Detox Shampoo has antifungal ingredients to cleanse your scalp.
As long as humanity doesn’t fall to a pandemic-level infection, you’ll have treatment options.
Dr. Knox Beasley is a board certified dermatologist specializing in hair loss. He completed his undergraduate studies at the United States Military Academy at West Point, NY, and subsequently attended medical school at Tulane University School of Medicine in New Orleans, LA.
Dr. Beasley first began doing telemedicine during his dermatology residency in 2013 with the military, helping to diagnose dermatologic conditions in soldiers all over the world.
Originally from Nashville, TN, Dr. Beasley currently lives in North Carolina and enjoys spending time outdoors (with sunscreen of course) with his wife and two children in his spare time.