Tinea capitis is a fungal infection caused by dermatophytes (fungi) that affects the scalp and hair follicles.
Tinea capitis is a fungal infection caused by dermatophytes (fungi) that affects the scalp and hair follicles. It starts on the outermost layer of the skin, called the stratum corneum.
Tinea (or dermatophytosis) is a contagious fungal infection affecting skin or nails. And capitis means “of the head,” like a cap.
Even though tinea capitis is also known as ringworm on the head or scalp, it doesn’t actually have anything to do with a worm.
How do you know if you have scalp ringworm? Honestly, it’s pretty hard to miss.
Here are common symptoms of tinea capitis.
A circular bald spot that’s scaly, itchy, and red
A black dot on the scalp
Crusted lesions (scutula) around the base of the hair shaft
Flaking or crusting of the scalp that may resemble severe dandruff
Patchy hair loss from the fungus attacking the hair shaft, causing infected hairs to fall out
Brittle strands, leading to broken hairs at the root
Generally, signs of infection appear four to 14 days after contact with the fungus that causes scalp ringworm. The good news is that baldness caused by an infection is usually temporary.
Having said that, this infection can cause scalp inflammation, which can cause scar tissue to develop. This could lead to a type of permanent hair loss called scarring alopecia.
This risk of permanent alopecia (the clinical term for hair loss) is another reason taking quick action after diagnosis is so crucial.
Scalp ringworm is frequently misidentified as another scalp issue, seborrheic dermatitis.
While these two conditions can appear similarly, seborrheic dermatitis can’t result in hair loss — so that’s a telltale way to differentiate between the two. Seborrheic dermatitis also doesn’t cause broken hairs, but it can lead to dandruff.
Still, it can be difficult for the untrained eye to distinguish between them. It’s always best to check in with a healthcare provider (like a dermatologist or trichologist) who can make a differential diagnosis — especially since tinea capitis is contagious.
Over 40 types of dermatophytic fungi can cause tinea infections on different parts of the body. Fungal infections of the scalp are usually caused by:
Microsporum canis (M. canis)
Microsporum audouinii (M. audouinii)
Trichophyton tonsurans (T. tonsurans)
Trichophyton schoenleinii (T. schoenleinii)
These fungal strains can infect the scalp area and create inflammation, among other symptoms (more on these below).
Favus (or tinea favosa) is a severe form of scalp ringworm caused by Trichophyton schoenleinii that can destroy the hair shaft if left untreated. This is called an endothrix infection.
Tinea capitis is a contagious infection. This means you can catch it when you come into contact with one of the fungi strains listed above. After contact, the fungus would transfer to your scalp and hair.
One thing to know: Scalp ringworm is most common in children and people with weakened immune systems. However, tinea capitis in adults is entirely possible.
The most common ways to come into contact with this contagious fungi is through:
Other people. If you’re in physical contact with an infected person, you could get tinea capitis from them. The contagious fungi can spread onto your hands, and when you touch your head, it can be transferred again. You can also pick it up from sharing items like clothes and hair brushes.
Animals. Dogs, cats, and many farm animals can get this type of ringworm. It’s particularly common in young animals.
The environment. Damp surfaces in communal areas can be breeding grounds for this infectious fungi — think locker room showers, where you could contract athlete’s foot. It can also be contracted through soil.
Anyone can get tinea capitis, but there are certain risk factors to be aware of. These include:
Age. Tinea capitis is most common in children, particularly pediatric patients between three to 14 years old.
Close contact. Tinea capitis primarily spreads through close physical contact. So if you live in close quarters with many family members or have kids in daycare or elementary school, you’re at a higher risk of contracting the skin disease.
Sharing personal items. Sharing combs, brushes, hats, towels, bedding, and other personal items can contribute to the spread of tinea capitis.
Weakened immune system. Folks with weakened immune systems, including conditions like HIV/AIDS, are more susceptible to scalp ringworm and other fungal infections.
Race. Tinea capitis is most common among Black people living in urban areas.
Climate. Fungi thrive in warm, humid environments, so people who live in those types of climates are at higher risk. It’s most common in Africa, Southeast Asia, and Central America.
An exam by a dermatologist is needed to diagnose tinea capitis.
Typically, they’ll ask the patient (or the patient’s parent if it’s a child) about their symptoms and medical history, then examine the scalp. Sometimes, they’ll use a microscope or a lighted instrument known as a wood light or wood lamp to get a closer look.
A healthcare provider might also do a “skin scrape” or a fungal culture, which involves taking a small skin sample to check for fungus or spores.
It’s possible to have a skin infection that’s bacterial rather than fungal, like Chromobacterium violaceum (C. violceum). The diagnosing process will rule out other potential infections.
If you suspect you have ringworm on your head, talk to a healthcare provider as soon as possible about tinea capitis treatments.
Treatment for tinea capitis can include antifungals, steroids, or topical treatments. Here’s what to know.
If you’re diagnosed with tinea capitis, you’ll likely be prescribed an antifungal medication. Griseofulvin is an oral medication often used to treat this condition.
Other antifungal therapies include:
Itraconazole
Fluconazole
Terbinafine
These can come in the form of creams or oral meds.
Anti-inflammatory treatments like steroids are needed for certain presentations of tinea capitis, like kerion (pus-filled sores, also known as abscess).
Typically, steroids are offered for a short period to help reduce the inflammatory response and lower the risk of permanent alopecia. They’re usually prescribed in tandem with oral antifungals.
There are also scalp fungus treatments that come in topical formulas, but research shows they’re largely ineffective.
However, antifungal medicated shampoos (often with ketoconazole or selenium sulfide) might be a helpful addition to a tinea capitis treatment plan. The active ingredients can prevent the spread of scalp ringworm but aren’t a cure.
Using your medication as prescribed for as long as you’re supposed to is crucial. Even as it starts to get better, the course of medication should be finished.
Research shows that a common cause of treatment failure is a lack of medication compliance, so it’s vital to be diligent. Those who aren’t treated are at a higher risk of developing an abscess.
While you can’t entirely prevent tinea capitis, you can reduce your risk of contracting or spreading the condition.
Here’s what you can do to avoid contracting tinea capitis and prevent it from spreading:
Wash your hair and hands regularly.
Keep your hair and skin clean and dry.
When in a locker room, avoid touching surfaces and then touching your scalp.
Don’t share combs, towels, or clothes.
If you’ve had an infection, replace your brush and wash your clothes, towels, and bedsheets in hot water.
If you or a family member has had tinea capitis, take any pets to the vet, as the disease can spread through infected animals.
If you notice signs of tinea capitis or know you’ve come into direct contact with someone who was diagnosed with it, make an appointment with a dermatology provider or another healthcare professional as soon as possible.
The skin infection commonly spreads person-to-person. You could contract tinea capitis from someone who has tinea corporis (that’s when ringworm affects the body). Early treatment helps reduce the spread and prevent unnecessary hair loss and bald patches.
This article is for informational purposes only and does not constitute medical advice. The information contained herein is not a substitute for and should never be relied upon for professional medical advice. Always talk to your doctor about the risks and benefits of any treatment. Learn more about our editorial standards here.