Tinea Capitis : A Comprehensive Guide to Fungal Infection on the Scalp

Definition

Tinea capitis is a fungal infection that affects the scalp and hair. Also known as "scalp ringworm," this condition commonly affects school-aged children but can occur at any age. This infection damages hair shafts and hair follicles, which can lead to temporary or permanent hair loss if not properly treated.

Causes

This infection is caused by several types of dermatophyte fungi, primarily from the genus:

• Microsporum (M. canis, M. audouinii) - Often originates from pets like cats and dogs.

• Trichophyton (T. tonsurans, T. violaceum) - Typically transmitted from person to person.

Transmission

Transmission can occur through :

• Direct contact with an infected person – For example, while playing or sleeping close to each other.

• Sharing combs, hats, or hair accessories – The fungus can survive on these items for days.

• Contact with infected pets – Especially cats and dogs that have not been vaccinated.

• Contact with contaminated soil – Often happens with children who play in the dirt.

Clinical Symptoms

Common symptoms include:

1. Round, scaly patches on the scalp – Appearing as white or grayish areas with a distinct edge.

2. Broken or falling hair creating bald spots – Hair usually breaks close to the scalp's surface.

3. Itchy scalp – May range from mild to intensely bothersome.

4. Redness and inflammation on the scalp – Indicating an immune response to the infection.

5. Swollen lymph nodes in the neck – The body’s response to infection.

6. Kerion formation in severe cases – Painful, pus-filled swelling that can leave scars.

Diagnosis

Diagnosis is carried out through:

1. Physical examination of the scalp – A doctor checks for lesion characteristics and hair loss patterns.

2. Examination with a Wood's lamp (UV light) – Some fungi will fluoresce under UV light.

3. Fungal culture from hair or skin samples – To identify the specific fungus type.

4. Direct microscopic examination – Using KOH to view fungal structures.

Treatment

Systemic Therapy

• Oral Griseofulvin (first-choice medication) – Taken for 6-8 weeks, it works by inhibiting fungal growth.

• Terbinafine – An effective alternative with a shorter treatment duration.

• Itraconazole – Used for cases resistant to other treatments.

• Fluconazole – A good option for children since it’s available in suspension form.

Topical Therapy

• Antifungal shampoos (ketoconazole, selenium sulfide) – Help reduce fungal spore spread.

• Antifungal creams or ointments – Used as an additional therapy.

• Topical corticosteroids – To reduce inflammation and itching in the short term.

Prevention

Preventive measures include:

1. Maintaining personal hygiene – Regular hair washing and keeping hair tools clean.

2. Avoiding sharing personal items – Especially combs, hats, towels, and other hair accessories.

3. Regular pet check-ups – Ensure pets are free from fungal infections.

4. Treating symptoms promptly – Early treatment prevents complications.

5. Regular cleaning of hair tools – Use appropriate disinfectants.

Complications

If untreated, tinea capitis can cause:

• Permanent baldness – Due to severe damage to hair follicles.

• Scar formation – Especially in cases with kerion.

• Secondary bacterial infection – May result from scratching the scalp.

• Psychosocial issues – Especially in children, it can affect self-esteem.

When to See a Doctor

Consult a doctor immediately if:

• Expanding bald areas are observed – Indicates active infection.

• Severe inflammation or pus formation – May indicate complications.

• Symptoms do not improve with treatment – Might need a therapy adjustment.

• Fever or other systemic symptoms – Indicates a more serious infection.

FAQ on Tinea Capitis

1. Is Tinea capitis contagious?

   Yes, it is highly contagious through direct contact and shared items.

2. How long is treatment required?

   Usually 6-8 weeks for complete healing.

3. Can it recur?

   Yes, recurrence is possible if treatment is incomplete or re-exposure occurs.

Tinea capitis is a serious and highly contagious fungal infection, especially if there is constant re-exposure or shared use of personal items. However, this condition can be quickly treated with the right treatment choice and prevention measures. Early diagnosis and treatment are crucial for preventing complications and speeding up recovery.

Ringworm of the scalp