What are the other Names for this Condition? (Also known as/Synonyms)

• Black Dot Ringworm Infection
• Ringworm Infection of the Scalp
• Trichophyton Rubrum Tinea Capitis Infection

What is Tinea Capitis Infection? (Definition/Background Information)

• Tinea Capitis Infection (Ringworm Infection of the Scalp) is a fungal infection that affects the scalp, including the eyebrows and eyelashes (in some cases)
• The group of fungus causing the infection are called dermatophytes (specifically belonging to the genus Trichophyton or Microsporum)
• The infection causes itching sensations that are felt on the scalp, with the appearance of small black dots and bald patches
• This highly contagious infection develops, due to poor hygiene and prolonged periods of warm moist condition of the scalp. It typically affects young children and is very common throughout the world (both in urban and rural areas), spreading by contact
• Tinea Capitis Infections are treated using antifungal medications and by maintaining a proper hygiene

Who gets Tinea Capitis Infection? (Age and Sex Distribution)

• Tinea Capitis Infection may infect individuals of any age, gender, race, or ethnicity; if factors for fungus growth on the head, are conducive
• The condition rarely affects adults, but it is most commonly seen in young children (up to age 10 years) that includes toddlers, school-going children, and those in their pre-pubertal stage
• It is also generally seen with a higher incidence in boys, than girls (in a 5:1 ratio)

What are the Risk Factors for Tinea Capitis Infection? (Predisposing Factors)

The potential risk factors for Tinea Capitis Infection are:

• Children, who are exposed to other infected children, particularly at schools, daycare centers for children, theme parks, play areas, etc.
• Individuals residing in overcrowded neighborhoods (that are warm and humid) with poor living conditions
• Children with sweaty (wet) scalp conditions
• Those having superficial (on the surface) and minor head injuries
• Sharing items like combs, rugs, bed linens, bath towel, brushes, with individuals having the fungal condition
• Playing with infected pets
• Neglecting fungal infection at other locations of the body
• If the individual has a weak immune system or diabetes, there is a greater susceptibility to fungal infections, such as Ringworm Infection of the Scalp
• Those, who were infected with fungal infections in the past, have an elevated risk for recurrences

It is important to note that having a risk factor does not mean that one will get the condition. A risk factor increases ones chances of getting a condition compared to an individual without the risk factors. Some risk factors are more important than others.

Also, not having a risk factor does not mean that an individual will not get the condition. It is always important to discuss the effect of risk factors with your healthcare provider.

What are the Causes of Tinea Capitis Infection? (Etiology)

Tinea Capitis Infection is caused by a fungus.

• Normally, there is fungus present in healthy individuals. The fungus is present in the dead skin cells that cover the body. A dry and clean skin does not allow the growth of the fungus
• However, damp and warm conditions increase their growth and proliferation, which results in an infection
• Mold-like fungi, belonging to any of the genus Trichophyton or Microsporum, transmitted in wet warm areas causes this scalp infection
• Tinea Infection of the Scalp spreads through:
  • Direct contact with an infected individual
  • An infected pet
  • By using shared items such as combs, hair clips, and hats

What are the Signs and Symptoms of Tinea Capitis Infection?

Tinea Capitis Infection signs and symptoms include:

• The fungus typically affects the hair root (follicles) and shaft causing hair breakage, hair loss, and patches of ‘black dot’ scaly patterns at various locations on the scalp
• Burning or itchy, stinging sensations worsen, to form expanded red patches and fluid and crusts on the scalp surface
• With time, the skin crack and peel, exposing the raw tender skin and tissue inside that get inflamed and painfully swollen
• The lymph modes of the posterior and lateral neck are often enlarged

How is Tinea Capitis Infection Diagnosed?

A Tinea Capitis Infection is visually recognizable and the physician may conclude the diagnosis based on a simple physical examination of the condition. However, the infection is normally confirmed by the following diagnostic tests:

• A sample of the hair or scalp is examined microscopically, to detect the presence of fungus
• Wood’s lamp test - the use of ultraviolet rays to check the fluorescent properties of the infection
• Performing a biopsy of the affected skin scalp (this is performed only infrequently though)
• A differential diagnosis may need to be considered in order to eliminate other skin infections/conditions

Many clinical conditions may have similar signs and symptoms. Your healthcare provider may perform additional tests to rule out other clinical conditions to arrive at a definitive diagnosis.

What are the possible Complications of Tinea Capitis Infection?

Complication due to Tinea Capitis Infections may include:

• The infection may spread to other body regions, like the groin, torso, limbs, etc.
• Permanent hair loss and bald patches may be caused, due to a worsening of the scalp condition. This may lead to intensely painful inflammations on the scalp, blisters oozing pus (kerions), followed by crusty formations
• Recurrence of the infection
• Children with Ringworm Infection of the Scalp may suffer mental and emotional agony - they may face ridicule and be shunned by other children, due to their appearance

How is Tinea Capitis Infection Treated?

The treatment measures for Tinea Capitis Infection include:

• Most skin-related fungal infections respond well to treatment, with over-the-counter antifungal medications and applications. On the scalp, oral medications are always needed
• The oral medications terbinafine and griseofluvin are most frequently used. Self-care is essential, which also helps shorten the recovery period. Certain basic steps to be followed include:
  • Regular washing and cleaning of the hair and scalp with a medicated shampoo to prevent spread of the infection to other regions. Shampoos containing ketoconazole or selenium are helpful
  • Using clean and disinfected towels, combs, and hairbrushes
  • Disinfecting common shared spaces such as toilets and shower areas, bathtubs, kitchens, and bedrooms
  • Taking oral medications as prescribed
• In order to avoid recurrence of the infection, the antifungal treatment measures have to be continued for an extended period of time (per advice of the physician), even after the condition has been controlled

How can Tinea Capitis Infection be Prevented?

Some basic steps to ensure the prevention of Tinea Capitis Infection, especially if the risk factors are high, include:

• Keep scalp and hair, clean and dry, using a shampoo regularly
• It is important to ensure that children habitually wash their hands and also keep their body, clean and dry
• Areas frequented by children (or common spaces used by them), have to be maintained in good, sanitary, and hygienic condition
• Fungal infections transmit through contact and hence, one must avoid sharing common personal items, like combs, towels, beddings, etc.
• Tinea Capitis Infection can spread from infected animals and pets. Such animals may show signs of bald skin patches on their body, or sometimes they may be asymptomatic
• Treat any fungal infection immediately and prevent them from spreading to other regions of the body
• Teach children about fungal infections and tell them how to recognize certain early signs

What is the Prognosis of Tinea Capitis Infection? (Outcomes/Resolutions)

The prognosis of Tinea Capitis Infection with appropriate treatment is excellent.

• Irrespective of the severity of the infection and active treatment measures followed, Ringworm Infection of the Scalp may last for many months
• It responds very well to antifungal treatment and good self-care
• In order to prevent its recurrence, the treatment has to be continued, even after all the signs of infection have ceased,
• If the infection spreads to other parts of the body, or other secondary bacterial infections arise, then an extended course of treatment with antibiotics may be required

Additional and Relevant Useful Information for Tinea Capitis Infection:

• Individuals with diabetes or other immunodeficiency-related diseases should seek immediate medical advice, if they develop any skin fungal infection
• There have been reported outbreaks of Tinea Capitis Infection in large numbers affecting many children at schools and other areas, where children generally crowd