Table of Contents

Tinea Capitis (Ringworm): Definition, Types, Symptoms, and Treatment

Tinea capitis is a fungal infection that affects the scalp of children between 3 and 14. Tinea capitis might not sound familiar, but you might have heard of a more commonly used term for it, ringworm of the scalp. 

Before diving into details, here are some key factors you can benefit from from the article: 

  • TINEA CAPITIS IS CONTAGIOUS.
  • IT CAN SPREAD WITH DIRECT HEAD CONTACT AND OTHER WAYS OF CONTACT
  • RESPONSIBLE FUNGI FOR TINEA CAPITIS IS DERMATOPHYTES.
  • THERE ARE TWO TYPES OF TINEA CAPITIS: NON-INFLAMMATORY AND INFLAMMATORY.
  • IT CAN BE TREATED WITH ANTIFUNGAL MEDICATION.
  • TREATMENT FOR TINEA CAPITIS CAN LAST 1 TO 3 MONTHS.
  • THE LOST HAIR WILL GROW BACK AFTER THE TREATMENT.

What Is Tinea Capitis?

Tinea capitis is basically a fungal infection that affects hairs on the scalp. You can refer to it as scalp ringworm too.

Children aged 4 to 13 are usually the ones who suffer from this but adults with weak immune systems can experience it too. 

The fungi that cause this infection are called dermatophytes species called microsporum and trichophyton and they can spread quite quickly. They live among the dead tissues and affect the outer sheath of the hair follicle, infesting the shaft. 

tine capitis ringworm

Types of Tinea Capitis

There are 2 types of tinea capitis which are:

  • NON-INFLAMMATORY (E.G. ECTOTHRIX INFECTIONS)
  • INFLAMMATORY (E.G. ENDOTHRIX INFECTIONS) 

 

The non-inflammatory type is not associated with hair loss, however, it can cause black dot and grey patch tinea capitis which break the hair shafts.

Inflammatory tinea capitis can cause an allergic reaction with pus-filled nodules, a.k.a kerion, that will trigger scarring alopecia.

Are Ringworm Body and Ringworm Scalp Different?

Although ringworm on the body is called tinea corporis, not tinea capitis, they both are fungal infections and are caused by the same genus of dermatophyte, which is trichophyton. 

The difference lies in the parts of the body they target. Tinea corporis can manifest itself on the arms and legs, while tinea capitis is typically found on the scalp.

Can You Have Ringworm Only on Your Scalp and Not Anywhere Else on The Body?

Yes, it is possible. However, as it’s a contagious fungal infection, untreated tinea capitis can potentially spread to other parts of your body. In that case, you’ll be dealing with ringworm both on the scalp and the body. So, people who suffer from tine capitis should avoid touching other parts of their body, if they scratch the affected area.

What Are Tinea Capitis Symptoms?

If you’re dealing with tinea capitis, you’ll probably notice symptoms such as:

  • REDNESS
  • ITCHING
  • HAIR LOSS
  • DRY/SCALY PATCHES
  • SWOLLEN LYMPH NODES
  • PROGRESSIVELY ENLARGING BALD SPOTS

 

Keep in mind that because inflammatory tinea capitis can lead to kerion, you might realize pus-filled bumps on your child’s scalp. You can also check for black dot or grey patch tinea capitis. They appear as small black dots on the bald patch, or slightly grayish areas where the hair is missing.

How Long Does It Take for Tinea Capitis to Improve?

For tinea capitis to be treated for good,  it must be taken care of properly by a professional. Yes, “for good”, because fungi tend to be quite persistent and make people think that it’s going away. So, in order for it to be treated completely, antifungal treatment is a must.

Tinea capitis treatment lasts about 4 to 8 weeks.

How Do You Get Tinea Capitis?

Tinea capitis is quite contagious. You can give it to other people if it’s left untreated by

  • SHARING PERSONAL ITEMS SUCH AS HATS, HAIR BRUSHES, COMBS, TOYS, TOWELS, PILLOWCASES, BED LINENS
  • DIRECT CONTACT WITH AN INFECTED PERSON’S SCALP
  • INFECTED ANIMALS (INCLUDING PETS SUCH AS CATS, DOGS, ETC.)
  • EXPOSURE TO FUNGAL SPORES THAT MIGHT EXIST IN PUBLIC FACILITIES (GYMS, SWIMMING POOLS, SHOWERS, ETC.)

 

Tinea capitis is contagious and can be transmitted to others for 1 month if not treated. After the treatment starts, it will not be contagious after 2 days. 

Can Wet Hair in a Tight Ponytail Cause Tinea Capitis?

One thing fungi love is dark, warm, and humid places. So, wearing a tight ponytail while the hair is still wet as well as going to bed with wet/damp hair can cause fungi to thrive.

Even though it is infectious, wet hair and tight ponytail may worsen the situation.

Can Adults Get Tinea Capitis?

Yes, adults can get ringworm of the scalp too but we can’t really say it’s that common compared to children. As a matter of fact, they make up around 11% of the total tinea capitis cases.

Some studies show that adults who are suffering from tinea capitis typically have underlying issues that weaken the immune system such as HIV.

Does Hair Grow Back After Tinea Capitis?

Once it’s treated thoroughly, yes, tinea capitis hair will grow back within 6 to 12 months. But if it’s ignored or left untreated, ringworm of the scalp can cause permanent hair loss.

How to Treat Tinea Capitis

The treatment of choice for tinea capitis is systematical antifungal treatment. Depending on the organism that causes tinea capitis, the treatment can last for 1 to 3 months. Since topical treatments won’t cure it, healthcare providers prescribe oral medication. Among the oral treatments to cure tinea capitis are:

  • GRISEOFULVIN
  • TERBINAFINE
  • ITRACONAZOLE
  • FLUCONAZOLE


In cases of kerion, corticosteroids can help reduce the inflammation and lower the risk of scarring alopecia. 

You can combine the oral medication with a shampoo that contains selenium sulfide or ciclopirox, or other medicated shampoos twice a week. This type of shampoo will help stop tinea capitis from spreading and speed up the treatment process. However, keep in mind that it won’t cure it by itself.

Can Hair Transplant Treat Tinea Capitis Hair Loss?

Yes, you can totally consider getting a hair transplant for tinea capitis hair loss. Since ringworm can result in permanent hair loss, hair transplant is a solid option. You can reach out to a reputable center to explore their treatment options and plans for your specific situation.

Will Hydrogen Peroxide Kill Tinea Capitis?

No, using hydrogen peroxide is not recommended.

Ringworm of the scalp is caused by fungi, thus it needs antifungal treatment.

Hydrogen peroxide can cause already damaged skin to be more irritated and dry than it already is. 

⚠️ So, if you think your child or you have the symptoms, consult your healthcare provider or a dermatologist. They’ll start by examining the affected area using a Wood’s lamp technique. Then, they may perform tests like culture swaps, scalp scraping, or biopsies to provide an accurate diagnosis. Once they have a diagnosis, they’ll suggest a suitable treatment for you.

💡Wood’s lamp technique

With UV lights, fungal infections are found. This technique reveals tinea capitis in a blue-greenish color. 

What Does It Look Like When The Ringworm Is Healing?

Tinea capitis can take some time to go away but you’ll notice the effects after a few days into treatment. To ensure that medications are doing their job properly, keep an eye on the healing stages of ringworm, which might include:

  • LESS ITCHING
  • DRY OR FLAKEY APPEARANCE OF SKIN
  • SKIN PEELING
  • SCALINESS AND REDNESS GOING AWAY
  • PATCHY AREAS OF RASH
  • SKIN DISCOLORATION

 

Be sure your child continues taking the prescribed medication for the full recommended duration. Because fungi may look like it’s gone but might not fully heal.

Completion of therapy as well as staying in touch with your healthcare provider and doing follow-up sessions after 4 to 6 weeks is important. 

Tinea capitis can be persistent and happen more than once but most of the time it stops after puberty.

Alopecia Areata vs Tinea Capitis

Although alopecia areata and tinea capitis can seem alike since they both affect the scalp and lead to hair loss, they are actually quite different. 

To put it simply, alopecia areata is an autoimmune disease that can affect people of all ages and genders and cause permanent hair loss. On the other hand, tinea capitis is a contagious fungal infection that is more common among children and treatable most of the time. 

To help you figure out which one you might have, bald spots caused by tinea capitis are often itchy and scaly, whereas with alopecia, they tend to be smoother to the touch.

Tinea Capitis vs Psoriasis

Just like alopecia areata, psoriasis is an autoimmune disease and unlike tinea capitis it can lead to irreversible hair loss regardless of the patient’s age. 

It might be difficult to tell tinea capitis from psoriasis because the symptoms can look alike such as inflammation, itchiness, and scaly scalp skin. However, with psoriasis, the bald patches will appear as silvery-white colored scales that are thick and can flake. 

If you think you might have one of these conditions, it’s a good idea to see a dermatologist. They can do an examination and run tests to figure out which condition you have.

[1] Frieden IJ, Howard R. Tinea capitis: Epidemiology, diagnosis, treatment, and control. Journal of the American Academy of Dermatology. 1994;31(3):S42-S46. doi:https://doi.org/10.1016/s0190-9622(08)81266-2

[2] Al Aboud AM, Crane JS. Tinea Capitis. PubMed. Published 2023. https://www.ncbi.nlm.nih.gov/books/NBK536909/#:~:text=Tinea%20capitis%2C%20also%20known%20as

[3] Cremer G, Bournerias I, Vandemeleubroucke E, Houin R, Revuz J. Tinea capitis in adults: misdiagnosis or reappearance? Dermatology (Basel, Switzerland). 1997;194(1):8-11. doi:https://doi.org/10.1159/000246048

[4] Buckley DA. Lesson of the week: Tinea capitis in adults. BMJ. 2000;320(7246):1389-1390. doi:https://doi.org/10.1136/bmj.320.7246.1389

[5] Phillips TG, Slomiany WP, Allison R. Hair Loss: Common Causes and Treatment. American Family Physician. 2017;96(6):371-378. Accessed September 1, 2023. https://pubmed.ncbi.nlm.nih.gov/28925637/#:~:text=Tinea%20capitis%20causes%20patches%20of

[6] Alkeswani A, Cantrell W, Elewski B. Treatment of Tinea Capitis. Skin Appendage Disorders. 2019;5(4):201-210. doi:https://doi.org/10.1159/000495909‌

[7] Souissi A, Ben Lagha I, Toukabri N, Mama M, Mokni M. Morse code-like hairs in tinea capitis disappear after successful treatment. International Journal of Dermatology. 2018;57(12):e150-e151. doi:https://doi.org/10.1111/ijd.14224

[8] Pomeranz AJ, Sabnis SS. Tinea Capitis. Pediatric Drugs. 2002;4(12):779-783. doi:https://doi.org/10.2165/00128072-200204120-00002 

[9] El-Taweel AE, El-Esawy F, Abdel-Salam O. Different trichoscopic features of tinea capitis and alopecia areata in pediatric patients. Dermatology Research and Practice. 2014;2014:848763. doi:https://doi.org/10.1155/2014/848763

‌[10] Al Aboud DM, Gossman W. Wood’s Light. PubMed. Published 2023. Accessed October 20, 2023. 

[11] Chen C, Koch LH, Dice JE, et al. A Randomized, Double-Blind Study Comparing the Efficacy of Selenium Sulfide Shampoo 1% and Ciclopirox Shampoo 1% as Adjunctive Treatments for Tinea Capitis in Children. Pediatric Dermatology. 2010;27(5):459-462. doi:https://doi.org/10.1111/j.1525-1470.2010.01093.x

[12] Peixoto RGB, Meneses OS, da Silva F, Donati A, Veasey J. Tinea Capitis: Correlation of clinical aspects, findings on direct mycological examination, and agents isolated from fungalculture. International Journal of Trichology. 2019;11(6):232. doi:https://doi.org/10.4103/ijt.ijt_88_19