Tinea capitis is also known as scalp ringworm. If you’ve noticed that your hair is falling out or breaking off in patches – or even if you’re losing hair from all over your scalp – this form of ringworm just might be the cause.
On this page, we’ll take a look at how to spot it, what to do about it once it’s diagnosed, and why home remedies or natural remedies for this condition are not recommended.
Also, make sure you take the free hair quiz further down in this article.
What is Tinea Capitis?
Most of us are familiar with the condition known as ‘athlete’s foot’. Athlete’s foot is actually caused by a fungus – similarly, it’s a type of fungus (known as dermatophytes) that’s responsible for tinea capitis.
This condition is also known as scalp ringworm, a name that may lead to some misconceptions!
For example, tinea capitis is not caused by any kind of ‘worm’ – ringworm is purely an issue of the skin.
But it is important not to confuse ringworm of the scalp with tinea corporis (ringworm of the body) – tinea corporis is caused by a different fungus and responds differently to treatment.
Many of the remedies suggested for ringworm of the body will NOT work for ringworm of the scalp.
Fungi that cause infections like tinea capitis thrive in damp, warm conditions.
Subsequently, there are certain factors that might make scalp ringworm more likely, including poor scalp hygiene, having wet skin for extended periods of time (eg. sweating a lot) or minor injuries to the scalp or skin.
And scalp ringworm may not JUST be confined to the scalp – it can affect your eyebrows and eyelashes, too.
The Symptoms of Tinea Capitis
Scalp ringworm can present itself in a variety of ways – and, according to an article published in the British Medical Journal, when it occurs in adults, its symptoms can be ‘atypical’.
This means that it might not be obvious – from simply reading through a list of the typical symptoms – that tinea capitis is actually what’s causing YOUR hair loss. Your symptoms may be different.
Nevertheless, the more common signs to look for are as follows:
Hair loss
With scalp ringworm, the hair can fall out / break off in patches, or hair loss can be ‘diffuse’ (dispersed all over the scalp).
What tends to happen is that a ‘papule’ forms around a hair shaft, usually on the scalp or occasionally on the eyebrows or eyelashes. Over the course of the next few days, the papule becomes scaly and starts to spread.
The infection works its way along the hair shaft and the hairs begin to look dull and brittle. They start to break off, usually just above the surface of the scalp.
This causes a patchy appearance – but instead of leaving completely bald spots, the patches tend to be filled with little dots (which are the bases of the hairs still in the scalp).
It’s this ‘stubbly’ appearance that makes tinea capitis distinctive and somewhat easy to identify, because the missing hair has broken off rather than fallen out.
Scaly skin
The scaly papules described above will often form a ‘ring’ shape and might be grey in color, or become red and inflamed. Sometimes, these scaly patches are mistakenly diagnosed as seborrhoeic dematitis or psoriasis. The scaly patches might be itchy or tender to the touch.
Severe inflammation
Sometimes, scalp ringworm goes beyond causing scaly patches and leads to severe inflammation.
You might notice the appearance of sores, filled with pus. These are called kerions and can be very painful – they can also trigger a low grade fever and you might find they are accompanied by swollen lymph nodes in your neck.
Kerions are caused by an extreme reaction by the immune system to the fungus that causes tinea capitis. They can cause scarring and permanent hair loss. That’s why it is VERY important to see your doctor straight away if you suspect you have scalp ringworm. Treating the condition promptly and effectively can prevent it from reaching this more serious stage at all.
But Can Women Get Tinea Capitis? Most Websites Say It’s a Condition That Affects Children
It certainly IS common among children – our own son suffered a bout of it when he was 6 years old and lost a sizable patch of hair (it subsequently grew back completely).
However, the condition isn’t LIMITED to children by any means – and despite the constant assurances on many sites that scalp ringworm is ‘rare’ in adults, if you dig deeper you may be surprised to learn that it’s not really that rare after all.
James Lewis Pipkin MD states in this article published in the Archives of Dermatology:
“My experience, as well as a geographic survey of the United States, indicates that the incidence of tinea capitis in the postpuberal person is higher than is generally realized.”
And this article, published in the US National Library of Medicine, states that:
“According to the literature, tinea capitis in adults is supposed to be rare; we have recently observed a significant increase in cases“
and
“The erroneous notion of the disease being uncommon and the frequent atypical clinical presentation require a high degree of clinical suspicion.”
Women seem to be more prone to scalp ringworm than men, probably because the condition is contagious and we’re more often in contact with children, among whom the problem is more common.
Some women, though, can carry the fungus (and – unfortunately – pass it on) without actually developing the condition.
You may also be more vulnerable to tinea capitis if you already suffer from a condition that compromises the immune system.
Research published in the Journal of the American Academy of Dermatology suggests that the problem may be even higher for African American women.
How is Tinea Capitis Diagnosed?
You MUST speak to a medical professional if you suspect you have ringworm of the scalp, in part to receive a proper diagnosis, but also to ensure you receive effective treatment.
Doctors can sometimes make a diagnosis just by carrying out a visual examination.
But your doctor MAY use something called a Wood’s Lamp examination (which uses UV light to spot the condition), or perhaps remove a few hairs using forceps (don’t worry, it’s pretty painless!).
Tinea Capitis Treatment
Once diagnosed with ringworm of the scalp, your doctor will prescribe you oral antifungal medication (medication that you take by mouth) AND an antifungal shampoo.
You usually need to continue with the treatment for several weeks at least, even if it looks as if the infection is clearing up. Your doctor will give you specific advice for your situation.
Most sources suggest that oral medication is absolutely necessary, because the scalp ringworm infection is too deep in the hair follicle to be treated ‘topically’ (i.e. by applying some sort of cream or shampoo to the skin).
BUT, research conducted by Dr Greer of the Department of Dermatology in New Orleans found that 2% ketoconazole shampoo ALONE was successful in both relieving the symptoms AND providing a complete cure in 33% of the participants of the study (although this research was carried out on children, not adults).
Nevertheless, we find that doctors tend to prescribe a combination of treatment (oral and topical medication), as it’s very important to treat the infection as effectively as possible, in order to prevent it worsening to the point that permanent hair loss could result.
If you are given oral antifungal medication, take it with fatty foods like milk or ice cream (good excuse!). The fats help your stomach better absorb the medication.
Natural Remedies for Tinea Capitis
We love to look for natural remedies for medical conditions and will always avoid paying a visit to the doctor if we can, but the medical profession warns strongly against using home remedies for tinea capitis.
Despite some people claiming success with treatments such as ACV (apple cider vinegar – the pure, unfiltered, organic version containing the ‘mother’); coconut oil; tea tree oil; Bentonite Clay and garlic – all of which have antifungal or antimicrobial properties – the fact remains that scalp ringworm can be difficult to treat externally.
And the consequences of failing to treat it effectively can be scarring to the scalp and permanent hair loss… a risk that many women prefer not to take.
We recommend being very careful if you decide to research natural remedies for tinea capitis more thoroughly.
Many sites will MENTION scalp ringworm, yet the bulk of the information they are offering relates to body ringworm – a very different condition.
For example, in our household we’ve successfully treated body ringworm on family members on many occasions with tea tree oil. But we’ve heard of very few instances of women successfully treating scalp ringworm with the same remedy.
Something we DO recommend, however, is consuming a good, healthy diet.
Tinea capitis has been shown to affect those with weakened immune systems – so give YOUR immune system a boost with plenty of anti-oxidant rich fruits, veggies, nuts, seeds and grains.
Despite the popular old wives’ tale, you do NOT need to shave your hair if diagnosed with ringworm of the scalp.
Can I Pass Tinea Capitis On To My Family?
Yes – it’s VERY contagious.
But there are lots of precautions you can take to protect the people you come into contact with…
- Avoid allowing anyone’s skin to come into direct contact with areas of YOUR skin affected by scalp ringworm.
- Speak to your doctor about whether or not it’s necessary for the rest of your family to use antifungal shampoos as a precaution.
- Keep your own hairbrush, comb, towels, hats, helmets, pillowcases and sheets. When you’ve finished using them, wash linens, hats etc in hot, soapy water and soak items like hairbrushes for at least one hour in a 50:50 solution of bleach and water, in order to kill the infection.
- Scalp ringworm can even be passed on via your couch! Place a pillowcase over the back of the seat when using the couch and clean it as described above.
- Check all the family pets for ringworm – puppies and kittens are common culprits as the source of infection! Make sure they’re treated if they have it, or they will pass the infection back to you.
The ringworm spores can survive up to 4 months on objects – so be scrupulous about cleaning everything you come into contact with.
How Quickly Will my Hair Grow Back After Having Tinea Capitis?
As long as there is no scarring, then the condition should not cause permanent hair loss and your locks should begin to grow back as soon as the infection has cleared up.
This is usually within 2 months but can sometimes take up to 6 months.
Be sure to keep your scalp nice and clean in the meantime to aid recovery and use hair clips, bobby pins or slides to arrange your hair in a way that successfully hides the bald patches.
Keep taking your medication as long as directed, maintain a healthy diet and you will soon see your hair restored to its former beauty!
We recommend rinsing with an apple cider vinegar solution every time you wash your hair to try to keep infections away in future.
Just mix 1/3 cup apple cider vinegar (we use Bragg’s organic apple cider vinegar) with 1 quart of water – and apply after shampooing and conditioning.
Other sources and references for more information:
