If you want to learn about ringworm affecting the scalp, then you've come to the right place. In this video, we're going to cover what it is, what causes it, how it can be treated, and where you can find out more information about it.

So first of all, let's start off with what is ringworm that affects the scalp. Well, the medical name for this is tinea capitis or scalp ringworm, and it's essentially an infection of the scalp, hair, and the surrounding skin with a fungus called a dermatophyte. Now, despite the name ringworm, it is not caused by a worm. It's called ringworm because it can cause a ring-shaped, scaly, red or silver rash.

So, how do you catch ringworm? Although it's common in children, it can also affect adults and your pets, and it is contagious, meaning that it can spread quite easily. The infection is spread through close contact with an infected person or by sharing things like combs, hair brushes, hats, clothing, towels, bed sheets, and other furniture with someone who's infected. It's also possible to catch ringworm from infected animals, so pets like dogs or cats, or even horses or farm animals.

What are the symptoms and signs of tinea capitis or scalp ringworm? The symptoms usually include itching, redness, and dryness of the scalp. Sometimes bald patches, like you can see in the photos here, can occur, and that's because the infected hairs are brittle and they tend to break easily. In more severe cases, there can be pustules which look like white or yellow-headed spots, as well as yellow crusts and matted hair. Very rarely, a painful, boggy swelling filled with pus and overlying hair loss, which is called a kerion, can form. In these cases, people might have a fever or swollen, painful glands in the neck, and you'd need to see a doctor about this.

How is scalp ringworm diagnosed? It's usually suspected if there's a combination of a scaly scalp and hair loss, especially in children. Most of the time, the doctor or health provider that's assessing you can just tell this from the clinical examination without the need for special tests. But if the doctor or health provider wants to confirm the diagnosis, then it is possible to take skin scales from the scalp and pluck hairs from the affected areas and send them for testing in the lab. The samples are typically looked at under the microscope and they're cultured to confirm that a fungal infection is the cause. Because fungus can grow slowly, the culture results typically take up to six weeks to come back.

So, how can tinea capitis be treated? Scalp ringworm needs to be treated with oral antifungal medicine, which can only be obtained on prescription, and a medicated antifungal shampoo that can be purchased from a pharmacy over the counter. This is in order to reduce the spread of fungus to other people. In this section, we'll cover some of the common medicines that are used.

The oral antifungal treatments that are used include griseofulvin. This is the only licensed oral antifungal for children, and if this is used, then typically a six to eight-week course is needed. The tablets can be crushed and mixed up with a little bit of water if your children are not able to swallow them whole. There are cautions with this medicine in pregnant ladies or ladies who plan to become pregnant, so you should mention this to your health provider if this applies to you.

Another oral antifungal medicine is terbinafine. This is another choice of medicine here in the UK that is licensed in adults, but because it's very effective, it can also be commonly used off-license in children. It's usually the first choice of treatment that's accepted because it's usually considered the best treatment. A two to four-week course is usually needed. Other antifungal medicines that are used include itraconazole and fluconazole.

It's also important to mention that before you take any medicine, you must always read the manufacturer's information leaflet to make sure that it's suitable for you or your child. This is going to contain all of the important information that you need to know about the medicine, including side effects.

In addition to the oral medicine you're going to take, you're also going to need to use an antifungal shampoo. This is going to be something like 2% ketoconazole or 1% selenium sulfide, and typically these need to be used twice a week to help stop the spread and recurrence of the infection. Here in the UK, you can buy these antifungal shampoos over the counter.

Some people might ask, "What if I don't have treatment? What are the complications?" If an infection is not treated, it can cause permanent scarring and hair loss. The inflammation of the skin caused by fungal infection can also lead to a secondary bacterial skin infection elsewhere in the body.

Finally, how do you prevent further infection and stop the spread of infection? If this is affecting your child, then you need to inform your child's school teacher, parents of classmates, and other playmates so that children can be examined and treated if necessary. In the UK, typically children should be allowed to attend school or nursery once treatment with the oral antifungal medicine and a medicated shampoo has been started, but obviously, this is going to depend on the individual policy of the schools.

To prevent further infection, other family members and pets should also be examined by a doctor or vet respectively and treated with oral antifungal medication if the infection is present. Sometimes it's best for the whole family to be treated with a medicated antifungal shampoo twice weekly for four weeks, whether or not a fungal infection is proven because it is very contagious. You should really try to avoid sharing combs, hair brushes, hats, towels, pillowcases, or things like bicycle helmets with other people. Fungus can live in combs, hair brushes, and hair accessories for a long period of time. It's also important not to visit hairdressers or barbers until the infection is clear. Wash all bedding, towels, and hats at a high-temperature wash—something like above 60 degrees Celsius.

That brings us to the end of the video. Please check out the description box for more information and resources. Remember to share your experiences in the comments section if you've gone through this or a member of your family has because this can be really helpful for other people. Please consider giving the video a thumbs up and subscribing to the channel for weekly medical education videos.

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