Ringworm (tinea capitis)

What is ringworm?  

Ringworm is a highly contagious fungal disease of the scalp and hair caused by fungi, dermatophyles, such as microsporum or Trichophyton that attack keratin.  It is a type of fungus that affects mostly children between 2 and 12 years old, but also animals such as cats, dogs and horses.  It can look like dandruff, cradle cap or small scaly patches that can be red, which is why it is important to know how to recognize it in order to treat it without delay. However, ringworm is not a serious disease. However, hair loss remains localized. 


What people risk? 

– In theory, ringworm can affect anyone, but children and young adults are most at risk of getting it. 

– Ringworm can affect farmers, veterinarians, and people who are in frequent contact with horses and some pets. 

– It also affects young children who are in frequent contact with pets. 

– It can affect people with diabetes and weakened immune systems. 

– It can affect people with eczema or psoriasis. 


How do you get it? 

 In North America, ringworm is often caused by the fungus Trichophyton tonsurans, but other forms of fungi are also believed to be responsible. Fungi can be spread in a number of ways:  

– By direct contact, such as touching a person with ringworm. 

– By contact with contaminated objects, such as brushes, barber razors, hats, caps, gloves, scissors, pillowcases, etc. 

– By objects that the child handles in his or her school environment, such as school materials and clothing.   

– By contact with infected skin flakes, especially in a humid and warm place (locker room, shower cabin, sauna, etc.). 

Ringworm is caused by the very resistant spores of the fungi. The spores penetrate the hair, weakening it and causing it to fall out.  

The incubation period for the first symptoms of ringworm is about two to three weeks. 


What is the symptoms of ringworm?  

The symptoms of ringworm vary according to the type of dermatophytes:  

1- Ringworm  

 – This type of ringworm accounts for nearly 80% of observed cases. 

– They mainly affect children.  

– Microsporum is the active fungus that can be transmitted by humans, cats or dogs.  

– Symptoms start with small red spots on the scalp accompanied by a few rounded whitish or grayish patches, quite large (4-6 cm) and covered with scales, with very short broken hair (3-5 mm).  

– These patches cause itching (pruritus) or burning sometimes intense. The hair outside of the patches looks normal. There may also be swelling and moisture secretion. 

– In mowing tinea due to the Trichophyton form, the plaques are smaller (1-2 cm), numerous with short broken hair. 


2- Kerion  

– This is a very inflammatory form of suppurative ringworm, often due to zoophilic dermatophytes (horse, goat, sheep…).  

– The fungi destroy the hair follicles and cause large lesions resembling raised macaroons dotted with pustules and damaged hair.   

– Localized lesions on the beard or scalp that are painful and occasionally accompanied by enlarged lymph nodes and fever.  At an advanced stage, hair loss can be permanent. 


3- Favic ringworm or favus 

– Although rare, this is the most aggressive form of ringworm because it causes permanent alopecia and leaves scars.  

– It is caused by an anthropophilic dermatophyte (Trichophyton schonleinii) and lodges in the hairline, causing small patches covered with a yellowish crust in the middle of which is a hair that, as it evolves, takes on the appearance of a cup. 


How you diagnostic the ringworm?  

As soon as the patient notices one of the symptoms of ringworm, he/she should consult a good dermatologist as soon as possible who will shed light on the presence of this infection.    

– An ultraviolet lamp (Wood’s light) is directed at the lesions which, for certain fungi, gives a bright blue-green, fluorescent appearance to the contaminated hair.  

– The dermatologist will prescribe a mycological sample to a specialized analysis laboratory, which, after scraping the surface of the spot, will collect the debris and take hair samples.  

– Examination of these samples under a microscope and the cultivation of the fungus will allow us to determine its exact nature (whether it is of human or animal origin).  The results are obtained after 3 to 4 weeks. 

Once the type of infection has been identified, the dermatologist can start the appropriate treatment for the form of ringworm. 


What is the treatment of ringworm? 

Due to the high resistance of the fungi, treatment of ringworm is lengthy and can usually take 6-8 weeks. Trichopyton tonsurans ringworm is more difficult to treat than other ringworms.  

It is important to shave the area to be treated and sometimes the entire head for best results.  

The treatment is based on the oral administration of antifungal or antimycotic drugs for several weeks in the form of tablets or cream combined with specific anti-fungal shampoos that can be obtained in pharmacies. 

The treatment of ringworm uses a very effective drug called Griseofulvin.  

For children, Griseofulvin or terbinafine can be used in combination with a selenium sulfide shampoo.  

On the other hand, it is essential to keep personal belongings and other accessories (comb, brush, towel, glove, pillow…) of the sick child separate.  

If it is a zoophilic fungus, a veterinarian must examine the animal. 


How to prevent the contagion?  

When someone in your family or community is infected, it’s important to prevent the infectious dander and hair from spreading to your home. Here are some helpful tips:  

– Be sure to wash your hands thoroughly after contact with the affected person. 

– Don’t share your clothes, hats, combs, brushes, hair clips, caps and other hair accessories with anyone. 

– Use your own towels and washcloths.  

– After use, thoroughly clean combs, brushes, razors and other toiletries with 70% alcohol.  

– Clean tables, chairs, floors, etc. with a damp cloth and then dry them. 

– Rinse the shower and faucets thoroughly after use. 

– Affected children can go to daycare or school if treatment is started. 

– If you think your pet is infected, go directly to the veterinarian. 

– Affected animals should be isolated and their items should not be used by other animals. 


► Can my child with ringworm go to school?  

Yes, your child can attend his or her school and daycare as long as he or she begins to strictly adhere to treatment. However, the daycare or school must be informed that your child is being treated for ringworm. In addition, your child must understand that he/she must not, under any circumstances, share his/her belongings, personal objects, with his/her classmates.  

Generally, your child’s hair will grow back except in the case of severe ringworm.  

If you notice any of the above symptoms, please do not hesitate to contact us to make an appointment at 514 400 3291. We will be happy to answer your questions and provide you with the help your situation requires.