What is ringworm?

You should seek medical attention if you suspect you or your child has ringworm on the scalp. Ringworm on the scalp can only be treated with prescription medication.
You should seek medical attention if you suspect you or your child has ringworm on the scalp. Ringworm on the scalp can only be treated with prescription medication.

Unlike the name suggests, ringworm isn’t actually caused by a worm. It gets its name because of the characteristic circular marks it leaves on the scalp. Ringworm is contagious and the fungus that causes it can affect your skin in different places on your body. 

Ringworm is caused by a mold fungus called dermatophytes. This fungus infects the skin and causes dry, scaly patches on the scalp. Ringworm is spread in three ways: 

  1. Direct contact with someone who is infected.
  2. Contact with infected personal items like clothes, bedsheets, and towels.
  3. Contact with animals who have ringworm. 

It’s mostly children aged 2-10 who get infected with ringworm. Because it spreads easily from person to person, children can pick it up in school, daycare, or even the playground. Adults can also get infected with ringworm and become carriers, though not as common. 

If you suspect you or your child may have ringworm, know what to look for. The main symptoms of ringworm on the scalp are: 

  • Hairless circular patches on the scalp
    • These patches can be red and inflamed or gray and scaly. They can also grow in size and multiply. 
  • Red patches filled with pus
    • These are severe cases and can be extremely painful and sensitive. 
  • Patches of black dots on the scalp
    • The infected area can be hairless and smooth, or the hairs can break off at the root causing stubble. It can look like black dots from afar.  

Ringworm is caused by dermatophytes, a fungus that can affect different areas of the body. The fungus that causes ringworm can infect: 

  • The feet and nails (Athlete’s foot)
  • Facial hair and beards 
  • The body
  • The genital area (jock itch

You should seek medical attention if you suspect you or your child has ringworm on the scalp. Ringworm on the scalp can only be treated with prescription medication.

Diagnosis for ringworm on the scalp

A physical exam is usually enough for your doctor to recognize and diagnose ringworm. They can also take a scraping from the affected area and examine it under a microscope, called a microscopy or KOH test.

If the doctor isn’t able to determine the type of fungus from the microscopy, they may take a culture. This usually takes a few days because the sample is sent to a laboratory for results. 

The same scraping method can be used to test for bacteria from the infected site. Your doctor may prescribe you a course of antibiotics if you have positive bacteria.

Treatments for ringworm on the scalp

Because the scalp is different from the rest of the skin, the antifungal powders and creams that work on athlete’s foot and other fungal infections don’t work for ringworm on the scalp. 

Medications

For ringworm on the scalp, the doctor will prescribe antifungal tablets or syrup that is taken by mouth for 4-12 weeks. The medicine could be:

You can also use an antifungal shampoo to speed up the healing time. While a shampoo alone won’t get rid of ringworm on the scalp, it will make you less contagious and help to control the infection. 

If your child has ringworm on the scalp, they will usually be able to return to school after taking their first dose of medication and using the antifungal shampoo. 

Home care

If you or your child has ringworm, it’s important to wash your clothing and bedsheets in soap and hot water. This will kill the fungus and keep it from reappearing after you’ve taken the medication. Any hair you might have lost should also start to grow back once the medication has taken effect. 

To avoid getting ringworm in the future, don’t share personal items like towels, hair accessories, or sporting equipment with someone who is infected with ringworm. Horses, dogs, and cats can also be carriers of ringworm. If you see an animal with circular bald spots in its fur, avoid it. 

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Complications of ringworm on the scalp

In rare cases, ringworm on the scalp can develop into a scalp condition known as kerion. A kerion is a red, pus-filled bump or growth on the scalp. You can have multiple kerions at once. Kerions can also cause you to have a fever

If the kerion is large or particularly painful, your doctor may prescribe corticosteroid pills to relieve the pain and inflammation. Hair regrowth after a kerion can take 6-12 months. 

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Medically Reviewed on 1/27/2021
References
CDC: “Ringworm Information for Healthcare Professionals.”

CDC: “Symptoms of Ringworm Infections.”

CDC: “Treatment for Ringworm.”

Gwinnett Pediatrics and Adolescent Medicine: “Ringworm (Scalp).”

Merck Manual: “Tinea Capitis (Scalp Ringworm).”

Skinsight: “Kerion.”