Scaly patches
Patchy scaling with itching and occasional redness.
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Fungal infection of scalp and hair · Dehradun
Scaly scalp and broken hairs? A fungal infection may be causing hair loss.
Scaly patches · broken hairs · black dots · kerionTinea capitis is a dermatophyte fungal infection of scalp hair and surrounding skin. It is more common in children but can also affect adults. Unlike ordinary dandruff, scalp ringworm can cause patchy hair loss, broken hairs, swollen nodes or a painful inflammatory swelling called a kerion.
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Illustrative medical image. The appearance can vary; an examination is needed for diagnosis.
Recognise the pattern
Common signs of tinea capitis (scalp fungal infection)
These clues help distinguish one kind of hair loss from another—but images and symptoms alone cannot confirm a diagnosis.
Broken hairs
Short snapped-off hairs or black dots at scalp level.
Patchy loss
Affected areas may look thinner or bald.
Kerion
A tender boggy inflammatory plaque may threaten scarring.
Understand the cause
How is scalp ringworm different from dandruff?
Tinea capitis involves infection of the hair shaft and follicle by dermatophyte fungi. Because the organisms enter hairs, topical shampoos or creams alone usually cannot cure it. It may spread through close contact, shared combs, hats or contaminated household items.
Several non-fungal conditions can resemble scalp ringworm, including seborrhoeic dermatitis, psoriasis, bacterial folliculitis and alopecia areata. Thick inflammation and pustules raise concern for kerion, where delay can contribute to permanent scarring.
Diagnosis first
How a dermatologist evaluates it
A scalp examination is the starting point. Trichoscopy and fungal testing of affected hairs or scales may help confirm the diagnosis; not every patient needs every test.
Clinical signs
Inspect for scale, broken hairs, patchy loss, pustules and enlarged regional lymph nodes.
Mycology testing
KOH microscopy of plucked hairs/scale and fungal culture or PCR where available can help confirm infection and guide choice of treatment.
Evaluate severe inflammation
A boggy tender kerion or rapidly worsening scalp lesion needs prompt treatment and assessment for secondary infection.
Evidence-informed care
Treatment options — chosen for the diagnosis
Management depends on the actual condition, its severity, age, medical history and your goals. Procedures are not a replacement for treating the underlying cause.
Prescription oral antifungals
Tinea capitis usually requires a doctor-prescribed oral antifungal such as griseofulvin or terbinafine; choice and duration depend on the organism, age, weight and clinical context.
Adjunct antifungal shampoo
Ketoconazole or selenium-sulfide shampoo may reduce surface fungal shedding and transmission but does not replace oral treatment.
Reduce household spread
Avoid sharing combs, hairbrushes, hats or towels, and clean hair-care items regularly. Symptomatic family members and possible animal sources of reinfection may need assessment; practical prevention steps are outlined below.
Avoid the wrong creams
Do not use steroid-containing combination creams on an undiagnosed scaly scalp; they can mask or worsen fungal infection. PRP/GFC and routine hair-growth supplements do not treat tinea capitis.
When to seek an earlier appointment: Painful swollen scalp, pus, fever, spreading inflammation or tender neck nodes warrants prompt examination because kerion may lead to lasting hair loss.
For parents and families
School attendance and preventing reinfection
Scalp ringworm is contagious, but simple steps can reduce spread while your child completes the prescribed treatment.
Can my child attend school?
Children can usually return to school or nursery once appropriate oral antifungal treatment has started and they are well enough to attend. Inform the school and follow its local policy. A painful, draining kerion or severe illness needs individual medical advice before returning; children do not usually need to stay home until all hair has regrown.
Combs, bedding and family members
Do not share hairbrushes, combs, hats, helmets, towels or pillowcases. Clean or replace potentially contaminated hair accessories and wash bedding regularly. Anyone at home with scalp scaling, itching or patches of hair loss should be assessed.
Prevent infection coming back
Complete the prescribed course even when the scalp starts improving. If infection recurs, discuss screening household contacts, including possible symptom-free carriers, with the dermatologist. A pet with patchy fur loss should be assessed by a veterinarian.
Realistic expectations
What follow-up usually looks like
Hair grows slowly. These are broad clinical milestones, not a guaranteed timetable for recovery or response.
At presentation
Check scalp and sample hairs or scale as appropriate.
Treatment period
Oral antifungals are usually required for several weeks and sometimes longer; complete the prescribed course.
Follow-up
Confirm clinical clearance and assess hair regrowth; scarring cases may not fully recover.
Common patient questions
Tinea Capitis FAQs
Clear answers without unrealistic promises or one-size-fits-all treatments.
Is scalp ringworm caused by a worm?
No. Tinea capitis is caused by dermatophyte fungi.
Can adults get tinea capitis?
Yes. It is more common in children but is not limited to them.
Will an antifungal shampoo cure it alone?
Usually not. Because hair shafts are infected, oral antifungal treatment is generally required.
Does tinea capitis spread?
It can spread through close contact and shared contaminated items; practical hygiene helps limit transmission.
Will hair grow back after treatment?
Hair commonly regrows after uncomplicated infection, but a severe kerion can cause scarring and permanent loss.
Should I apply steroid cream to stop the redness?
Avoid self-prescribing steroid combinations; they may alter or worsen fungal infection. Treatment depends on examination.
Patient education, not a personal prescription.
Do not begin or discontinue prescription treatments solely from a webpage. A dermatologist can identify overlapping disorders and discuss benefits, contraindications and follow-up. All clinical images on this page are AI-generated illustrations—not photographs of patients or treatment results.
Clinical reading: CDC: scalp ringworm treatment · DermNet: clinical features of tinea capitis
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Dr Neeraj Garg · MBBS (IMS-BHU), MD (IMS-BHU)
Maheshwari Hospital, Dalanwala, Dehradun · Consultation ₹800