Tinea Captis (Ringworm of the Scalp)
Ringworm of the scalp is the most common fungal infection in children. It most often affects children from 2 to 10 years of age. Fewer than 5% of cases of ringworm of the scalp occur in adults. Most cases are due to a fungus that is passed from person to person. Very few of today’s fungal infections on the scalp are due to fungus from pets, as was the case a decade ago.
The fungus can be passed from fallen hairs, dandruff, and shared combs, towels, or hats. It can begin as dandruff and bald patches. In some cases, parts of the scalp will become red and have swelling and pus bumps. Sometimes, enlarged lymph nodes in the neck may be felt.
Your doctor may suspect a fungal infection because of the appearance of the scalp. The diagnosis can be confirmed by a special exam of dandruff and hairs under a microscope. It may also be confirmed by doing a fungal culture. Most often, a fungal culture takes 3 - 4 weeks to get results. When the diagnosis is made, an oral anti-fungal medicine should be used for six to eight weeks. Medicine may be used longer if the infection is still present. Because the fungus is deep in the hair follicles, medicated creams and lotions do not work.
Treatment
Griseofulvin is a medicine taken by mouth to treat the fungal infection. It is very safe to use in children. Although it comes in liquid form, it tastes very bad. You have been prescribed tablets that can be given to your child as described below. Your child will need to take this medicine twice daily for at least 2 months. Even if the infection seems to be clear, finish the medicine as prescribed by the doctor.
For smaller children who cannot swallow pills:
Take the tablet and crush to a powder. Using two spoons works best. Mix the powder in a tablespoon of grape jelly, chocolate syrup, applesauce, or something that the child likes. Have the child take the entire tablespoon at once.
Griseofulvin is absorbed better when taken with something that is fatty. After the child takes the tablespoon with the crushed tablet, he should be given a glass of whole milk, one serving of ice cream or yogurt (do not use low-fat yogurt).
You should also shampoo your child’s hair with Nizoral® (ketoconazole) shampoo or selenium sulfide 2.5% shampoo. You may be given a prescription for the Nizoral® shampoo. If not, you can buy it at the grocery or drug store. Twice a week, when you are washing the child's hair, the Nizoral® or selenium shampoo should be applied onto the scalp. Leave it in place for 5-10 minutes, and then rinse. Be careful to avoid contact with eyes, as it may sting. Using over the counter oiling products on the hair after you shampoo will slow the clearing of ringworm. Also, all family members or close contacts should have their bodies and scalps checked for ringworm.
Your child may go back to daycare or school after starting the Nizoral® shampoo treatment. It is best to try and keep the head covered for the first two weeks. Avoid sharing of hats, pillows, scarves, brushes, and hair accessories until the treatment is complete.
Joyce M. C. Teng, M.D. PhD
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UW Dermatology Department 1 S. Park St 7th Floor Madison, WI 53715 Clinic: 608 287-2450 |
American Family Children’s Hospital Pediatric Dermatology Specialty Clinic 1675 Highland Ave. Madison, WI 53792 Clinic: 608 263-6420 |
The information provided should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed physician should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Any duplication or distribution of the information contained herein is strictly prohibited.
Last Updated: 11/16/2007
Copyright © 02/05/2007 University of Wisconsin Hospitals and Clinics Authority. All rights reserved. Produced by the Department of Nursing. UWH #6482
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