Ringworm of the scalp is a fungus infection of the hair. It causes:
Children who get ringworm of the scalp are usually 2 to 10 years old. A positive microscope test (KOH prep) or fungus culture is needed to confirm the diagnosis.
Over 90% of the cases of ringworm of the scalp are caused by Trichophyton tonsurans, a fungus that infects the hairs and causes them to break. A worm does not cause ringworm.
Ringworm is usually transmitted by other children who are infected. Combs, brushes, hats, barrettes, seat backs, pillows, and bath towels can transmit the fungus.
Less than 10% of cases are caused by a fungus from infected animals, such as kittens and puppies. The animal-type of fungus causes more scalp irritation, redness, and scaling. If your child has the animal-type of fungus, he is not contagious to other children.
Ringworm of the scalp is not dangerous. Without treatment, however, hair loss and scaling may spread to other parts of the scalp.
Some children develop a kerion, which is a boggy (soft), tender swelling of the scalp that can drain pus. Kerions are an allergic reaction to the fungus. They get better when you use antifungal medicine.
Hair normally grows back 6 to 12 months after treatment. In the meantime, your child can wear a hat or scarf to hide the bald areas.
The main treatment for ringworm of the scalp is griseofulvin taken orally for 8 weeks. Your child's dosage is ________, given twice a day. Griseofulvin comes in a 125-mg-per-5-ml suspension and 250-mg capsules. This medicine is best absorbed by the stomach if your child takes it with fatty foods such as milk or ice cream. Shake the bottle well each time before you use it.
Antifungal creams or ointments are not an effective treatment because they can't reach the fungus deep in the hair roots.
If you wash your child's hair with an antifungal shampoo, he will be less contagious and able to return sooner to child care or school. The shampoo kills ringworm spores. Your child's shampoo is _______________________. Lather and leave it on your child's scalp for 10 minutes before rinsing. Use the antifungal shampoo twice a week for 1 month. On other days, use a regular shampoo. Avoid putting any oil or ointment on the scalp because it increases contagiousness of the ringworm.
Ringworm is mildly contagious. In the days before antifungal medications, about 5% of children in contact with an infected child at school became infected. However, 25% of siblings (close contacts) acquired ringworm. After your child has started taking griseofulvin and washed his hair once with antifungal shampoo, he is not contagious and can return to school. Warn your child not to share combs, brushes, hats, etc. Siblings with an itchy scalp or scalp rash should be examined. Pets with a skin rash or sores should be examined by a vet.
It is not necessary and it can be psychologically harmful to shave your child's hair, give him a close haircut, or force him to wear a protective skull cap.
In 6 weeks return to your health care provider's office to be certain the ringworm has been cured. If the ringworm is not yet cured, your child will need to take the griseofulvin for longer than 8 weeks.
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