Ringworm

Although not a worm at all, the fungal infection of the scalp is most recognizable by its common name of "ringworm". Dozens of fungi are capable of infecting the scalp, the incidence of the fungi in scalp infections varying in different geographic areas and climate zones of the world.

Tinea capitis (commonly called ringworm of the scalp) is the most common fungal scalp infection seen in the United States and other temperate-zone countries. The description "ringworm of the scalp" derives from Latin root words: "tinea" is a Latin root word for "worm", and "capitis" derives from the Latin root for "head".

No single fungal organism is the cause of tinea capitis. A number of fungi in the broad generic categories called Microsporum and Trichophyton are the most frequent infecting organisms. The infection is easily spread from person to person by contact with hairs shed from an infected scalp, or by contact with a pillow, hat, etc., where the infecting fungi have been deposited. Because schools are a frequent site of transmission, tinea capitis has a high incidence among school children.

Three patterns of tinea capitis are identified:

In all forms of tinea capitis, hair that is infected and broken may be permanently lost.

Because tinea capitis may have features that also suggest seborrheic dermatitis or psoriasis, diagnosis must be confirmed by laboratory tests specific for fungal infection. After diagnosis is confirmed, treatment may include oral anti-fungal drugs such as:

• Terbinafine
• Griseofulvin
• Ketoconazole
• Steroid to reduce inflammation

Note: Many organisms are moderately resistant to griseofulvin and ketoconazole, which are also difficult to use long-term. Thus, terbinafine is most commonly given orally for 2 to 4 weeks to eradicate the infection. Oral medications are required because topical creams cannot reach the base of the hair follicle deep within the scalp where infection may be present.

From article:
Diseases and Disorders of the Scalp