What is Ring Worm?
Tinea capitis, also known as ringworm or herpes tonsurans infection, is a type of fungal infection that affects the hair on the scalp. This condition is primarily caused by fungal species called Microsporum and Trichophyton. These fungi can get through the outer layer of the hair follicle and may even reach the actual hair shaft.
We can classify tinea capitis into two types: inflammatory and non-inflammatory. The non-inflammatory variety doesn’t usually lead to scarred hair loss. However, the inflammatory variety can cause a painful condition with pus-filled lumps, called a kerion, as well as scarred hair loss.
Tinea capitis mainly affects children between the ages of 3 and 14, but anyone can get it. The infection can also spread to the eyelashes and eyebrows.
What Causes Ring Worm?
Tinea capitis, also known as a scalp infection, is caused by a fungus that can infect keratin, which is a type of protein found in our hair. These fungi, known as dermatophytes, include several types, such as Trichophyton, Microsporum, and Epidermophyton. Common types of this fungus include Trichophyton Sudanese, Trichophyton tonsurans, Trichophyton verrucous, Trichophyton rubrum, and Microsporum canis.
You can get this infection in a few different ways:
– Direct contact with people who have the infection (Anthrophilic organisms)
– Direct contact with infected animals (Zoophilic organisms)
– Contact with infected soil (Geophilic organisms)
– Indirect contact through items that an infected person or animal has touched, such as hats and hairbrushes, etc.
Risk Factors and Frequency for Ring Worm
Tinea Capitis is a widespread skin condition that can be found across the globe. It’s particularly common in hot and humid climates, such as those found in Africa, Southeast Asia, and Central America. Whether the condition tends to occur more in one sex depends on the specific type of fungus causing it. For example, infections caused by the fungus Trichophyton affect both girls and boys equally during childhood, while those caused by Microsporum canis occur more often in boys. However, Tinea Capitis mostly impacts children instead of adults.
- Tinea Capitis is a widespread skin condition seen worldwide.
- It is particularly common in hot, humid climates like Africa, Southeast Asia, and Central America.
- The sex prevalence varies depending on the type of fungus causing the infection.
- Trichophyton infections usually affect both boys and girls equally in their childhood.
- Boys are more likely to be affected by Microsporum canis.
- The condition usually affects children more than adults.
Signs and Symptoms of Ring Worm
Tinea capitis, commonly known as scalp ringworm, often affects children. If your child has this condition, you may learn about other affected children from the same school, as it could suggest how the infection is spreading. It initially shows up as small red spots that grow over time and can eventually spread to cover the entire scalp. The skin on the scalp might look normal near the center of the round patch but may appear red and inflamed at the edges. Symptoms of tinea capitis include redness, itching, flaky skin and hair loss.
The appearance of scalp ringworm can vary greatly, depending on the specific organism causing it. In some cases, it may look like severe dandruff scattered on the scalp. Other infections can cause areas of hair loss. A severe, inflammatory type of scalp ringworm, known as kerion, results in pus and could lead to permanent hair loss. This type can also spread to the eyelashes and eyebrows. Swelling of the neck lymph nodes is common with kerion.
Tinea capitis can show up in three ways:
- “Black dot” tinea capitis: This is seen as an infected area with broken hairs.
- Kerion: This is a severe type causing inflammation that can progress to scarred, permanent hair loss.
- Favus: This manifests as deep, oozing nodules, abscesses, crusty areas, and a condition known as scutula.
Sometimes, people can have an id reaction or idiosyncratic reaction to the fungus causing the infection. This reaction can result in itchiness, blisters, often in the area of the feet, or skin redness and inflammation, typically found away from the site of infection. It is usually brought on by antifungal treatment.
Testing for Ring Worm
If a doctor suspects a patient has tinea capitis, a type of scalp fungal infection, they might take a sample from the scalp to confirm. This could involve using a swab, removing a small piece of skin (biopsy), or scraping off some skin cells. The collected sample is then put on a glass slide, had a solution (KOH 20%) added to it, and inspected under a microscope. The doctor will be looking for signs of fungal elements like hyphae and spores.
Another technique called ‘Woods light’ might also be used. This involves shining a special type of light onto the scalp, which makes certain types of fungi glow specific colors. For instance, if the fungus M. canis, M. audouinii, M. rivalieri, or M. ferrugineum is causing the infection, their presence will make the hair glow green or yellow-green. If T. schoenleinii is the culprit, the light will appear blue. However, it’s important to note that not all types of this infection will glow. Tinea capitis caused by T tonsurans, for example, usually doesn’t show up under Woods light.
Treatment Options for Ring Worm
Tinea capitis, a type of fungal infection, can be treated with certain medications. Griseofulvin is commonly used, and the treatment usually lasts for 4 to 8 weeks. However, topical treatments aren’t recommended as they aren’t effective.
Other treatment options include antifungal medications like itraconazole and fluconazole. If the infection presents as a ‘kerion’, which is a severe form of tinea capitis, additional treatments like short-term systemic steroids may be needed. These steroids reduce inflammation and can help prevent permanent hair loss. They are given alongside other oral antifungal treatments. Terbinafine, an allylamine, can also be taken orally as a part of the treatment.
Using antifungal shampoos can be beneficial as a part of the treatment plan, mainly to help stop the infection from spreading. However, they aren’t enough to treat tinea capitis on their own. Creams can also be used to reduce the spread of the infection, but they can’t cure it completely.
What else can Ring Worm be?
When a doctor is diagnosing skin conditions, there are several possibilities they might consider. These can include but are not restricted to:
- A specific type of skin infection known as dissecting folliculitis
- Cellulitis, a common bacterial skin infection
- Bacterial folliculitis, which is inflammation of the hair follicles caused by bacteria
- Secondary syphilis, a stage of the sexually transmitted disease syphilis
- Abscesses, which are painful pockets of pus that can form in many parts of your body
- Infected eczema, where eczema skin becomes infected
- Pyoderma, a group of skin infections that are usually caused by bacteria
- Pustular psoriasis, a rare form of psoriasis that causes pus-filled blisters
- Syphilis, another stage of the sexually transmitted disease syphilis
- Seborrheic dermatitis, a common skin condition that mainly affects your scalp
- Systemic lupus erythematosus, an autoimmune disease that can damage any part of the body
- Drug eruption reaction, which is a skin reaction to a drug
By checking for these conditions and conducting necessary tests, the doctor can make an accurate diagnosis.
What to expect with Ring Worm
With proper treatment, tinea capitis (a type of scalp infection) generally has a positive outcome. However, if left untreated, an abscess (also known as a kerion) may develop. The infecting fungi can release spores for several months, which can spread the disease. One common reason for treatment not being effective is patients not taking their medication as prescribed. Nevertheless, early and appropriate treatment of tinea capitis usually results in a good outcome.
Possible Complications When Diagnosed with Ring Worm
Some issues people deal with due to hair loss are:
- Hair loss itself
- Loss of self-esteem and mockery from others
- Emotional problems in children
Preventing Ring Worm
It’s crucial to test everyone living in the same house for tinea capitis, a type of skin infection. Even if they don’t show any symptoms, they should still receive treatment. If not, the infection will keep spreading.
Using special shampoo that fights fungus or contains selenium is typically recommended for a duration of 2 to 4 weeks. It’s also important to inform school teachers about tinea capitis so they can take precautions, like seating infected students away from healthy students. Avoiding the sharing of personal items like combs or hairbrushes can also help stop the infection from spreading.