What is a scalp fungal infection?
Fungal infections can affect various parts of the skin. When fungi occur on the hairy scalp, we call this tinea capitis.
What do the patches on the head look like?
With a fungal infection on the scalp, one or a few bald patches are sometimes seen, covered with a fine grey scaling. Sometimes there are countless small scaly spots. Spots, or weeping, pus-producing areas, can also be visible. The signs depend on the type of fungus and the patient’s immune response.
What causes it?
There are various fungal species that can cause complaints on the scalp. They can be divided into two groups:
- Fungi that remain on the outside of the hair shaft (ectothrix infections), including Microsporum canis, Microsporum audouinii, Trichophyton verrucosum and Trichophyton mentagrophytes. In these infections the hairs break off a few millimetres above the scalp.
- Fungi that grow into the hair shaft (endothrix infections), including Trichophyton violaceum, Trichophyton tonsurans and Trichophyton soudanense.
Who gets it?
In practice, fungal infections of the scalp are seen mainly in children. Not infrequently these are children who, some time before the signs arose, were on holiday in their family’s country of origin. Children who have been in contact with animals infected with a fungus also run a greater risk.
How is the fungus demonstrated?
It is possible to demonstrate fungi with microscopic examination, culture of the fungus and, nowadays, modern and rapid laboratory tests (PCR). To carry out this investigation the dermatologist will take a few hairs and skin scales.
How is it treated?
Because severe fungal infections of the scalp can sometimes lead to permanent bald patches, prompt treatment is important. Various antifungal courses are available; which type is chosen depends among other things on the species of fungus found. Scalp fungal infection generally needs an antifungal medicine taken by mouth, as creams alone do not reach the fungus in the hair.
When to see a doctor
See your GP or a dermatologist promptly if a child (or adult) develops a scaly bald patch, broken-off hairs, or a weepy, crusted or boggy swollen area on the scalp, especially after contact with animals or travel. Early treatment reduces the risk of permanent bald patches and stops spread to others.