Hair Glossary

Tinea Capitis, or "herpes tonsurans," which is also known as Ringworm, is an infectious fungus  (dermatophytes) disease. 

There are at least eight species of fungus which result in ringworm. Tinea is the Latin word for worm, even though ringworm infections are not caused by worms.

Commonly it's thought that the word tinea (worm) is used to describe the snake-like appearance of the dermatophyte on the skin.

It's considered a scalp disease that may present as alopecia with scale.  It may also present as different colored patches such as gray or black, or yellow.

A Scalp Disease Which May Invade Hair Shafts

Even though ringworm is considered a scalp disease, the fungus may invade the hair shaft. 

When ringworm manifests on the scalp, common symptoms include, but are not limited to:

• inflammation
• scaling
• severe itching of the scalp
• dandruff,
• bald patches where the fungus has rooted itself in the skin.

The bald patches may continue to grow in size until the fungus is treated and matched.

It often presents identically to dandruff or seborrheic dermatitis.

Ringworm is commonly found in pre-pubertal children, more frequently in males than females.  It is highly infectious.  Even though it is not commonly found in adults, it may occur due to exposure from infected children.

Oral Antifungal Agents

Treatment of tinea capitis requires an oral antifungal agent. 

Griseofulvin is the most commonly used drug, but other newer antimycotic drugs, such as terbinafine, itraconazole, and fluconazole, have started to gain more acceptance.

It may appear as thickened, scaly, and sometimes boggy swellings or as expanding raised red rings (ringworm).

The highest incidence in the United States of America is in American boys of school age.

There are three types of tinea capitis:

• microsporosis

• trichophytosis

• favus

These are based on the causative microorganism and the nature of the symptoms.

Microsporosis manifests as lesions which are small red papules around a hair shaft that later becomes scaly; eventually, the hairs break off 1–3 mm above the scalp.  This disease used to be caused primarily by Microsporum audouinii, but in Europe, M. canis is more frequently the causative fungus.

Trichophytosis is usually caused by Trichophyton tonsurans, while T. violaceum is more common in Eastern Europe, Africa, and India. In the United States, this fungus causes dry, non-inflammatory patches that tend to be angular in shape. When the hairs break off at the opening of the follicle, black dots remain.

Favus is caused by T. schoenleinii, and is endemic in South Africa and the Middle East. It is characterized by a number of yellowish, circular, cup-shaped crusts (scutula) grouped in patches like a piece of honeycomb, each about the size of a split pea, with a hair projecting in the center. These increase in size and become crusted over so that the characteristic lesion can only be seen around the edge of the scab.

The source of this fungus is typically sick cats and kittens; it may be spread through person-to-person contact or by sharing contaminated brushes and combs.

If left undetected or untreated, it may lead to hair loss issues.