Tinea Capitis & Hair Loss

Tinea Capitis WikicommonsTinea capitis is a common skin condition that affects the scalp, eyebrows, and eyelashes. It is caused by a fungal infection and can lead to hair loss, inflammation, and other symptoms. In this article, we will explore the causes, symptoms, treatments, and hair loss solutions for tinea capitis.

Tinea capitis is caused by a superficial fungal infection of the skin on the scalp, eyebrows, and eyelashes. This infection has a propensity for attacking hair shafts and follicles. The disease is considered to be a form of superficial mycosis or dermatophytosis, and is also known as ringworm of the scalp or tinea tonsurans.

Types of Fungi Responsible for Tinea Capitis

There are several types of fungi that can cause tinea capitis, including:

  1. Microsporum species: These fungi are responsible for causing gray-patch ringworm or microsporosis, an ectothrix infection that primarily affects prepubertal children. Gray patch refers to the scaling and lack of inflammation seen in affected individuals, with hairs in the infected areas appearing dull, grayish, and discolored. Infected hairs are often broken and shorter than healthy ones.
  2. Trichophyton species: These fungi can cause various forms of tinea capitis, including tinea favosa (favus resulting from infection by Trichophyton schoenleinii), tinea imbricata (ringworm caused by Trichophyton concentricum), and others.

The type of tinea capitis infection and its severity depends on the interaction between the host and the specific fungus causing the infection.

Symptoms of Tinea Capitis

The clinical presentation of tinea capitis can vary greatly, ranging from a scaly, noninflamed dermatosis resembling seborrheic dermatitis to an inflammatory disease with scaly erythematous lesions, hair loss, or alopecia. In severe cases, the infection can progress to cause deeply inflamed abscesses called kerions, which have the potential to result in scarring and permanent hair loss.

Some common symptoms of tinea capitis include:

  1. Itching and redness on the scalp, eyebrows, and/or eyelashes
  2. Scaling and flaking of the skin
  3. Hair loss or alopecia, which can be patchy or diffuse
  4. Inflamed, erythematous lesions
  5. Formation of kerions (deep abscesses) in severe cases

Diagnosis of Tinea Capitis

Diagnosing tinea capitis typically involves a physical examination by a healthcare provider, who will look for characteristic signs and symptoms of the infection. Additionally, laboratory tests may be performed to confirm the diagnosis and identify the specific fungus causing the infection.

Laboratory Tests

Common laboratory tests used to diagnose tinea capitis include:

  1. Microscopic examination of skin scrapings, hair samples, or nail clippings
  2. Fungal culture to identify the specific fungus causing the infection
  3. Wood’s lamp examination to detect fluorescence in infected hairs (primarily used for Microsporum species)

Treatment of Tinea Capitis

Treatment for tinea capitis typically involves the use of antifungal medications, which may be administered orally or applied topically. The specific medication and duration of treatment will depend on the severity of the infection and the type of fungus causing it.

Oral Antifungal Medications

Oral antifungal medications are generally the preferred treatment for tinea capitis, as they are more effective at penetrating the hair shaft and follicle than topical treatments. Some common oral antifungal medications used to treat tinea capitis include:

  1. Griseofulvin: This medication has been used since the 1950s to effectively treat tinea capitis. It is typically taken for 6 to 8 weeks and may be prescribed alongside a topical antifungal medication.
  2. Terbinafine: This medication may be prescribed for 2 to 4 weeks and is also used to treat other forms of dermatophytosis, such as tinea pedis (ringworm of the feet).
  3. Itraconazole: This medication is typically used to treat more severe cases of tinea capitis and may be prescribed for 2 to 4 weeks.

Topical Antifungal Medications

Topical antifungal medications may be used in conjunction with oral medications or as a standalone treatment for milder cases of tinea capitis. Some common topical antifungal medications include:

  1. Ketoconazole shampoo: This shampoo may be used to reduce scaling and inflammation, and is typically applied 2 to 3 times per week.
  2. Clotrimazole cream: This cream may be applied to affected areas of the skin once or twice daily.
  3. Ciclopirox gel or cream: This medication may be applied to affected areas once or twice daily.

Hair Loss Solutions for Tinea Capitis

While treating the fungal infection is the primary focus in managing tinea capitis, there are additional steps that can be taken to address hair loss and promote healthy hair growth once the infection has been treated.

Gentle Hair Care
During and after treatment for tinea capitis, it is crucial to practice gentle hair care. This includes using a mild shampoo and conditioner, avoiding excessive heat styling, and refraining from tight hairstyles that may cause additional stress on the hair shafts and follicles.

Scalp Massage
Scalp massage can help stimulate blood flow to the scalp, which m