Brief overview
- Description: Scalp fungus (tinea capitis) is a fungal disease of the hairy scalp caused by an infection with skin fungi. Children are frequently affected.
- Symptoms: Symptoms include circular, bald patches on the scalp (hair loss) with grayish scales, inflamed areas of skin and itching.
- Treatment: In mild cases, the doctor treats head fungus with antifungal agents in the form of shampoos, creams or solutions. In more severe cases, antifungal agents in the form of tablets or injections are necessary.
- Causes: Head fungus is caused by an infection of the scalp with skin fungi. Carriers are usually animals such as dogs, cats, hamsters, rabbits and guinea pigs.
- Diagnosis: Consultation with the doctor, physical examination (e.g. examination under the microscope, preparation of a fungal culture in the laboratory).
- Prevention: Avoid contact with animals with conspicuous bald patches of skin, do not share objects (e.g. brushes, towels) with sick people and disinfect them regularly, wash laundry at 95 degrees Celsius.
What is head fungus?
Head fungus, medically known as tinea capitis, is an infectious fungal disease (mycosis) that affects the hairy area of the head (e.g. scalp hair, eyebrows, eyelashes, beard). It is a subtype of fungal skin disease and is caused by skin fungi such as filamentous fungi (dermatophytes), rarely also molds (Aspergillus) and yeasts (Candida).
Animals such as dogs and cats are often infected with a fungal pathogen that is transmitted to humans through contact (e.g. petting). Head fungus is very contagious and is also transmitted from person to person.
Who is particularly affected?
Animal owners and people who work with animals (e.g. in agriculture, on breeding farms) also fall ill with head fungus very often. In Germany, head fungus is also increasingly occurring in older people.
How do you recognize head fungus?
The symptoms of head fungus vary greatly. Initially, reddened nodules (papules) usually form around the hair shaft. After a few days, the papules become paler and flaky. The hair becomes brittle and breaks off. As a result, one or more sharply defined, circular bald patches (alopecia) form on the scalp. The affected areas of skin are usually covered with grayish scales. The scalp is often reddened, itchy and painful.
In some cases, painful abscesses, which are usually covered with crusts (tinea barbae), appear in men’s beard hair as a result of the infection.
In severe cases, the lymph nodes in the neck and throat are swollen and sensitive to pressure. Occasionally, fever also occurs.
The severe inflammation can cause permanent damage to the hair roots. In severe cases, the scalp in these areas remains bald forever after healing. Scars often remain on the scalp.
A severe infestation of scalp fungus in particular impairs the quality of life of many sufferers. They feel ashamed of the bald patches on their head and are therefore often under psychological strain.
How is scalp fungus treated?
It is important to treat head fungus as quickly as possible and for as long as possible. This is because the symptoms often subside quickly as a result of treatment, causing many patients to stop treatment early. However, this makes it possible for the fungus to spread again. If pets are the carriers of the fungus, it is also necessary to treat them in order to prevent re-infection.
It is important to start treatment as soon as possible to prevent the fungal infection from spreading further and to reduce the risk of infection.
Shampoos, solutions and creams
First of all, the doctor treats head fungus externally with antifungal agents (antimycotics) in the form of shampoos, solutions and creams that are applied locally to the skin. These kill the fungi (fungicidal) or inhibit fungal growth (fungistatic).
Active ingredients such as terbinafine, itraconazole and fluconazole are used.
In most cases, additional treatment with antifungal medication in the form of tablets, drinking solutions (suspensions) and injections (systemic therapy) is necessary for head fungus. It is important to take the medication for a sufficiently long period of time until no more pathogens can be detected.
Treatment lasts from a few weeks to several months. As some medications can damage the liver in rare cases, it is advisable for the doctor to check the blood values regularly.
In most cases, doctors recommend a combination of local and systemic treatment with antifungal agents for the treatment of head fungus.
Antibiotics and cortisone
In the case of an infestation with bacteria, the doctor usually also prescribes antibiotics to be applied to the skin (e.g. ointments, creams). These inhibit bacterial growth (bacteriostatic antibiotics) or kill the pathogens (bactericidal antibiotics).
Home remedies
Some home remedies can also help to relieve the irritation of the scalp and itching caused by head fungus. Cold compresses, an aloe vera gel or witch hazel gel have a cooling effect and can help to relieve itching.
Do not scratch itchy areas of skin. This exacerbates the symptoms and may lead to infection with bacteria and inflammation.
When washing your hair, it is important that you do not use water that is too hot. This further irritates the already stressed scalp and increases the itching. To shorten the duration of treatment, it often makes sense to cut long hair short.
Relaxation alleviates the symptoms for some sufferers. For example, autogenic training or progressive muscle relaxation can help.
How does head fungus develop?
Scalp fungus occurs when skin fungi such as filamentous fungi (dermatophytes), molds (Aspergillus) and yeasts (Candida) infest the scalp and penetrate the hair follicles. Often filamentous fungi, for example Microsporum canis, Trichophyton tonsurans, more rarely Trichophyton violaceum, cause the disease. In Germany, an increasing spread of the pathogen Microsporum canis can be observed, which is mostly transmitted by cats and dogs.
How is head fungus transmitted?
In most cases, infection occurs through animals such as dogs, cats, hamsters, rabbits and guinea pigs. Calves on farms are also potential carriers. The animals are infected with the pathogens, which are transmitted to humans through direct contact. Children in particular who play with animals are often affected by head fungus and become carriers for other people. As head fungus is very contagious, outbreaks are increasingly occurring in schools and nurseries.
To prevent permanent hair loss or scars caused by head fungus, it is important to consult a doctor as soon as possible at the first signs. If you suspect you have a head fungus, your GP is your first port of call. They will refer you to a dermatologist if necessary or for further examinations.
Many other skin diseases (e.g. psoriasis, atopic eczema, seborrhea, contact eczema) have similar symptoms, but usually require fundamentally different treatment. The doctor will therefore carry out a detailed examination.
Consultation with the doctor
Physical examination
The doctor then examines the affected areas of skin for visual abnormalities (e.g. redness). He will examine the skin closely (e.g. with a special skin magnifying glass or a microscope) and palpate it. The typical skin changes often give the doctor initial indications of a fungal disease.
Creating a fungal culture
For a reliable diagnosis, the doctor will then take a fungal culture to determine the exact pathogen. To do this, he takes hair or hair stumps and skin flakes from the affected area. A culture is then grown in the laboratory on a special culture medium to determine the exact type of fungus. The fungal culture provides the doctor with important information about the pathogen and which medication is effective against it.
Observation under UV light
Family members and other people who have had close contact with people with head fungus should also be examined.
Can head fungus be cured?
Head fungus usually develops over the course of a few days and, if treated early, subsides after a few weeks. However, if the head fungus is not treated and the affected areas are already infected with fungi or bacteria, they may remain hairless (bald) forever after the infection has healed.
In some cases, severe infections may leave scars on the scalp. Therefore, consult a doctor as soon as possible at the first signs of head fungus.
Even if head fungus heals successfully, it is possible to become infected again!
How can you prevent head fungus?
It is best to wash laundry (e.g. pillows, towels, hats) at 95 degrees Celsius or use special hygiene detergents to safely kill the fungi. Avoid contact with animals that have bald, circular, scaly patches on their bodies.
As long as you have head fungus, it is better to avoid going to the hairdresser. Infected children should not go back to school or kindergarten until at least one week after the doctor has started treatment. Be sure to inform the school or kindergarten to alert parents and teachers of a possible infection.
