Head Fungus (Tinea Capitis): Causes, Symptoms & Treatment

Head fungus (tinea capitis) is an infection of the skin with so-called dermatophytes (skin fungi). The head fungus occurs mainly in children. It is assumed here that their immune system is not yet fully developed and is therefore susceptible to the pathogens. Head fungus (tinea capitis) is a contagious skin disease that usually affects the hairy head.

What is head fungus?

Head fungus (tinea capitis) is an infection with skin fungi. This usually occurs in children, but can also affect adults, as head fungus is very contagious. Head fungus is transmitted by the following pathogens: Microsporum canis and various forms of Trichophyton. Often free-ranging animals such as dogs and cats are infected with the pathogens, from where they are transmitted to humans. An infection with the pathogen Microsporum canis can be recognized by the circular, hairless and sharply defined areas. In addition to broken hairs, the scalp may be covered with grayish scales. Infection with the pathogen Trichophyton is often accompanied by inflammatory reactions. Furthermore, the hair also breaks off here, but the bald spots in the scalp are rather irregularly shaped and strongly reddened. The head fungus (tinea capitis) usually heals without consequences.

Causes

The head fungus is usually transmitted by so-called head fungus pathogens. In Central Europe, these are mainly Microsporum canis and several forms of Trichophyton. The pathogens are transmitted mainly by domestic animals such as cats, dogs and guinea pigs. Since the symptoms of skin rash, bald, round spots, dandruff, itching, inflammatory reactions, etc. can also hide other diseases, it must also be clarified whether there is not another cause. The following diseases must be clarified: Psorisis, atopic dermatitis, seborrhea, contact dermatitis, pityriasis, carbuncles, etc.

Symptoms, complaints and signs

Scalp fungus can be recognized by its typical symptoms, which mainly affect the scalp and hair. Sufferers notice a noticeable skin rash relatively early, which occurs in conjunction with dandruff, burning and itching. Bald, round areas in the hair are also typical, which are limited to a few, usually palm-sized areas. In addition, painful, weeping skin areas may form. These become inflamed in the course of the disease and secrete pus and tissue fluid. The lymph nodes are usually swollen and excessively sensitive to pain. The hair of those affected is very sensitive and breaks off quickly. Split ends occur in certain areas, and the characteristic hair pattern with thinning areas and an unkempt appearance develops. The hair itself is very greasy as a result of the secretions, which the sufferers usually find extremely unpleasant. In the case of a deep infection, scars and sensory disturbances may remain on the scalp. If the pathogen is carried over, a variety of general symptoms may also develop, such as fever, nausea and vomiting, headache and a general feeling of illness. Head fungus usually develops over the course of a few days and subsides after a few weeks with appropriate treatment.

Diagnosis and course

The diagnosis of head fungus can sometimes be difficult. To be able to start a suitable therapy, the pathogen must first be determined. For this purpose, a fungal culture is created. For this, hair or hair stumps are taken from the affected area. The disadvantage of the fungal culture is that the cultivation of a pathogen can take between three and six weeks. An infection with Microsporum canis can, if necessary, be detected with a UV lamp – the so-called Wood light. If an infection is present, this can be recognized by the yellowish-green fluorescence. However, since the sensitivity of the test is not very high, this alone is not sufficient for diagnosis. The course is usually uncomplicated. Tinea capitis usually heals without complications. In the case of a deep infection, however, scars may remain. In most cases, no more hair grows in this area afterwards. Healing is usually faster in adults than in children. The healing phase also depends on the length of the hair. In the case of head fungus, it is therefore recommended to cut the hair short, as this can significantly shorten the treatment period.

Complications

Head fungus causes very unpleasant discomfort on the patient’s head.In most cases, the affected person’s hair breaks off and severe dandruff appears. Likewise, the scalp may be red, itchy and painful. It is also not uncommon for the hair itself to become greasy as a result and for the affected person to experience reduced aesthetics. The quality of life is greatly reduced by the head fungus in most cases. It is not uncommon for those affected to also suffer from mental illness or depression, which can be triggered by inferiority complexes or reduced self-esteem. Furthermore, infections can occur, which can also leave scars on the scalp. The treatment itself does not lead to further complications or discomfort. Medications or creams can be used to limit and treat the discomfort. However, the treatment itself can take several weeks. As a rule, the affected person must also cut his hair short, which can also lead to psychological discomfort. The life expectancy remains unaffected by the head fungus. Furthermore, the patient can also fall ill with this disease again.

When should one go to the doctor?

With dandruff, brittle hair and an oily scalp, a doctor should be consulted in any case. It is possible that there is an underlying head fungus that needs to be diagnosed and treated. Medical advice is required if the symptoms mentioned cannot be alleviated by the use of care products or even become more severe. If the symptoms have not subsided after one to two weeks, the family doctor should be consulted. Swollen lymph nodes, repeated infections or increasing malaise are also clear warning signs that point to a serious illness. People who notice corresponding symptoms are best advised to contact their general practitioner or a dermatologist. Psoriasis patients and people with seborrhea in particular should seek medical advice. Risk groups also include people with another chronic skin disease. Children, the elderly and pregnant women should seek medical advice if further symptoms occur or serious complications develop. In addition, if the head fungus has an impact on mental health, a therapist may need to be consulted.

Treatment and therapy

Head fungus is treated both systemically and locally. Furthermore, treatment must take into account whether adults or children are affected. In adults, systemic treatment involves the use of antifungals, which are medications that kill fungi. The following agents are approved for the treatment of head fungus: Griseofulvin, terbinafine, itraconazole, and fluconazole. However, only the active ingredient griseofulvin is approved for the treatment of children. In drug treatment, it is important that the drugs are taken for a sufficiently long period of time. Therapy covers a minimum period of four to eight weeks. Even if symptoms are no longer present, the medication must continue to be taken. Only when the physician informs the patient that the drug can be discontinued is the treatment sufficient. In addition to the systemic treatment, a local treatment with special antifungal creams, which are applied to the skin, is carried out at the same time. Furthermore, in addition to the scalp, the hair must also be treated, since scalp fungus also spreads to the hair. There are special antifungal shampoos for this purpose. To shorten the treatment time, it makes sense to cut off long hairs, otherwise it may take several months to successfully treat the head fungus. Treatment of tinea capitis should not be stopped until no more pathogens can be detected by another fungal culture.

Outlook and prognosis

If expert treatment is not started, the prognosis is rather unfavorable. This is because the disease can spread. Often the appearance suffers, which leads to psychological problems. In the worst case, scarring can occur, where subsequently no more hair grows back. A permanent optical restriction thus marks the head. In addition, the risk of infection for other people must not go unnoticed. A transmission to uninvolved persons is possible. A non-treatment of the head fungus is harmful both for an affected person himself and his environment. On the other hand, a positive outlook arises when starting a therapy.Currently available drugs combat the pathogen sustainably, provided that treatment is not discontinued prematurely. In addition to antimycotics, creams and shampoos have also become established. Children have to accept restrictions in the choice of drugs, but these do not hinder the success of treatment. It is not uncommon for patients to have to wear their hair short. This can cause a temporary psychological stress situation. If a fungal culture shows no more pathogens, the treatment was successful. The patient can go on with his regular life. Several months pass before therapy is completed.

Prevention

Infection with head fungus can be prevented to a limited extent. Suspicious animals should not be touched in any case. The most common sources of infection are cats and guinea pigs. Because of this, they should be regularly examined by a veterinarian. If the pets show signs of infection with the head fungus, they should be quarantined to the veterinarian. To avoid spreading the pathogen further, the following rules should be followed:

Hairbrushes, combs, towels, washcloths, bedding, clothing, stuffed animals and other toys must be thoroughly disinfected. This also applies to the shelves on which the items are placed. The same applies to pets’ toys and resting places. Children must be excused from kindergarten and school. When these can be attended again must be decided by the doctor on a case-by-case basis. The institutions must be informed of the infestation so that they can take precautions to prevent it from spreading among the students. As long as the head fungus is present, visits to the barber should be avoided at all costs. If the diagnosis of tinea capitis has been made, the source of infection should also be sought. It is helpful if a fungal culture is taken from all family members. Furthermore, a thorough disinfection of the house should be carried out. Only if the source of infection has been found and eliminated, a new infection with head fungus can be prevented.

Aftercare

The disease heals successfully through therapy. However, this does not eliminate the risk of re-infection. Patients are informed about causes of head fungus during initial treatment. Subsequently, they themselves are responsible for avoiding contact with possible triggers. This includes infected pets in particular, but also people. Everyday objects close to the head must be thoroughly cleaned. Scheduled follow-up examinations are not scheduled due to the absence of symptoms after initial treatment. In the case of a stubborn fungal disease, the therapy can last for months. During this time, doctors clarify the question of whether tinea capitis is still present by preparing a fungal culture. Often patients are temporarily burdened by the changed appearance to their disadvantage. In addition, isolation is necessary in order not to infect other people. In addition to these complications, scarring sometimes appears. Psychological support may be indicated if the patient suffers from the altered appearance. The patient then learns to cope with his situation and adopt a self-confident attitude to life. Scheduled follow-up examinations therefore play a minor role in tinea capitis. Medication causes the disease to heal after some time. Only in the context of a long therapy over months, complications can be expected, which the follow-up must catch.

What you can do yourself

Head fungus can be treated like other skin fungi with different home remedies. One proven remedy is apple cider vinegar, which should be applied regularly to the affected areas with a piece of absorbent cotton. The apple cider vinegar is best not diluted for this purpose. Furthermore, head fungus can be treated by means of tea tree oil. The tea tree oil contains a naturally occurring antibiotic, which can be used against fungi and also other germs. This is also applied by the affected person with a piece of absorbent cotton on the affected areas of the skin. This treatment is then repeated regularly until there is an improvement. Another home remedy against fungi is natural yogurt. This can be applied to the affected areas and should be allowed to act for about 15 minutes. Afterwards, the yogurt is washed off with warm water. In addition, head fungus can also be treated with lavender oil. The essential oils of lavender oil have been proven to help rid the skin of fungus.The lavender oil should also be applied to the affected areas with a cotton swab. If the affected person tends to skin irritation, then it is advisable to dilute the lavender oil before treatment. This treatment should also be repeated regularly until there is improvement.