Ringworm is an infectious disease caused by a wide range of parasitic fungal elements which localize and proliferate at different levels of the body: scalp, nails, hands, feet, crotch and armpits. When the fungal infections characteristic to ringworm are localized in the region of the scalp, the disease is referred to as ringworm of the scalp. Ringworm of the scalp is a very common type of ringworm among children, predominantly affecting the very young. However, in rare cases ringworm of the scalp can also be acquired by people belonging to other categories of age.
Ringworm of the scalp comprises three subtypes, each of them having distinctive features and requiring specific medical intervention. The most common form of ringworm of the scalp is responsible for causing more than 95 percent of the overall reported annual cases of ringworm. This type of ringworm of the scalp generally occurs in very young children, disappearing before the age of puberty even in the absence of the specific medical treatment. Being very contagious, this form of ringworm of the scalp is easily transmissible from one individual to another. Due to this fact, the affected persons should avoid entering in contact with other people until the disease is appropriately cured. Afflicted children should be instructed by their parents to restrict from physical contact with their playmates, teachers and other people they normally interact with. Under special circumstances, the young patients may even require to remain indoors until the disease ameliorates and loses its infectious character.
This common type of ringworm of the scalp is highly resistant to regular treatments, rarely being successfully cured with local antifungal medications. At first, the disease is manifested through the occurrence of multiple patches with diameters of approximately 1 cm. As the infectious progresses, the patches begin to grow in size, eventually involving the entire surface of the scalp. Also, the patches characteristic to this type of ringworm have a grayish aspect, mostly due to scaling of the superficial layers of the scalp. The affected patients rarely present symptoms such as irritation, itching and inflammation of the scalp, the disease triggering no other noticeable physical manifestations. However, this form of ringworm may sometimes lead to atrophy of the hair, causing visible damage to the hair follicles found on the affected regions of the scalp. Thus, temporary baldness can also be considered a symptom characteristic to this very common form of ringworm of the scalp.
The second type of ringworm of the scalp is referred to as kerion. This form of fungal infection is very different from the previously described type of ringworm, producing soft, moist excrescences at the superficial level of the scalp. Despite the fact that kerion is commonly diagnosed in children, the disease can also occur in adults. This type of ringworm of the scalp is rare, being responsible for causing less than 3 percent of all ringworm of the scalp cases. Although kerion is not considered to be highly contagious, the afflicted persons should avoid entering in contact with other people until the disease becomes non-infectious. Kerion is manifested through the following symptoms: the occurrence of various swellings (soft prominences that are filled with fluid), tenderness and inflammation of the scalp, inflammation of the lymph nodes.
Similar to the previously described type of ringworm, kerion also involves deterioration of the hair. In the affected regions of the scalp, the hairs become very fragile and may eventually detach from their follicles. Kerion often involves temporary or permanent baldness associated with scarring. However, this type of ringworm of the scalp is easier to treat, most patients responding well to local treatments with antifungal creams, ointments and lotions. Even in the absence of treatment, kerion generally clears up in 3-4 weeks, depending on the seriousness of the infection.
The third and last type is also a very rare form of ringworm of the scalp. Although it is not considered to be very serious, the disease is responsible for causing few noticeable symptoms, thus being more difficult to detect during medical examinations. This form of ringworm of the scalp causes the occurrence of tiny black spots which are sometimes spread over the entire surface of the scalp. The infection causes no inflammation or redness, and it rarely involves deterioration of the hair or scarring. This type of ringworm of the scalp is considered to be contagious and thus temporary isolation is recommended to all affected patients. However, the disorder can be easily overcome with local treatments consisting of specific antifungal agents. With appropriate treatment, this form of ringworm can be completely cured in several weeks or less.