Scalp Ringworm (Tinea Capitis): Symptoms, Causes and Effective Treatment

Scalp ringworm (Tinea Capitis) is a fungal infection of the scalp and hair. It is most common in school-age children aged 5–15 and spreads easily through direct contact, shared items or pets. The key point is that if left untreated, the fungus can damage the hair follicles and cause permanent hair loss and scarring (cicatricial alopecia). In this article, a dermatologist explains the symptoms, diagnosis, treatment and how to prevent spread.

Symptoms of scalp ringworm

Symptoms of scalp ringworm vary widely, from round patches of hair loss to severe inflammation. Common symptoms include:

• Patchy hair loss: round patches of hair loss, which may be a single patch or several patches on the scalp.

• Black dots from broken hair: hairs break off short, leaving black stumps on the scalp, known as the black dot type of ringworm.

• Itching and scaling: a very itchy scalp, sometimes severe enough to disturb sleep, with scales or dandruff-like flakes.

• Severe inflammation: a kerion is a swollen, red and painful inflamed lump that develops in advanced cases. It needs urgent treatment because of the risk of permanent scarring.

Diagnosis and treatment

The doctor diagnoses the condition with a fungal culture or a KOH preparation of the hair to confirm the type of fungus. The key point of treatment is that scalp ringworm needs an oral antifungal, because the fungus lies deep in the hair follicles where topical medicine cannot reach.

• Oral antifungal medicine: the commonly used oral medicines are Griseofulvin or Terbinafine, usually given continuously for 6–8 weeks as assessed by the doctor.

• Antifungal shampoo: used together with a shampoo containing an antifungal ingredient to reduce the spread of fungal spores to other people.

• Completing the treatment: continue treatment until the course set by the doctor is complete and attend follow-up, because stopping medicine too early may allow the infection to return.

How to prevent infection and spread

Because scalp ringworm spreads easily among school-age children, prevention is as important as treatment. Recommended steps include:

• Avoid sharing items: do not share combs, hats or towels with others, and do not share hair-cutting tools.

• Be careful with pets: wash hands regularly after touching pets, because pets can be a source of fungal infection.

• Watch for symptoms and see a doctor early: if a child has round patches of hair loss together with itching or scaling, take them to a dermatologist promptly, because late treatment may lead to permanent hair loss.

Frequently asked questions

Can scalp ringworm be treated with topical medicine alone? No. Scalp ringworm requires an oral antifungal such as Griseofulvin or Terbinafine, because the fungus lies deep in the hair follicles where topical medicine cannot reach. Antifungal shampoo is used only as an add-on to reduce spread.

How long does treatment take? Oral medicine is usually given continuously for about 6–8 weeks as assessed by the doctor, and the course should be completed to prevent recurrence.

Does scalp ringworm cause permanent hair loss? If treated in time, hair usually grows back. But if the condition is left until severe inflammation (kerion) develops, or treatment is delayed, scarring and permanent hair loss may occur, so see a doctor promptly.

Can it spread within the family? Yes. Scalp ringworm spreads through contact and shared items, so avoid sharing combs, hats and towels, and have family members with symptoms examined.

Scalp ringworm can be cured if it is diagnosed and treated correctly and continuously. If your child has round patches of hair loss together with itching or scaling, consult a dermatologist at Siam Dermatology, tel. +66 61 448 7000 or LINE @siamderm.

Written by Dr. Patara Voravutinon, Dermatologist · Last reviewed 16 July 2026