Tinea Capitis: Symptoms, Causes, Treatment and Prevention
Updated: 3 days ago
Medically reviewed by Dr. Baraa Alnahhal, MD · Last reviewed: October 2026
Quick Answer: What is tinea capitis?
Tinea capitis is a fungal infection of the scalp and hair in which mold-like fungi called dermatophytes enter the hair follicles and shafts. It can cause itchy, scaly patches, hair breakage and patches of hair loss. Diagnosis involves testing hairs or scrapings. Treatment generally requires an oral antifungal for at least six weeks, since shampoos alone rarely cure it. [5]
What the research says
Oral antifungals are needed, and the best choice depends on the fungus. A Cochrane review of 25 trials (4,449 children) found terbinafine for four weeks and griseofulvin for eight weeks had similar complete cure rates in Trichophyton infections (84.2% vs 79.0%). Terbinafine worked better against T. tonsurans (52.1% vs 35.4%), while griseofulvin worked better against Microsporum (50.9% vs 34.7%). Side effects were mild and similar (9.2% vs 8.3%), and severe events were rare (0.6% in each group) (Chen et al., Cochrane Database Syst Rev, 2016). [1]
Silent carriers in a household can keep the infection circulating. Among 209 household contacts of people with tinea capitis in South London, only 7.2% had visible disease, yet 44.5% carried the fungus on the scalp without symptoms. Children under 16 were much more likely to be carriers than adults (White et al., J Eur Acad Dermatol Venereol, 2007). [2]
Current guidance favors combined treatment over topical-only care. A 2026 consensus-based German guideline recommends combining systemic and topical antifungal treatment because topical monotherapy is generally insufficient. In children, the oral drug is chosen by the identified fungus; in adults, terbinafine is recommended first-line. The guideline also addresses treating asymptomatic carriers and hygiene measures to interrupt chains of infection (Mayser et al., J Dtsch Dermatol Ges, 2026). [3]
What does tinea capitis look like?
Tinea capitis can affect all or part of the scalp. It may appear as swollen red patches, dry scaly rashes or areas of severe itchiness. The scalp may flake in a way that resembles dandruff.
The infection can also cause patches of hair loss, known medically as alopecia. Hair may break at the scalp surface and leave what look like black dots. In another pattern, hair shafts break above the scalp and leave short stubs.
Some children develop a low fever or swollen lymph nodes. Painful, swollen patches with crusty blisters or pus suggest an inflammatory form called kerion and should be assessed by a healthcare provider.
What causes tinea capitis?
Dermatophytes cause tinea capitis. In the United States, fungi in the Microsporum and Trichophyton groups are common causes. These fungi grow well in warm, moist environments, and the infection is especially common in tropical areas.
Tinea capitis is contagious. A person can spread it even without obvious symptoms if they carry the infection. Dogs, cats and other animals can also transmit the fungi. Soil, objects and surfaces may carry the infection for a long time.
Who is most likely to get scalp ringworm?
Tinea capitis most commonly affects children ages 3 to 14. Adults can develop it as well, particularly people with weakened immune systems.
Factors that may increase risk include living in or visiting hot, humid areas, living in close quarters, playing contact sports, having minor scalp injuries, excessive sweating and sharing personal or sports equipment.
A weakened immune system related to conditions such as HIV/AIDS, cancer or diabetes can also increase risk. Infrequent bathing or hair washing is listed as another risk factor, but anyone can develop tinea capitis after exposure to the fungi.
How does tinea capitis spread?
Tinea capitis spreads mainly through three routes: people, animals and fomites. Fomites are objects or materials that can carry an infection. [5]
Route | Examples |
People | Direct contact with someone who has the infection, including someone who carries it without symptoms. |
Animals | Touching an infected animal, including a dog or cat. |
Shared objects | Sharing clothes, hats, combs, hairbrushes, helmets or other materials that carry the fungi. |
Surfaces and soil | Contact with surfaces or soil where the fungi are present. |
Because the infection can spread quickly among children, families should mention possible exposure to a healthcare provider and follow the recommended treatment and cleaning plan.
What are the types of tinea capitis?
Tinea capitis may be inflammatory or non-inflammatory. The difference matters because inflammatory disease can create a greater risk of scarring and permanent hair loss.
Pattern | What it can involve | Main concern |
Non-inflammatory tinea capitis | Scaling, hair breakage, black-dot pattern or gray patches with short hair stubs. | It usually does not cause permanent hair loss, especially with early and persistent treatment. |
Inflammatory tinea capitis | Painful swollen patches called kerion that may contain pus, crust or ooze. | It may cause scarring and permanent hair loss. |
A kerion is not simply a cosmetic change. It results from an immune reaction to the fungus and may need additional treatment to reduce inflammation and protect hair growth.
How is tinea capitis diagnosed?
A healthcare provider asks about symptoms and examines the hair, scalp and skin. Sometimes the appearance is enough to suggest scalp ringworm, but testing may be needed to confirm the diagnosis or identify the fungus.
The provider may pluck some hairs or take a small scraping of the scalp. Possible tests include a KOH stain, a culture and a Wood light examination.
KOH stain
For a KOH stain, a technician places collected skin or hair samples on a slide with potassium hydroxide. The KOH makes fungus easier to see under a microscope. Results are generally available within 24 hours.
Culture
If a KOH stain does not provide accurate results, a provider may order a culture. A culture allows fungi to grow so the laboratory can identify the organism. It is more specific than a KOH stain, but results may take several weeks.
Wood light
A Wood light is a special ultraviolet light. Some types of ringworm glow under it when other rashes do not. Depending on the dermatophyte, the affected scalp may glow yellow, green or blue.
How is tinea capitis treated?
Tinea capitis generally requires an oral antifungal medication because the infection involves hair follicles and hair shafts. Topical treatment alone usually does not work.
Children typically need oral treatment for at least six weeks. Common medicines for children include griseofulvin and terbinafine. Adults also generally need oral treatment for at least six weeks; options include terbinafine and itraconazole.
A qualified healthcare provider should choose the medication and explain how to use it. The infection may appear to be improving before it is completely cleared, so stopping early can allow it to return.
Shampoos and creams
A provider may prescribe selenium sulfide shampoo. The hair may need to be washed with it at least twice a week. Selenium sulfide shampoo can help reduce spread, but it will not cure tinea capitis by itself.
An antifungal cream may also help prevent spread when applied directly to the scalp as directed. It does not usually cure the infection alone.
Treatment for kerion
When a child has kerion, a provider may prescribe a corticosteroid such as prednisone. Steroids can reduce inflammation and lower the risk of scarring and permanent hair loss.
What should families do at home?
If a child or adult in the household has tinea capitis, check other household members for signs of infection. Ask a healthcare provider whether other people should be treated even if they do not have symptoms. Without coordinated care, the infection may pass back and forth within the household.
Wash pillows, bedding and towels thoroughly. Clean, disinfect or replace shared combs, brushes and other hair equipment. Follow any shampoo or cream instructions given by the healthcare provider.
Do not share hats, combs, brushes, pillows, helmets or other personal items. Keeping the scalp clean and dry may also help reduce risk.
Can tinea capitis cause permanent hair loss?
Non-inflammatory tinea capitis usually does not cause permanent hair loss, particularly when treated early and consistently. Severe inflammatory tinea capitis can scar the scalp and prevent hair from growing back in affected areas.
Hair may break during the infection and later grow back after treatment. A healthcare provider can help determine whether a pattern of hair loss is related to active infection, inflammation or scarring.
How long does tinea capitis last?
Tinea capitis can be difficult to cure. Oral antifungal medication may be needed consistently for at least six weeks. The scalp may look better before the infection is completely gone, and it can return if treatment is not completed as directed.
Many infections improve on their own after puberty, but waiting for that to happen is not a substitute for evaluation and treatment. Early, persistent treatment is important, especially when inflammation, pain or hair loss is present.
How can families prevent tinea capitis?
Prevention focuses on reducing contact with infected people, animals, objects and surfaces.
Prevention step | Practical example |
Avoid sharing personal items | Keep hats, combs, hairbrushes, pillows and helmets personal. |
Keep the scalp clean and dry | Follow regular scalp-care routines and address excessive sweating when appropriate. |
Wash bedding | Wash pillows, sheets and other bedding frequently. |
Clean hair equipment | Clean, disinfect or replace shared combs, brushes and other hair tools. |
Consider exposure from pets | Wash hands after petting or playing with pets, and discuss concerns about an animal with a qualified professional. |
Reduce close contact during infection | Keep children with tinea capitis away from healthy children as advised by their healthcare provider. |
How is tinea capitis different from seborrheic dermatitis?
Seborrheic dermatitis can resemble tinea capitis, especially when there are scaly patches on the scalp. A key difference is that seborrheic dermatitis does not cause hair loss, and the hairs are not broken.
Seborrheic dermatitis may sometimes respond to over-the-counter treatments. Tinea capitis generally requires prescription medication, so a child with scalp scaling and hair loss should be evaluated rather than assumed to have dandruff or dermatitis.
How is tinea capitis different from tinea barbae?
Tinea barbae is a related fungal infection that affects the beard and mustache areas of the face. It is less common than tinea capitis and generally affects adult males, especially farmers. It most commonly spreads through direct contact with an infected animal and very rarely spreads from person to person.
When should you contact a healthcare provider?
Arrange a healthcare visit when a child or adult has a persistent itchy or scaly scalp, patches of hair loss, broken hairs, painful swelling or a rash that resembles scalp ringworm.
Prompt professional assessment is especially important when there are painful swollen patches, crusty blisters, pus, fever, swollen lymph nodes, scarring or rapidly worsening hair loss. A provider can determine whether testing and oral medication are needed.
What questions should you ask at a tinea capitis visit?
Useful questions at a tinea capitis visit include which tests and antifungal medicine are needed, how long treatment lasts and whether household members should be checked.
Could this be tinea capitis or another scalp condition?
Does the scalp need a KOH stain, culture or Wood light examination?
Which oral antifungal medicine is appropriate?
How long should treatment continue?
Should a selenium sulfide shampoo or antifungal cream be used to reduce spread?
Does the scalp inflammation look like kerion?
Could the infection cause scarring or permanent hair loss?
Should other household members or pets be checked?
How should bedding, towels, combs and brushes be cleaned?
When can the child return to close-contact activities?
Conclusion
Tinea capitis is a contagious fungal infection of the scalp and hair. It commonly causes itchiness, scaling, redness, hair breakage and patches of hair loss. An inflammatory form can cause kerion, painful swollen patches that may ooze and lead to scarring or permanent hair loss.
A healthcare provider may examine the scalp and test hair or skin samples with a KOH stain, culture or Wood light. Because the infection involves hair follicles and shafts, treatment usually includes an oral antifungal medication for at least six weeks. Shampoos and creams may help limit spread but generally do not cure the infection alone.
Families can reduce spread by checking household members, avoiding shared personal items, washing bedding and towels, and cleaning or replacing shared hair equipment. Consistent treatment matters because tinea capitis can return when the infection is not fully cleared.
If a child or adult has scalp scaling with hair loss, severe itchiness, painful swelling or an unusual rash, schedule a visit with a qualified healthcare provider. Bring a list of symptoms and possible exposures, including contact with children, pets, shared hair equipment or hot, humid environments.
Frequently Asked Questions
Is tinea capitis the same as scalp ringworm?
Yes. Scalp ringworm is another name for tinea capitis. It is a fungal infection of the scalp and hair.
Is tinea capitis contagious?
Yes. It can spread through infected people, animals, soil, objects and surfaces. Shared hats, combs, hairbrushes, clothes and helmets can carry the fungi.
Can adults get tinea capitis?
Yes. Although it most commonly affects children ages 3 to 14, adults can develop it too. It is especially common in people with weakened immune systems.
Does tinea capitis cause hair loss?
Tinea capitis can. The infection may cause patches of hair loss and hair breakage. Severe inflammatory disease may scar the scalp and cause permanent hair loss.
What is kerion?
Kerion is an inflammatory form of tinea capitis that causes painful, swollen, pus-filled patches that may ooze. It can cause scarring and permanent hair loss.
Can shampoo cure tinea capitis?
Selenium sulfide shampoo may help reduce spread, but it does not cure tinea capitis by itself. Treatment generally requires an oral antifungal medication prescribed by a healthcare provider.
How long does treatment take?
Children and adults may need oral antifungal medication for at least six weeks. Use the medication as directed and complete the recommended course, even if the scalp looks better sooner.
Can tinea capitis come back?
Yes. The infection can return if it is not treated completely. Re-exposure within a household can also allow the infection to pass back and forth.
How is tinea capitis diagnosed?
A provider examines the scalp, hair and skin and may collect hairs or a small scalp scraping. Tests can include a KOH stain, culture or Wood light examination.
What should I wash if someone in the household has tinea capitis?
Wash pillows, bedding and towels thoroughly. Clean, disinfect or replace shared combs, brushes and other hair equipment.
Can tinea capitis look like dandruff?
Yes. Tinea capitis can cause flaking that resembles dandruff. Hair loss or broken hairs make a fungal infection more concerning and should prompt professional evaluation.
What is the difference between tinea capitis and seborrheic dermatitis?
Seborrheic dermatitis can cause scalp scaling, but it does not cause hair loss and the hairs are not broken. Tinea capitis generally requires prescription medication.
Related Reading
Wood's Lamp Examination: What the Blacklight Skin Test Shows explains the blacklight skin test and what its colors mean.
References
Chen X, Jiang X, Yang M, et al. Systemic antifungal therapy for tinea capitis in children. Cochrane Database Syst Rev. 2016;(5):CD004685. PMID 27169520. https://doi.org/10.1002/14651858.CD004685.pub3
White JML, Higgins EM, Fuller LC. Screening for asymptomatic carriage of Trichophyton tonsurans in household contacts of patients with tinea capitis: results of 209 patients from South London. J Eur Acad Dermatol Venereol. 2007;21(8):1061-1064. PMID 17714125. https://doi.org/10.1111/j.1468-3083.2007.02173.x
Mayser P, Abeck D, Bosshard PP, et al. Consensus-based guideline on tinea capitis. J Dtsch Dermatol Ges. 2026;24(10):e1510-e1522. PMID 42444404. https://doi.org/10.1111/ddg.70395x
National Library of Medicine. Fungal Infections. MedlinePlus. Last updated September 21, 2025. https://medlineplus.gov/fungalinfections.html
Centers for Disease Control and Prevention. Ringworm Basics. CDC. Updated February 9, 2026. https://www.cdc.gov/ringworm/about/
Disclaimer
This article is for general educational purposes and is not a substitute for professional medical advice, diagnosis or treatment. Always seek the advice of a qualified health provider with any questions you may have regarding a medical condition.
It is educational content, not a diagnosis, prognosis or personalized treatment plan. A qualified healthcare professional should interpret symptoms, testing, medicines, duration of treatment and household-care needs. Medication names and cleaning steps should be followed only as directed by a qualified provider. If symptoms are rapidly worsening or a person is seriously ill, seek prompt medical care.
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