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Dear Readers,
Sasha is the mother of two boys, ages four and six years old. They attend school in Portmore. In recent months she noticed rashes on their scalps. Whenever she cuts their hair very low, she sees circular patches that everyone tells her is ringworm of the scalp. The children attended clinic and were given treatment but the rash keeps coming back.
Ringworm of the scalp, or tinea capitis, is a fungal infection of the scalp which involves the hair shafts and hair roots. It is highly contagious and spreads from one person to another via close contact. This could be close contact in the crowded environment at schools, buses, swimming pools and other communal facilities. Contact with an affected animal such as a pet dog or cat can also be responsible for the spread of this infection.
The condition begins as a slightly scaly rash in the scalp hair. It begins as a small, round, itchy spot which spreads outwards, healing from the centre with an outer scaly rim and giving rise to the typical ring-like look. It is not a serious infection but it can be persistent and does take a few weeks to clear up. If it is not treated correctly, however, it can cause hair loss and a chronic rash. Scratching of the scalp when it itches can lead to the spread of the fungus to other areas of the scalp.
The application of topical anti-fungal agents can give the appearance that the rash has cleared up within a few days to a week, but if the full course of medication is not used the relapse rate can be significant.
In addition, as tinea capitis (scalp fungus) affects the hair follicle and root below the level of visible skin (scalp), topical treatment (skin applications) alone often does not serve to cure fungal infection of the scalp. Oral (systemic) anti-fungal preparations should be included routinely in any treatment for scalp fungus to treat unexposed hair roots.
Acceptable treatment for tinea capitis should include an oral anti-fungal preparation, an anti-fungal shampoo as well as a topical anti-fungal agent. Many times, the oral preparation, as a sole treatment, is enough (eg Lamisil, terbisil, ketoconazole, nizoral, sporonox, itracare, etc). As the hair follicle also has to be treated, with scalp fungus the acceptable course of treatment is significantly longer than for other types of ringworm (up to six weeks). The medication must be used as prescribed, diligently, for the entire length of time prescribed or relapses can occur.
It is also necessary to keep a child with this fungus at home until treatment is well established, as this infection is easily spread to other children when there is frequent contact. If the source of the infection is unclear and it recurs, have a Vet check pets at home and see if they require treatment. Also, barber shears are common culprits. Investing in your own shear can be a good idea! Hats and caps must be thoroughly washed as they can also serve as a source of re infection.
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KGN 8
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