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Ringworm: There's a Fungus Among Us

From the WebMD Archives

April 17, 2001 -- Does your child seem to have dandruff? That's not a common condition in kids -- but ringworm of the scalp is, and it can look just like dandruff. This fungal infection is on the rise in the U.S. and requires treatment, so if your child has a flaking, scaling scalp, it's time for a visit to the doctor to prevent potential long-term problems.

"Tinea capitis, also known as ringworm of the scalp, is a common childhood infection ... caused by [a fungus] called T. tonsurans," expert Boni E. Elewski, MD, tells WebMD.

"In [big cities in] the northern U.S. and Canada ... I'm guessing that 15% of children between 5 and 10 have this infection," says Elewski, professor of dermatology at the University of Alabama in Birmingham (UAB). "I'm betting that in the Southern U.S., based on data, it's even more common. I wouldn't be surprised if in Alabama, Georgia, and Florida, we may go to 25% of children in that young age group."

Black children, especially boys, are especially prone to contract ringworm of the scalp. However, the condition does occur in adults and in children of all races, and identifying it can be tricky.

"We see a ton of it in our office," says David Fleece, MD, a pediatrician working in a clinic at Temple University School of Medicine in Philadelphia. "It is not always easy to diagnose based on the way it looks because it has many various appearances. Sometimes it's obvious and you have a circular patch of inflamed scalp and hair loss. But it can present as pimples or just a little flakiness [on the scalp]."

Patches of baldness and a scaly scalp are also common signs.

Even doctors have trouble identifying the disease and often confuse it for a bacterial infection of the hair follicles and treat it with antibiotics, Fleece says. This doesn't help because antibiotics only attack bacteria, not fungi.

To further complicate matters, Elewski says, a child may carry the disease for years before developing symptoms. It's always contagious, however, so during that time the child may pass it on to dozens of other kids.