Ringworm, Scalp (Tinea Capitis):
A parent's guide for infants and babies

To confirm the diagnosis of scalp ringworm, the physician might scrape some surface skin scales onto a slide and examine them under a microscope. This procedure, called a KOH (potassium hydroxide) preparation, allows the doctor to look for tell-tale signs of fungal infection.

Sometimes the doctor will also perform a culture in order to document the presence of fungus or to discover the particular fungus that is causing the scalp ringworm. The procedure involves:

1. Plucking a few hairs from involved areas of the scalp
2. Rubbing a sterile cotton-tipped applicator across the skin to collect scale and any pus
3. Sending the specimen away to a laboratory

Typically, the laboratory will have results within 2–3 weeks. Sometimes the laboratory is able to identify the type of dermatophyte that is causing the scalp ringworm.

Occasionally, a Wood's lamp is used to look for the fungus. In this procedure, the doctor shines a black light at the scalp, and certain strains of dermatophyte may appear as fluorescent yellow-green spots.

Scalp ringworm is treated with oral antifungal medicines because the fungus invades deep into the hair follicle, where topical creams and lotions cannot penetrate. Scalp ringworm usually requires at least 6–8 weeks of treatment with oral antifungal pills or syrup, including:

• Griseofulvin
• Terbinafine
• Itraconazole
• Fluconazole
• Ketoconazole

Often, the doctor will also prescribe a medicated shampoo to reduce the risk of spreading the infection to someone else:

• Selenium sulfide shampoo
• Ketoconazole shampoo

Occasionally, untreated scalp ringworm seems to heal on its own when a child reaches puberty.