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“Ringworm” is the most common terminology used to describe fungal infections of the scalp? Traditionally, if you would happen to acquire this type of infection, you would lose hair in a round patch of baldness. However, in my many years of diagnosing and treating hair loss, I have encountered many individuals with fungal infections and hair loss that did not match the classical picture.
Widespread areas of dryness and scaling that you would attribute to a dandruff problem is one of the more common ways in which fungal infections can show up on the scalp. While this version is more common in children, I have made this diagnosis in grandmothers in their 70’s and 80’s. One of the clues to making this diagnosis is the presence of scattered black dots on the scalp which occur because hairs infected with the fungus break off at the surface of the scalp. However, these broken off hairs may or may not form bald spots, so often times the only finding is the dandruff like dryness and flaking.
Another way that fungal infections can show up on the scalp is by causing you to develop small pimple like bumps which is most commonly associated with bacterial infections or folliculitis. However, microscopic evaluation of a scraping from the scalp or culturing a lesion can confirm that the problem is really a fungal infection. This version of fungus infection seems to be more common in men, but can really affect women as well. When the problem persists and goes untreated, then larger infected skin lesions can appear. In more extreme cases, these infected lesions can be swollen and protrude from the scalp similar to a boil on other parts of the body.
The most common source for fungal infections of the scalp is from another human, but it is also possible to acquire the problem from contact with animals or direct contact of the scalp with dirt or soil. Human to human contact can develop as a result of sharing combs and brushes between parents and children, or inadvertent transfer at barbershops or salons, or casual contact with surfaces that can serve as a reservoir for spores such as head rests or other forms of seating.
When fungal infections of the scalp occur, effective treatment would mean that you would have to take medication internally for usually 4 to 8 weeks, plus usually topical therapy as well to help prevent further spread of the infection. When a bacterial infection is present at the same time, additional medication might be required for 10 to 14 days to get the responsible organisms to go away.
You know that individuals can lose hair due to a number of reasons, but fungal infections might not be on the top of your list of possibilities, especially for adults. For that reason, the problem tends to be more advanced in adults when the diagnosis if finally made.
So if you find yourself bothered with persistent pimples, or ongoing flaking and itching of the scalp with or without hair loss, it would be best for you to get evaluated, diagnosed and treated to make sure that a fungal infection is not masquerading as something else.
Once present, the problem does not really go away until you get the appropriate treatment. I have had patients come in with this problem going undetected for as long as six years before a diagnosis was made, so it’s one of those things that does not usually go away on its own.
Your dermatologist can perform a fungal scraping or culture that can provide guidance to the treatment that will give you relief and help your scalp get back to normal.
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Dr Weaver,
Excellent post re your clinical experience and observations.
I am sharing your information with many of my clients.
Gratefully,
Mike
Can fungal infections of the scalp be treated completely?
My cousin developed a bald patch and started losing hair from her head. Hair grew back on the pAtch eventually but overall hairfall became worse and now she has much less hair left and also her hairline has gone back about an inch.
A homeopathic doctor showed us her scalp under a microscope and suggested fungal infection, we could see a gel like substance allover her scalp.
Now everyone in her family including me are suffering from hairloss.
Any suggestions what we should do?
Will the lost hair ever grow back?
Thanks in advance
I had sever hair loss and have lost alot of hair now. The hairs on the back have fallen and my hair line has receded in a widows peak shape…I was diagnosed with a fungal infection, and given cortisol treatment and oral anti allergens…Will my hair grow back? what steps do I have to take? How do i regrow my hair? Please Im very depressed about my hair, and looking for some direction…
It would be necessary to examine your scalp and check for the presence or absence of scar tissue to provide an opinion about whether your hair will grow back or not. On some occasions it is necessary to do a skin biopsy of the scalp to come up with the best treatment plan.
My sister has fungal infection in her hairs, she had a bald patch in her head. Doctor suggested the medicines 1. dermosporin, (Clotrimazole USP 1%) 2. Evion and 3. ViDaylin-T.
while the last two tablets are multivitamins, i am a bit scary about his prescription.
the Doctor directly apply a injection to her bald portion, aftre that her Blood pressure gets low. So please tell me whether the tablets are right or we should consult some other Dermatologist??
Both of the tablets you mention are vitamins which should not be at risk of harm to your sister. A number of hair loss conditions are treated with injections to the areas of baldness. However, injections are not usually done for hair loss due to fungal infections. So, get clarification on your sister’s exact diagnosis to better understand her treatment. Individuals who are fearful of needles can develop vagal reactions with lowered blood pressure as part of the body’s response to encounters that are threatening. These symptoms usually clear up fairly quickly once the fear is over.
Hi my daughter has a fungal infection on her scalp. Her doctor prescribed dandrazol. She has been using this for two weeks with no change. Is there anything else that can be used to get rid of the fungal infection.
Dandrazol is an antifungal shampoo containing ketoconazole. If your daughter has a fungal infection of the scalp that has been confirmed by a positive culture or microscopic scraping, then shampoo alone is not usually effective. She would need to take an oral anti-fungal medication for a period of 4 to 8 weeks to cure the problem.
My daughter scalp is inflamed and bold spots, severe itchiness, dry scaling, matted hair, yellow crusting appearance and ts bleeding with little lumps on her scalp and while I am braiding her hair she is in pain. It has been almost a month and I am still waiting for a dermatologist. I am feed up and I want to know while I am waiting what can I use. My daughter is African american so is it good to wash her hair everyday?
You do not mention the age of your daughter, but if she is between 2 and 8 years old there is a 95% chance that she has a fungus infection. A scalp examination and scraping +/- fungal culture can help verify if this is the real problem or not. Washing African American hair everyday with medicated shampoos can result in dry, brittle hair with excessive breakage, so doing so would require extra effort to moisturize, strengthen, and condition the hair to minimize this risk.