Scalp Ringworm (Child)
Ringworm is a skin infection caused by a fungus. It's not caused by a worm. Ringworm is contagious. It can be spread by contact with people or animals infected with the fungus. It can also be spread by contact with an object that is contaminated by an infected person or animal.
A ringworm scalp infection causes a ring-shaped patch on the scalp. The rash may be small or a few inches across. The ring is often clear in the center with a scaly, red border. In some cases, the ring shape is not apparent. The area is dry, scaly, itchy, and flaky. There may also be blisters. These can ooze clear or cloudy fluid (pus). Your child may also have hair loss in patches where the rash is on the scalp. You may see what looks like black dots in the area. This is hair that has broken off at the skin. Hair or a scraping of the scalp may be taken and sent for testing.
Ringworm on the scalp is most often treated with antifungal medicine taken by mouth. Medicated shampoo may also be advised. It may take a week before the infection starts to go away. It may take a several weeks or months to clear up completely. Bad cases of ringworm of the scalp can also develop into a kerion. This is a thick, pus-filled area on the scalp. In most cases, any lost hair will regrow when the infection is gone. But in severe cases, hair loss may be long-term (permanent).
Home care
Your child’s healthcare provider will prescribe antifungal medicine by mouth. Don’t stop giving this medicine until your child has finished it. Follow all instructions for using any medicine on your child. The medicine is absorbed better when given with fatty foods like ice cream or milk.
General care
-
The healthcare provider may recommend medicated shampoo for your child. The shampoo may help reduce the risk of spreading the infection to others. Be sure to wash your hands with soap and clean, running water before and after bathing your child and washing their hair.
-
Follow all directions from the provider if your child's healthcare provider has prescribed antifungal pills.
-
Make sure your child does not scratch the affected area. This can delay healing and may spread the infection. It can also cause a bacterial infection. You may need to use “scratch mittens” that cover your child’s hands. Keep his or her fingernails trimmed short.
-
If there are blisters, put a clean compress dipped in Burow’s solution (aluminum acetate solution) on them. This solution is available in stores without a prescription. Wash the compress well before reusing it. This prevents the infection from spreading.
-
Wash any items such as hats, combs, brushes, or hair clips that may have touched the infection. Tell your child not to share these items with others.
-
Don’t shave or close cut the hair. This does not help heal the infection.
-
Check your child’s scalp every day for the signs listed below.
-
It can take up to 6 weeks for the head lesions to go away.
Special note to parents
Ringworm of the scalp is contagious. Keep your child from close contact with others and out of day care or school for at least 2 days after treatment has started. Wash your hands well with soap and clean, running water before and after caring for your child. This is to help prevent spreading the infection.
Follow-up care
Follow up with your child’s healthcare provider. Ringworm of the scalp can be very hard to treat. In very rare cases, the infection does not go away fully until the child reaches the teen years.
When to seek medical advice
Call your child’s healthcare provider right away if any of these occur:
-
Your child has a fever (see “Fever and children” below)
-
The scalp becomes swollen, soft, hot and tender
-
Fussiness or crying that can’t be soothed
-
Bad-smelling fluid leaking from the skin
-
Ringworm continues to spread after 2 weeks of treatment and regularly taking medicine
Fever and children
Always use a digital thermometer to check your child’s temperature. Never use a mercury thermometer.
For infants and toddlers, be sure to use a rectal thermometer correctly. A rectal thermometer may accidentally poke a hole in (perforate) the rectum. It may also pass on germs from the stool. Always follow the product maker’s directions for proper use. If you don’t feel comfortable taking a rectal temperature, use another method. When you talk to your child’s healthcare provider, tell him or her which method you used to take your child’s temperature.
Here are guidelines for fever temperature. Ear temperatures aren’t accurate before 6 months of age. Don’t take an oral temperature until your child is at least 4 years old.
Babies under 3 months old:
-
Ask your child’s healthcare provider how you should take the temperature.
-
Rectal or forehead (temporal artery) temperature of 100.4°F (38°C) or higher, or as directed by the provider.
-
Armpit (axillary) temperature of 99°F (37.2°C) or higher, or as directed by the provider.
Child age 3 to 36 months:
-
Rectal, forehead, or ear temperature of 102°F (38.9°C) or higher, or as directed by the provider.
-
Armpit temperature of 101°F (38.3°C) or higher, or as directed by the provider.
Child of any age:
-
Repeated temperature of 104°F (40°C) or higher, or as directed by the provider.
-
Fever that lasts more than 24 hours in a child under 2 years old. Or a fever that lasts for 3 days in a child 2 years or older.