If your child has a scaly round patch on the side of his scalp or elsewhere on his skin, and he seems to be losing hair in the same area of the scalp, the problem may be a contagious infection known as ringworm or tinea.
This disorder is caused not by worms but by a fungus. It’s called ringworm because the infections tend to form round or oval spots that, as they grow, become smooth in the center but keep an active red scaly border.
Scalp ringworm often is spread from person to person, sometimes when sharing infected hats, combs, brushes, and barrettes. If ringworm appears elsewhere on your child’s body, he may have the type spread by infected dogs or cats.
The first signs of infection on the body are red, scaly patches. They may not look like rings until they’ve grown to half an inch in diameter, and they generally stop growing at about 1 inch. Your child may have just one patch or several. These lesions may be mildly itchy and uncomfortable.
Scalp ringworm starts the same way the body variety does, but as the rings grow, your child may lose some hair in the infected area. Certain types of scalp ringworm produce less obvious rings and are easily confused with dandruff or cradle cap. Cradle cap, however, occurs only during infancy. If your child’s scalp is continually scaly and he’s over a year old, you should suspect ringworm and notify your pediatrician.
A single ringworm patch on the body can be treated with an over-the-counter cream recommended by your pediatrician. The most frequently used ones are tolnaftate, miconazole, and clotrimazole. A small amount is applied two or three times a day for at least a week, during which time some clearing should begin. If there are any patches on the scalp or more than one on the body, or if the rash is getting worse while being treated, check with your pediatrician again. She will prescribe a stronger medication and, in the case of scalp ringworm, will use an oral antifungal preparation. Your child will have to take medicine for several weeks to clear the infection.
You also may need to wash your child’s scalp with a special shampoo when he has scalp ringworm. If there’s any possibility that others in the family have caught the infection, they also should use this shampoo and be examined for possible signs of infection. Do not allow your child to share combs, brushes, hair clips, barrettes, or hats.
You can help prevent ringworm by identifying and treating any pets with the problem. Look for scaling, itchy, hairless areas on your dogs and cats, and have them treated right away. Any family members, playmates, or schoolmates who show symptoms also should be treated.