Head fungus
Tanja Unterberger studied journalism and communication science in Vienna. In 2015 she started her work as a medical editor at in Austria. In addition to writing specialist texts, magazine articles and news, the journalist also has experience in podcasting and video production.
More about the experts All content is checked by medical journalists.Head fungus (tinea capitis) is a contagious fungal disease of the scalp caused by an infection with skin fungi. It is one of the most common fungal infections in children. A frequent symptom are circular, sharply demarcated hairless areas on the head with grayish scales. The doctor usually treats head fungus with antifungal agents (e.g. shampoos, creams, tablets). Find out more about causes, symptoms and treatment here!
ICD codes for this disease: ICD codes are internationally recognized codes for medical diagnoses. They can be found, for example, in doctor's letters or on certificates of incapacity for work. B35
Brief overview
- Description: Head fungus (tinea capitis) is a fungal disease of the hairy scalp caused by an infection with skin fungi. Children are often affected by this.
- Symptoms: Symptoms include round, bald spots on the scalp (hair loss) with greyish scales, inflamed areas of the skin, itching.
- Treatment: The doctor treats head fungus in mild cases with antifungal agents in the form of shampoos, creams or solutions. If the course is more severe, antifungal agents in the form of tablets or injections are necessary.
- Causes: Head fungus is caused by an infection of the scalp with skin fungus. Most carriers are animals such as dogs, cats, hamsters, rabbits and guinea pigs.
- Diagnosis: conversation with the doctor, physical examination (e.g. examination under the microscope, creation of a mushroom culture in the laboratory).
- Course: Treated early, head fungus is curable. If the head fungus is already advanced, however, the bald areas of hair are often left behind permanently and scars develop.
- Prevention: Avoid contact with animals with noticeable bald patches of skin, do not share objects (e.g. brushes, towels) with sick people and disinfect them regularly, wash laundry at 95 degrees Celsius.
What is head fungus?
Head fungus, medically called tinea capitis, is a contagious fungal disease (mycosis) that affects the hairy area of the head (e.g. scalp hair, eyebrows, eyelashes, beard). It is a subtype of fungal skin diseases and is caused by skin fungi such as thread fungi (dermatophytes), rarely also molds (Aspergillus) and yeasts (Candida).
Animals such as dogs and cats are often infected with a fungal pathogen that is transmitted to humans upon contact (e.g. when stroking). Head fungus is very contagious and is also transmitted from person to person.
Who is particularly affected?
Head fungus is one of the most common fungal infections in children (usually under ten years of age). Children often get infected when petting pets and farm animals (e.g. cats, dogs, guinea pigs or even calves on the farm). Infants and newborns are rarely affected.
Animal owners and people who work with animals (e.g. in agriculture, in breeding farms) are also noticeably often sick with head fungus. In Germany, head fungus is also increasingly found in older people.
How do you recognize head fungus?
The symptoms of head fungus are very different. At the beginning, reddened nodules (papules) usually form around the hair shaft. After a few days, the papules become paler and scaly. The hair becomes brittle and breaks off. As a result, one or more sharply demarcated, circular, bald spots (alopecia) form on the scalp. The affected areas of the skin are usually covered with grayish scales. The scalp is often red, itchy and painful.
If the infection is more advanced, the symptoms sometimes appear on the face or other parts of the body. These areas are usually severely inflamed and up to eight centimeters in size. In some cases, the affected areas of the skin are also colonized by bacteria, which results in weeping, purulent and honeycomb-like wounds (tinea capitis profunda).
In some cases, the infection causes painful abscesses in men's beard hair, which are usually covered with crusts (tinea barbae).
In severe cases, the lymph nodes in the neck and throat are swollen and tender. Occasionally, there is also a fever.
The strong inflammation can cause permanent damage to the hair roots. In severe cases, the scalp in these areas remains bald forever after healing. Scars are also often left on the scalp.
Above all, a strong infestation with head fungus affects the quality of life of many affected. They are ashamed of the bald spots on their heads and are therefore not infrequently psychologically stressed.
How do you treat head fungus?
For the treatment of head fungus, doctors usually recommend a combination of local therapy (e.g. in the form of shampoos, ointments or creams) and internal (systemic) treatment (e.g. in the form of tablets). The goals of treatment are to eliminate the causative agent, alleviate the symptoms and prevent permanent hair loss and further infection.
It is important during treatment that head fungus is treated as quickly as possible and for a long enough time. This is because the symptoms often subside quickly as a result of the treatment, which means that many patients discontinue therapy early. However, this makes it possible for the fungus to spread again. If pets are the carriers of the fungus, it is also necessary to treat them to prevent re-infection.
It is important to start treatment as soon as possible to prevent the fungal infection from spreading further and to reduce the risk of infection.
Shampoos, solutions and creams
First of all, the doctor treats head fungus externally with antifungal agents in the form of shampoos, solutions and creams that are applied locally to the skin. These kill the fungi (fungicidal) or inhibit fungal growth (fungistatic).
Active ingredients such as terbinafine, itraconazole and fluconazole are used, among others.
Tablets, drinking solutions and syringes
In most cases of head fungus, additional treatment with antifungal agents in the form of tablets, drinking solutions (suspensions) and syringes (injections) is necessary (systemic therapy). It is important to take the medication for a sufficiently long period of time until no more pathogens can be detected.
The treatment lasts from a few weeks to several months. Since some drugs rarely damage the liver, it is recommended that the doctor check your blood values regularly.
When treating head fungus, doctors recommend a combination of topical and systemic therapy with antifungal agents in most cases.
Antibiotics and cortisone
In the event of an infestation with bacteria, the doctor usually also prescribes antibiotics to be applied to the skin (e.g. ointments, creams). These inhibit the growth of bacteria (bacteriostatic antibiotics) or kill the pathogens (bactericidal antibiotics).
Treatment with cortisone (glucocorticosteroids) is rarely necessary if the scalp is severely inflamed. The patient applies these in the form of ointments, creams or solutions to the affected areas of the skin.
Home remedies
To relieve the irritation of the scalp and the itching of head fungus, some home remedies are also said to help. Cold compresses, an aloe vera gel or witch hazel gel have a cooling effect and can help relieve itching.
Do not scratch itchy areas of skin. This worsens symptoms and can lead to bacterial infection and inflammation.
When washing your hair, it is important not to use water that is too hot. This irritates the already stressed scalp and increases the itching. To shorten the duration of the treatment, it is often useful to cut long hair short.
Relaxation alleviates the symptoms of some sufferers. For example, autogenic training or progressive muscle relaxation can be used for this purpose.
The effects of home remedies have not been adequately proven scientifically. Head fungus cannot be treated with home remedies alone!
How does head fungus arise?
Head fungus occurs when skin fungi such as thread fungi (dermatophytes), molds (Aspergillus) and yeasts (Candida) attack the scalp and penetrate the hair follicles. Filamentous fungi, for example Microsporum canis, Trichophyton tonsurans, more rarely Trichophyton violaceum, often trigger the disease. In Germany, an increasing spread of the pathogen Microsporum canis can be observed, which cats and dogs mostly transmit.
How is head fungus transmitted?
In most cases, the infection comes from animals such as dogs, cats, hamsters, rabbits and guinea pigs. Farm calves are also potential vectors. The animals are infected with the pathogens that are transmitted to humans through direct contact. Children who play with animals in particular are often affected by head fungus and become a vector for other people. Since head fungus is very contagious, outbreaks are increasing in schools and kindergartens.
How does the doctor make a diagnosis?
To prevent permanent hair loss or scars from the head fungus, it is important to consult a doctor as early as possible at the first signs. If head fungus is suspected, the first point of contact is the family doctor. If necessary or for further examinations, he will refer you to a dermatologist.
Many other skin diseases (e.g. psoriasis, atopic eczema, seborrhea, contact eczema) have similar symptoms, but usually require fundamentally different treatment. That is why the doctor does a thorough examination.
Talk to the doctor
First, the doctor conducts a detailed discussion (anamnesis) with the person concerned. Among other things, he asks questions about existing skin problems and skin changes, for example where they first occurred, whether they occurred suddenly or have developed over a longer period of time. It is also important to know whether the patient has had contact with animals before. In addition, the doctor asks whether there are other diseases (e.g. psoriasis, neurodermatitis).
Physical examination
The doctor then examines the affected areas of the skin for visual abnormalities (e.g. redness). He examines the skin closely (e.g. with a special skin magnifier or a microscope) and scans it. Often the typical skin changes give the doctor the first indications of a fungal disease.
Creation of a mushroom culture
For a reliable diagnosis, the doctor then creates a fungal culture in order to determine the exact pathogen. To do this, he removes hair or hair stumps and flakes of skin from the affected area. In the laboratory, culture is grown on a special nutrient medium in order to determine the exact type of fungus. The fungal culture provides the doctor with important information about which pathogen it is and which drugs are effective against it.
Observation under UV light
Some fungi (e.g. dermatophytes) fluoresce when exposed to ultraviolet light. To do this, the doctor irradiates the affected part of the house in a darkened room with a so-called Wood lamp (also known as black light lamp or UV light). If there is an infection, the doctor will recognize this by the fact that the affected area glows yellow-green.
Family members and others who have been in close contact with people with head fungus should also be screened.
Is head fungus curable?
Head fungus usually develops over the course of a few days and, if treated early, disappears again after a few weeks. However, if the head fungus is not treated and the affected areas are already infected with fungi or bacteria, they may remain hairless (bald) forever after the inflammation has healed.
In some cases, if the infection is severe, it is possible that scars remain on the scalp. Therefore, consult a doctor as soon as possible at the first signs of head fungus.
Even if head fungus heals successfully, it is possible that you will be infected again!
How can you prevent head fungus?
In order to avoid infection with head fungus, there are a few things to consider. Fungal pathogens can remain viable for a long time in combs, brushes, towels, plush toys or on bedsheets. If a family member suffers from head fungus, you should therefore not use them together and disinfect them regularly. This also applies to the storage areas on which the objects lie.
It is best to wash laundry (e.g. pillow, towels, hats) at 95 degrees Celsius or use special hygiene detergents to safely kill the fungi. Avoid contact with animals that have bald, circular, scaly patches on their bodies.
As long as you have head fungus, you'd better avoid visiting the hairdresser. Infected children should go back to school or kindergarten at the earliest one week after the doctor has started therapy with them. Be sure to inform the school or kindergarten to alert parents and teachers of a possible infection.
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