Black Dot Ringworm of the Scalp: Signs and Treatment

It is a form of tinea capitis, not a worm and not ordinary dandruff. Because the fungus involves hair shafts and follicles, treatment generally requires a prescription antifungal taken by mouth.

Affected patches may show short broken hairs, dark stubs at scalp level, scale, itch and uneven hair loss. Some people develop tenderness, pustules or a soft boggy swelling when inflammation is stronger.

Other causes of broken hairs and patchy hair loss can look similar. A clinician may examine hairs and scalp scale under magnification or collect material for fungal testing to confirm the diagnosis and guide medicine choice.

Arrange medical care rather than relying on a skin cream. Topical antifungals do not reach an infection deep within the hair shaft well enough to serve as sole treatment, though an antifungal shampoo may be added to reduce spores on the scalp.

Take prescribed medicine exactly as directed and attend any requested monitoring. Do not share combs, brushes, hats, towels or pillowcases; clean hair tools and discuss whether close household contacts or pets have signs that need assessment.

Seek prompt assessment for a painful swollen scalp lump, pus, fever, rapidly spreading redness or increasing tenderness. Marked inflammation can damage follicles and may lead to lasting hair loss, so it should not wait for routine self-care.

Contact the prescriber if an antifungal medicine is followed by a widespread rash, facial swelling, breathing difficulty, yellowing of the eyes or skin, dark urine or severe vomiting.

Ask how the diagnosis will be confirmed, which oral medicine fits the suspected fungus, whether monitoring is needed, and when hair regrowth should be reassessed. Also ask how to handle shared hair equipment and whether anyone else in the household needs examination.