Fungus on the scalp and hair loss: what to know

Scalp ringworm is a contagious fungal infection that can involve the skin and hair shafts. It may produce round or irregular patches with flaking, tenderness, black dots from broken hairs, or swollen areas. Hair loss from inflammation may improve after the infection is controlled, although a severe or prolonged infection can scar follicles. Hair loss without scale or itch may have another explanation, such as alopecia areata, pattern hair loss, telogen effluvium, or traction alopecia.

Arrange an assessment with a dermatologist or clinician rather than treating the scalp with random creams. Diagnosis may involve examining the scalp and taking a small sample of scale or hair. Scalp ringworm commonly requires a prescription medicine taken by mouth because treatment must reach infected hairs; an antifungal shampoo may be added to reduce spread. Do not share combs, hats, pillows, or hair tools, and wash items that touch the scalp. Household members or pets may need assessment if infection is suspected.

Seek prompt medical care for a painful boggy swelling, pus, fever, rapidly expanding patches, marked tenderness, or swollen glands. These features can signal a stronger inflammatory response and a risk of follicle damage. Arrange review for any new patch of hair loss with scale, broken hairs, or crusting, particularly after contact with an affected person or animal.

Ask whether the pattern fits scalp ringworm or another cause of hair loss, whether a sample is needed, how long treatment should continue, and when regrowth can be assessed. Mention recent contact with children, household members, pets, shared hair tools, and any medicines or liver problems.