What should you know about ring worms in hair?

Scalp ringworm affects the skin and hair shafts rather than being a worm. It may appear as itchy, scaly areas, black dots where hairs have broken close to the scalp, or patches where hair looks thinner. Tender swelling, crusting or pus can occur in a stronger inflammatory reaction. A clinician may examine the scalp and use a hair or skin sample to distinguish fungal infection from conditions such as eczema, psoriasis or bacterial inflammation.

The infection can spread through close contact and through shared combs, brushes, hats, pillows or towels. Children are often affected, but adults can develop it too. A scalp rash or scaling pattern does not by itself confirm ringworm, so avoid treating an uncertain diagnosis with leftover medication.

Arrange a dermatology or primary-care assessment, especially when there is patchy hair loss, broken hairs or a spreading scaly area. Scalp infection commonly requires an oral antifungal medicine because creams do not reliably reach the fungus inside hair shafts. A clinician may also recommend an antifungal shampoo to reduce spores on the scalp and limit spread; use it exactly as directed.

Do not share hair tools, headwear, towels or bedding while infection is being assessed. Wash and dry these items regularly, clean combs and brushes, and check household members or pets if more than one person has symptoms. Do not shave the scalp unless a clinician advises it, and avoid scratching areas that are sore or crusted.

Seek prompt medical care for a painful, boggy or rapidly enlarging scalp swelling, pus, marked crusting, fever, or swollen glands in the neck. These features can signal a strong inflammatory response and may increase the risk of scarring hair loss if treatment is delayed. Arrange an appointment soon for persistent itching, scaling, broken hairs or new bald patches, even if the scalp is not painful.

If treatment has started but symptoms are worsening, new areas appear, or medicine causes a concerning reaction, contact the prescribing clinician. Hair regrowth can take time after the infection is controlled, and scarring areas may need specialist follow-up.

Ask whether the scalp needs a fungal test, which treatment reaches the hair shaft, how long to use any shampoo, and when it is safe to return to shared activities. Mention medicines, liver problems, pregnancy or breastfeeding, and tell the clinician about affected family members or pets.