Ringworm on an African American scalp: what to know

Scalp ringworm is a fungal infection of the skin and hair shafts. It may present with a scaly or tender patch, itching, small bumps, black dots where hairs have broken, or areas that look thinner. Hair texture, tight hairstyles, and darker skin can make early changes harder to spot, so a close examination is useful. A scalp rash is a common presentation of scalp ringworm, but other scalp conditions can look similar.

Because the infection involves hair, creams alone may not reach the affected area adequately. A clinician may inspect the scalp and take skin or hair samples before choosing treatment.

Arrange a medical assessment rather than sharing combs, brushes, hats, pillows, or hair tools. Wash bedding and towels regularly, avoid scratching, and do not apply steroid cream alone to an undiagnosed rash. A clinician may prescribe an oral antifungal course; an antifungal shampoo can sometimes reduce spread but does not replace prescribed medicine. See [Ringworm](/conditions/ringworm/) and [Oral Antifungal Treatment](/treatments/medical-dermatology/oral-antifungal-therapy/) for related information.

Seek prompt care for painful swelling, pus, fever, rapidly spreading inflammation, or a soft boggy lump on the scalp. These changes can signal a stronger inflammatory reaction and may increase the risk of scarring hair loss. Also arrange an assessment soon if hair is coming out in patches, a child has a new scaly scalp area, or symptoms continue despite treatment.

Ask whether the scalp and hairs need testing, which medicine is appropriate, how to use any antifungal shampoo, and whether household members or pets should be checked. Mention recent salon tools, shared headwear, close contacts with a similar rash, allergies, liver problems, and all medicines you take.