Ringworm is a type of fungus that likes keratin protein – the same protein that can be found in our hair, skin and nails. Because of this, these are the very areas that this fungus can invade and infect. 

When it comes to the scalp, it can cause tinea capitis or scalp ringworm, which can leave you with bald circular patches. It can also cause many other discomforting symptoms. 

The reason why you need to be careful about this infection is that it can spread very easily (it’s actually very common in children). And it may be some time before you even develop its symptoms. 

However, once you do, you must get treatment as soon as possible because it can lead to a more serious scarring alopecia. In this guide, you’ll learn more about ringworms and, in particular, ringworm hair loss on the scalp. 

What Is A Ringworm? 

Ringworm, which also goes by the name tinea or dermatophytosis, is a fungal infection of the skin and can even affect the hair and nails (fingers and toes). 

The reason why ringworm infects these areas is that it’s “keratinophilic” – it likes keratin-rich areas like the skin, hair, and nails. 

Depending on where the ringworm’s infected the body, there are different types of this infection, which are as follows: 

• Tinea capitis – ringworm of the scalp
• Tinea pedis – ringworm of the foot (athlete’s foot)
• Tinea corporis – ringworm of the body 
• Tinea barbae – ringworm of the beard hair (in men and women with hirsutism)
• Tinea unguium – ringworm of the nails 
• Tinea cruris – ringworm of groin and inner thighs (jock itch)
• Tinea manuum – ringworm of the hands (one or both)
• Tinea faciei – ringworm of the face 

Keep in mind that ringworm is a fungal infection, so there’s no worm or other parasite involved. Still, the reason why it’s so called is that the rash that it forms is circular in shape.

According to the Centers for Disease Control and Prevention (CDC), most of the ringworms don’t cause serious health problems. 

However, they can cause social and physical discomforts, especially if the infected individual’s immunity is compromised. 

Is A Ringworm Contagious?

Ringworm is a very contagious infection that you can get from an infected person, animal or object. In fact, according to WebMD, you don’t even have to physically touch someone to contract this infection. 

That’s because this fungus can linger, and that’s why, for instance, if you use the comb of an infected person, you can end up infected as well. Additionally, since this fungus thrives in damp and hot environments like gyms, saunas, public showers, and locker rooms.  

Also note that while anyone can get this infection, the following people might be more likely to get exposed to it:

• Those who work with animals
• Those who have a weak immune system 
• Those who play contact sports
• Those who have a poor personal hygiene 
• Those who’re on corticosteroids or chemo drugs. 

For the entirety of its 1-3 weeks incubation period – the time between the exposure to infection and the showing of its symptoms – the ringworm remains contagious. 

According to Seattle Children’s, it’s not contagious 2 days after the treatment, but you should further consult your doctor about it. 

What Causes Ringworm On The Scalp? 

Ringworm infection is caused due to transmission from another person. It can happen if you’ve sharing things with them, such as your clothes, bedding, hats, towels, or combs. 

Secondly, ringworm’s causes include infected animals, kittens and puppies, in particular. Also, if you work at a farm, you can get it from animals like cattle, sheep, and goats. And as mentioned above, since this fungus likes damp areas, you can get it from there as well. 

As far as scalp ringworm is concerned, according to StatPearls, it’s more commonly caused by two species of dermatophytes: Microsporum and Trichophyton. The former affects more girls than boys, while there are no sex-based differences when it comes to the latter.

Additionally, tinea capitis, which is the ringworm of the scalp, is more commonly found in Africa, Southeast Asia, and Central America (because of the heat and humidity). So, you might be more likely to get this infection if you live in such regions. 

What Are The Stages Of Ringworm Infection? 

Ringworm can incubate for 1-3 weeks. During this time, it’s possible that you don’t notice anything. 

However, in the early stages of the ringworm infection, you may start noticing your skin get scaly, red and raised. You can also go on to feel itchy, and the skin might also feel dry. 

In the initial ringworm stages, the size of the rash is also small at first. However, with time, it will grow larger in size. And while it can have a bumpy border, the centre of the rash is usually clear. 

This progression can be different depending on what area of the body has been affected. In the start of a ringworm of the scalp, you might only see a pimple-like bump at first. 

But then, it can go on to have dandruff-like flakes, and you can end up with a bald circular patch. In more severe cases, a pus-filled swelling can also form on the scalp (or other areas of the face and body), known as a kerion. 

Within this inflamed area, your hair may feel quite loose and come out more easily. This can also leave you with a bald patch. If this happens, with treatment, you can grow your hair back. But if you develop scarring, it can also cause permanent hair loss. 

What Are The Symptoms Of Ringworm? 

One of the main ringworm symptoms is the circular or ring-shaped rash it forms. However, this isn’t always the case. For instance, ringworm on nails isn’t circular. 

But other than a ringworm rash, you can also have: 

• Scaliness
• Redness

And if you’re wondering does ringworm itch, the answer to that is also yes. 

These ringworm symptoms, of course, vary depending on the area that’s been infected. For instance, on the scalp, you can also notice the formation of bald patches. 

Where the hair has broken off from the scalp, it can also leave a black dot behind. Moreover, you might have swollen lymph nodes on the neck or the back of the head. And you might feel pain. 

While these are some of the signs of a ringworm, it’s important to get checked by a medical professional for an accurate diagnosis. 

Does Ringworm Cause Hair Loss? 

The fungus that causes ringworm can invade the shaft of the hair since it contains the protein keratin. This can weaken your hair, making it more fragile and easily breakable. Moreover, if you have ringworm on scalp, the hair can be plucked out more easily. 

Ringworm hair loss can be clearly seen as bald circular patches on the scalp. It should be noted that there are two types of scalp ringworms: 

• Black dot – when hair breaks at the surface of the scalp. 
• Grey patch – when hair breaks above the surface of the scalp. 

If you develop a kerion, it can have crusting and be large and swollen. The reason why it develops is that there’s a strong immune response to the presence of this fungus. 

Unfortunately, this ringworm in the scalp can cause scarring. It is painful, and according to DermNet, it can be “several centimetres in diameter.”

Can Ringworm Cause Permanent Hair Loss?

Sometimes, ringworm can cause permanent hair loss. However, this happens in its inflammatory types. In this case, the following can cause scarring and permanent alopecia: 

• Kerion –  Without treatment, these swollen masses can cause scarring alopecia, and in that type of hair loss, hair follicles are destroyed, so they can’t grow back. 
• Favus – Favus, meaning honeycomb. is characterised by the presence of “scutula” or saucer-shaped yellow crusts that also cause scarring and extensive hair loss. 

It should be noted that in both of the above, early treatment may prevent the progression to scarring alopecia. Therefore, if you have ringworm on head, make sure to get help as soon as possible. 

Does Hair Loss From Ringworm Grow Back? 

It is possible for your hair to grow back following a ringworm infection. However, to make sure that this happens, you need to get treatment for the ringworm on your hair as soon as you can. 

If you delay the treatment, you can end up with permanent scarring alopecia. If you don’t have hair follicles left, you won’t be able to grow your hair again. 

How To Prevent Hair Loss From Ringworm? 

To prevent hair loss due to ringworms, you should consider doing the following: 

• Do not share your hair accessories, clothing, hats, scarves, combs, brushes, etc. with other people. 
• Make sure to wash your hair and scalp to keep it clean, and also dry it (since this fungus like damp environments) 
• If you’ve been in contact with someone who has this infection, consider wearing gloves and make sure to wash your hands. 

How To Treat Ringworm Hair Loss? 

For scalp ringworm treatment, you’ll need to take an oral antifungal. This can be griseofulvin, terbinafine, or itraconazole. The duration of treatment can be between 1-3 months, but it varies depending on the choice of the drug. 

In addition to the oral medication, your doctor might also recommend an antifungal shampoo with selenium sulfide or ketoconazole. While it’s not a treatment for the fungal itself, it may help curb its spread. 

Some remedies are also touted as the best ringworm treatments, such as those with turmeric, aloe vera, garlic, etc. However, you must be cautious about using them for the healing of ringworm because of lack of research. You must consult your doctor first. 

Conclusion 

Because it’s highly contagious, you need to be very careful about ringworm infection. And you must keep in mind that you need to be in touch with someone to get this fungus. It can even linger in certain environments that allow it to thrive. 

Depending on which part of the body it affects, there are different types of ringworms. However, the one affecting the scalp is known as tinea capitis. If you have this ringworm, you might notice bald circular patches on your scalp. 

Fortunately, with treatment, your hair should grow back. However, if left untreated, in some cases, it can cause scarring and permanent alopecia. 

If you have this and are considering hair transplant in Istanbul or elsewhere, you must first consult a board-certified and experienced dermatologist. Before you even get to the treatment part, you need to get an accurate diagnosis of your problem. 

Reviewed and Approved by Trichologist Yaprak Yazan

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