Overview

Tinea capitis is a fungal infection of the scalp and hair shaft, primarily affecting children aged 3-14. Caused by dermatophyte fungi (mainly Trichophyton and Microsporum species), it is contagious and can cause permanent hair loss if not treated promptly. It is common in Kuwait's schools and nurseries.

Symptoms

• Scaly ring-shaped patches on scalp; broken-off hair shafts leaving black dots
• Patchy hair loss with scaling; itching and tenderness
• Kerion: severe boggy pustular mass requiring urgent treatment
• Swollen cervical lymph nodes

Causes & Risk Factors

• Trichophyton species: spread human-to-human
• Microsporum canis: spread from cats and dogs (common in Kuwait households)
• Transmission: direct skin contact, sharing combs/hats/pillowcases/towels, school and nursery settings

Complications

• Kerion causing permanent scarring and hair loss if untreated
• Secondary bacterial infection; spread to school or household contacts

Diagnosis

Clinical exam. Wood's lamp: Microsporum species fluoresce green. KOH microscopy of scraped scales. Fungal culture: gold standard, takes 2-4 weeks.

Treatment

• Oral antifungals always required — topicals alone are insufficient
• Griseofulvin: 6-8 weeks; terbinafine (oral): preferred for Trichophyton, shorter course
• Antifungal shampoo (ketoconazole/selenium sulfide) as adjunct to reduce spore shedding
• Children can return to school 48 hours after starting oral treatment

Prevention

• Don't share combs, hats, pillowcases, or towels
• Treat infected pets promptly — see a vet
• Screen siblings and household contacts; notify school authorities

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