Tinea capitis is a fungal infection of the scalp, often called scalp ringworm, and it can cause patchy hair loss. It is most common in children, but adults get it too, and in older adults it is often mistaken for other scalp conditions. Unlike pattern hair loss, it usually comes with scaling, itch or inflamed patches, and it needs prescription treatment rather than a wait-and-see log.
Treated in time, it usually clears. Left too long, it can lead to scarring hair loss. This page explains how it differs from pattern thinning and what to note before you see a doctor.
TL;DR
- Tinea capitis is a fungal scalp infection that can cause patchy hair loss with scaling, itch or swelling.
- It is most common in children before puberty, but it is reported in adults and older adults.
- Scalp ringworm usually needs prescription antifungal tablets; creams alone are not enough.
- Diagnosis needs testing, because it can look like seborrheic dermatitis and other conditions.
- Pattern hair loss does not scale, itch or form inflamed patches. If yours does, see a doctor first.
Important
This article is educational and not medical advice. If you are worried about sudden shedding, scalp symptoms, or side effects, talk to a licensed clinician.
What it looks like
Ringworm on the skin is usually a ring-shaped rash that can be scaly, dry, swollen or itchy, and on the scalp it can look different and may cause patchy hair loss, according to the NHS (NHS: ringworm). Some people develop a kerion, a swollen and inflamed patch.
Tinea capitis and ringworm of the body are most common in children before puberty. Diagnosis by appearance alone can be unreliable, because other conditions look similar, and oral antifungal tablets are used when the infection involves the hair follicles, as it does on the scalp (Caplan and colleagues, 2025).
Adults can get it too
A 2025 systematic review collected 91 reported cases of tinea capitis in people aged 65 or older from 19 countries. Most were women. Misdiagnosis happened in 37.4 percent, most often as seborrheic dermatitis or another scalp condition, and inflamed forms were common, with a kerion in 42.9 percent. Oral antifungal treatment cured 91.2 percent. The authors stress that the infection is underrecognised in older adults and that testing is key to prevent scarring hair loss (Valdez-Martinez and colleagues, 2025).
Ringworm or pattern hair loss?
- Scalp surface: ringworm often scales, flakes or looks inflamed. Pattern hair loss leaves a normal-looking scalp.
- Shape: ringworm causes patches. Pattern loss thins gradually at the hairline, temples or crown.
- Symptoms: itch, tenderness or swelling point toward infection or inflammation. Pattern loss does not hurt.
- Contacts: a pet with patches of missing fur, or a family member with ringworm, raises the chance of infection.
For other conditions that cause patches, see alopecia areata vs androgenetic alopecia.
Treatment and spread
The NHS advises seeing a GP for ringworm on the scalp, because it usually needs prescription antifungal tablets and shampoo. It also advises not sharing towels, combs or bedsheets with someone who has ringworm, and taking a pet to the vet if it might have it (NHS: ringworm). The American Academy of Dermatology has more on how ringworm spreads (AAD: ringworm overview). Which medicine, and for how long, is your doctor's decision.
What to record
- Photos of each patch: close and from a set distance, in the same light, with the date.
- Symptoms: itch, pain, swelling or oozing.
- Possible sources: pets, children in the home, shared combs or hats, a recent barber visit.
- Treatment dates: when you started what your doctor prescribed and when you stopped.
- Regrowth: once treated, the same patch photographed every few weeks shows whether hair returns.
Keep the comparison fair with matched photos. See comparing hair photos without bias.
When to see a doctor
See a GP or dermatologist for any scaly, itchy or inflamed patch with hair loss, and sooner for a swollen, painful or oozing patch. Do not rely on creams you have at home. A 2025 review advises against combination antifungal and steroid creams (Caplan and colleagues, 2025). See also when to see a dermatologist for hair loss.
Next step
Photograph the patch today, note when it started and any pets or contacts, and book an appointment. That record helps the doctor decide which tests to run.
Related reading
- Alopecia areata vs androgenetic alopecia
- Seborrheic dermatitis and hair shedding
- When to see a dermatologist for hair loss
Sources: NHS: ringworm; AAD: ringworm overview; Caplan et al. 2025, American Family Physician; Valdez-Martinez et al. 2025, Antibiotics.
