Tinea capitis (ringworm): diagnosis, griseofulvin and antifungal treatment | Clinique Omicron<\/title>\n<meta name=\"description\" content=\"Tinea capitis is a dermatophytosis of the scalp causing alopecic scaly patches and kerion. Microsporum Trichophyton, griseofulvin terbinafine itraconazole and school expulsion in Quebec.\">\n<meta name=\"keywords\" content=\"tinea capitis, teigne cuir chevelu, tinea capitis traitement, gris\u00e9ofulvine teigne, k\u00e9rion teigne, tinea capitis enfant, Microsporum canis, Trichophyton tonsurans, teigne antifongique, tinea capitis Qu\u00e9bec\">\n<link rel=\"preconnect\" href=\"https:\/\/fonts.googleapis.com\">\n<link href=\"https:\/\/fonts.googleapis.com\/css2?family=Cinzel:wght@600&family=Poppins:wght@400;500;600;700&display=swap\" rel=\"stylesheet\">\n<style>\n@import url('https:\/\/fonts.googleapis.com\/css2?family=Cinzel:wght@600&family=Poppins:wght@400;500;600;700&display=swap');\n\n.co-wrap * {\n font-family: 'Poppins', sans-serif;\n box-sizing: border-box;\n}\n.co-wrap {\n max-width: 1100px;\n margin: 0 auto;\n padding: 30px 0 60px;\n margin-top: 10px;\n}\n.co-label {\n font-family: 'Cinzel', serif;\n font-size: 14px;\n font-weight: bold;\n letter-spacing: 1px;\n text-transform: uppercase;\n color: #4D6577;\n margin-bottom: 14px;\n display: block;\n}\n.co-wrap h1 {\n font-size: 32px;\n font-weight: 500;\n color: #323C52;\n margin: 0 0 22px;\n line-height: 1.2;\n letter-spacing: 0.5px;\n}\n.co-intro {\n font-size: 16px;\n font-weight: 400;\n line-height: 1.75;\n color: #4D6577;\n margin-bottom: 36px;\n padding-bottom: 32px;\n border-bottom: 1px solid rgba(77,101,119,.2);\n}\n.co-wrap h2 {\n font-size: 20px;\n font-weight: 600;\n color: #323C52;\n margin: 32px 0 12px;\n letter-spacing: 0.3px;\n}\n.co-wrap p {\n font-size: 15px;\n font-weight: 400;\n color: #4D6577;\n line-height: 1.7;\n margin-bottom: 14px;\n}\n.co-list {\n list-style: none;\n padding: 0;\n margin: 12px 0 24px;\n}\n.co-list li {\n font-size: 15px;\n font-weight: 400;\n color: #4D6577;\n padding: 10px 14px 10px 38px;\n margin-bottom: 8px;\n border-radius: 6px;\n position: relative;\n background: rgba(77,101,119,.06);\n border-left: 3px solid #4D6577;\n}\n.co-list li::before {\n content: \"\u2713\";\n position: absolute;\n left: 12px;\n font-weight: 700;\n color: #4D6577;\n}\n.co-table {\n width: 100%;\n border-collapse: collapse;\n margin: 14px 0 22px;\n font-size: 14px;\n border-radius: 8px;\n overflow: hidden;\n}\n.co-table thead tr {\n background: #323C52;\n color: #fff;\n}\n.co-table thead th {\n padding: 11px 16px;\n text-align: left;\n font-weight: 600;\n font-size: 13px;\n}\n.co-table tbody tr:nth-child(even) {\n background: rgba(77,101,119,.06);\n}\n.co-table tbody tr:nth-child(odd) {\n background: #fff;\n}\n.co-table td {\n padding: 10px 16px;\n color: #4D6577;\n border-bottom: 1px solid rgba(77,101,119,.12);\n font-size: 14px;\n vertical-align: top;\n}\n.co-table td:first-child {\n font-weight: 600;\n color: #323C52;\n}\n.co-infobox {\n display: flex;\n gap: 12px;\n background: rgba(77,101,119,.06);\n border-radius: 8px;\n border-left: 4px solid #4D6577;\n padding: 14px 18px;\n margin: 18px 0 28px;\n font-size: 14px;\n font-weight: 400;\n color: #4D6577;\n line-height: 1.65;\n}\n.co-infobox .ico {\n font-size: 18px;\n flex-shrink: 0;\n}\n.co-urgence {\n background: #fff8f8;\n border-left: 5px solid #c0392b;\n border-radius: 6px;\n padding: 20px 26px;\n margin: 24px 0 32px;\n}\n.co-urgence .co-urgence-titre {\n font-size: 13px;\n font-weight: 700;\n color: #c0392b;\n letter-spacing: 1.5px;\n text-transform: uppercase;\n margin-bottom: 10px;\n}\n.co-urgence p {\n color: #5a2020;\n font-size: 14px;\n margin: 0 0 10px;\n line-height: 1.7;\n}\n.co-urgence p:last-child {\n margin-bottom: 0;\n}\n.co-disclaimer {\n font-size: 13px;\n color: #8a9aaa;\n font-style: italic;\n border-top: 1px solid rgba(77,101,119,.15);\n padding-top: 24px;\n margin-top: 40px;\n line-height: 1.6;\n}\n<\/style>\n<\/head>\n<body>\n<div class=\"co-wrap\">\n\n <span class=\"co-label\">Dermatology & Pediatrics & Family Medicine<\/span>\n <h1>Tinea capitis (ringworm of the scalp)<\/h1>\n\n <div class=\"co-intro\">\n Tinea capitis\u2014commonly known as scalp ringworm\u2014is a superficial fungal infection of the scalp, hair follicles, and hair caused by dermatophytes of the genus <em>Microsporum<\/em> (mainly <em>M. canis<\/em> - of animal origin: cats + dogs) and <em>Trichophyton<\/em> (mainly <em>T. tonsurans<\/em> - of human origin + inter-human transmission + predominant in North America + Africa + Afro-American and African populations) + which invade the keratin of the hair shaft + follicle + and sometimes the scalp itself. Tinea capitis almost exclusively affects prepubertal children (aged 3-12) - adult resistance being attributed to the long-chain fatty acids produced by post-pubertal sebaceous glands, which have fungistatic activity - and is the most common dermatophytosis in children worldwide + with a particularly high prevalence in African and African-American communities. Its fundamental therapeutic feature distinguishes tinea capitis from all other cutaneous dermatophytoses: topical antifungals alone are INEFFECTIVE because they don't penetrate the hair follicle sufficiently \u2192 systemic oral treatment is mandatory to reach the fungus in the hair shaft and follicle. Diagnosis is often delayed because the clinical presentation is polymorphous - ranging from simple, barely symptomatic scales (mimicking psoriasis or seborrheic dermatitis) to severe inflammatory alopeciating lesions (kerion) that can lead to permanent scarring alopecia if not treated promptly.\n <\/div>\n\n <h2>Clinical forms<\/h2>\n <ul class=\"co-list\">\n <li><strong>Microsporum moth (Microsporum spp.) :<\/strong> large single or few + well-defined circular plaques + diameter 2-6 cm + broken hair a few mm from the scalp + dull + greyish hair + whitish scales + green-yellow fluorescence under the Wood's lamp (characteristic of Microsporum - not found with Trichophyton) + moderate pruritus<\/li>\n <li><strong>Ringworm of the scalp (Trichophyton spp. \u2014 T. tonsurans):<\/strong> small, multiple, irregular, poorly defined patches + grey scales + broken hair flush with the scalp (black dots - \u00abblack dot tinea\u00bb = stumps of broken hair visible as black dots in the follicle) + little or no Wood's lamp fluorescence + variable pruritus + sometimes mildly inflammatory picture resembling seborrheic dermatitis or scalp psoriasis \u2192 frequent cause of delayed diagnosis<\/li>\n <li><strong>Inflammatory ringworm \u2014 Kerion of Celsus<\/strong> intense inflammatory reaction (hypersensitivity to fungal antigens) \u2192 erythematous + oozing + crusty + painful + suppurative plaque (pus draining from follicles on pressure) + alopecia of affected area + reactive cervical or sub-occipitaloccipital adenopathies + fever possible + may appear bacterial (impetiginized) but is mainly fungal + systemic antifungal treatment ++ + corticoids to reduce inflammation and prevent scarring alopecia<\/li>\n <li><strong>Favus (ringworm \u2014 Trichophyton schoenleinii):<\/strong> rare chronic form + scutules (cup-shaped yellowish crusts around the follicle) + characteristic mouse-like odor + scarring alopecia + endemic regions (North Africa + Middle East)<\/li>\n <\/ul>\n\n <h2>Pathogen agents by geography and source<\/h2>\n\n <table class=\"co-table\">\n <thead>\n <tr>\n <th>Agent<\/th>\n <th>Source<\/th>\n <th>Geographic zones<\/th>\n <th>Wood lamp<\/th>\n <\/tr>\n <\/thead>\n <tbody>\n <tr>\n <td>Trichophyton tonsurans<\/td>\n <td>Human (anthropophilic) \u2014 child-to-child transmission + sharing of accessories (combs + hats + pillows)<\/td>\n <td>North America ++ + United Kingdom + Sub-Saharan Africa + African American populations<\/td>\n <td>Negative (no fluorescence)<\/td>\n <\/tr>\n <tr>\n <td>Microsporum canis<\/td>\n <td>Animal (zoophile) \u2014 cats + dogs + kittens ++ + direct contact with animal<\/td>\n <td>Europe + Canada + Latin America + Mediterranean<\/td>\n <td>Positive \u2014 characteristic yellow-green fluorescence<\/td>\n <\/tr>\n <tr>\n <td>Microsporum audouinii<\/td>\n <td>Human (anthropophile)<\/td>\n <td>West Africa + Europe (in decline)<\/td>\n <td>Positive \u2014 yellow-green fluorescence<\/td>\n <\/tr>\n <tr>\n <td>Trichophyton violaceum<\/td>\n <td>Human (anthropophile)<\/td>\n <td>North Africa + Middle East + Central Asia<\/td>\n <td>Negative<\/td>\n <\/tr>\n <\/tbody>\n <\/table>\n\n <h2>Diagnosis<\/h2>\n <ul class=\"co-list\">\n <li><strong>Clinical examination + Wood's lamp :<\/strong> green-yellow fluorescence = Microsporum (darkroom examination) + absence of fluorescence = Trichophyton (majority in North America) \u2192 do not exclude tinea capitis on a negative Wood's lamp<\/li>\n <li><strong>Fungal sample collection:<\/strong> scalp scraping (scales + broken hair) + fresh state (KOH 10-20 %) \u2192 visualization of spores arranged in a sleeve around the hair shaft (ectothrix - Microsporum) or inside (endothrix - Trichophyton) + culture on Sabouraud medium (2-4 weeks) \u2192 species identification + antifungus if resistance suspected<\/li>\n <li><strong>Mycological PCR :<\/strong> available in certain reference laboratories \u2192 rapid identification + higher sensitivity than culture<\/li>\n <li><strong>Biopsy (kerion):<\/strong> rarely necessary + sometimes useful if there is any doubt about the diagnosis of a bacterial abscess or decalcifying folliculitis<\/li>\n <\/ul>\n\n <h2>Treatment<\/h2>\n <ul class=\"co-list\">\n <li><strong>Absolute rule:<\/strong> ORAL antifungal treatment is mandatory - topical antifungals alone (clotrimazole + miconazole + terbinafine cream) are INEFFECTIVE on tinea capitis because they do not penetrate the hair follicle where the fungi are located.<\/li>\n <li><strong>Griseofulvin (historical treatment of choice - particularly effective against Microsporum):<\/strong> 20-25 mg\/kg\/day (micronized) + or 10-15 mg\/kg\/day (ultramicronized) \u00d7 6-12 weeks (Microsporum) + or \u00d7 6-8 weeks (Trichophyton) + with a fatty meal (increased absorption) + effective on Microsporum canis ++ + less effective on T. tonsurans + monitoring: CBC + transaminases if prolonged treatment<\/li>\n <li><strong>Terbinafine (gold standard treatment for T. tonsurans \u2014 North America):<\/strong> 125 mg\/day if 40 kg \u00d7 4\u20136 weeks + more effective than griseofulvin on Trichophyton (meta-analyses) + less effective on Microsporum \u2192 adapt according to the identified species<\/li>\n <li><strong>Itraconazole (alternative - effective on both genders):<\/strong> 5 mg\/kg\/day \u00d7 4-8 weeks + or pulsed regimen (5 mg\/kg\/day \u00d7 1 week\/month \u00d7 2-3 cycles) + effective on Microsporum AND Trichophyton<\/li>\n <li><strong>Fluconazole (less well-documented alternative):<\/strong> 6 mg\/kg\/week \u00d7 8-12 weeks + or 6 mg\/kg\/day \u00d7 3-4 weeks<\/li>\n <li><strong>Adjuvant antifungal shampoo (ketoconazole 2% or selenium sulfide 2.5%):<\/strong> 2-3 times\/week \u00d7 all treatment times + reduces spore load + reduces contagiousness + reduces transmission to contacts + DOES NOT replace oral treatment<\/li>\n <li><strong>Kerion \u2014 specific treatment:<\/strong> systemic antifungal (terbinafine or griseofulvin depending on species) + prednisone 1 mg\/kg\/d \u00d7 1-2 weeks to reduce inflammation and prevent scarring + DO NOT incise-drain (aggravates) + DO NOT prescribe antibiotics alone (fungal, not bacterial cause)<\/li>\n <li><strong>Contacts - Decontamination Measures<\/strong> examine symptomatic contacts (brothers + sisters + classmates) + treat carrier contacts (possible asymptomatic carriage of T. tonsurans - prevalence 30-50 % in close contacts) with antifungal shampoo \u00d7 4-6 weeks + possibly oral antifungal if confirmed carriage + check and treat pet if Microsporum canis (veterinarian)<\/li>\n <li><strong>School expulsion:<\/strong> in Quebec - the child can return to school as soon as the oral antifungal treatment is initiated (no prolonged eviction) + but wearing a hat is not recommended (promotes heat + humidity) \u2192 information at school<\/li>\n <\/ul>\n\n <div class=\"co-infobox\">\n <span class=\"ico\">\u2119\ufe0f<\/span>\n <span>Celsus' kerion is often confused with a bacterial abscess or bacterial folliculitis, leading to inappropriate antibiotic prescriptions and delayed antifungal treatment. Kerion is a hypersensitivity reaction to fungal antigens within the follicle; it weeps profusely upon pressure, but bacterial cultures are typically sterile (or show secondary superinfection). Treatment should be with systemic antifungals plus anti-inflammatory corticosteroids to prevent scarring alopecia. Never incise a kerion.<\/span>\n <\/div>\n\n <div class=\"co-urgence\">\n <div class=\"co-urgence-titre\">Medical consultation recommended<\/div>\n <p>Consult a doctor if a child has scaly or hair-loss patches on the scalp that persist for more than 2 weeks, especially if black dots (stumps of broken hairs) are visible in the patches, or if a painful, oozing, crusted lesion of the scalp develops (kerion) \u2014 these conditions require systemic antifungal treatment to prevent scarring alopecia. Topical antifungals alone are insufficient. For diagnosis and prescription of oral antifungal treatment adapted to the species, Clinique Omicron offers medical consultations at its service points in Quebec and via telemedicine. To make an appointment, visit <a href=\"https:\/\/cliniqueomicron.ca\" style=\"color:#c0392b;font-weight:600;text-decoration:none;\">cliniqueomicron.ca<\/a>.<\/p>\n <\/div>\n\n <h2>Consult at Clinique Omicron<\/h2>\n <p>Clinique Omicron's physician assistants and nurse practitioners (PAs\/NPs) diagnose tinea capitis through clinical examination (Wood's lamp + mycological sampling), prescribe oral antifungal treatment appropriate for the suspected species (griseofulvin for Microsporum + terbinafine for T. tonsurans) plus an adjunctive antifungal shampoo, treat kerion with systemic antifungals + corticosteroids, inform about decontamination of contacts and pets, and specify conditions for returning to school. Consultations are available at several service points across Quebec and via telemedicine. To book an appointment, visit <a href=\"https:\/\/cliniqueomicron.ca\" style=\"color:#4D6577;font-weight:600;text-decoration:none;\">cliniqueomicron.ca<\/a>.<\/p>\n\n <p class=\"co-disclaimer\">The content of this page is for informational purposes only and is not a substitute for medical or dermatological advice. Topical antifungals are insufficient to treat tinea capitis\u2014systemic oral treatment is mandatory. Kerion should never be incised-drained nor treated with antibiotics alone\u2014it is a dermatological emergency requiring systemic antifungal treatment + corticosteroids.<\/p>\n\n<\/div>\n<\/body>\n<\/html>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>","protected":false},"excerpt":{"rendered":"<p>Tinea capitis (teigne du cuir chevelu) : diagnostic, gris\u00e9ofulvine et traitement antifongique | Clinique Omicron Dermatologie & P\u00e9diatrie & M\u00e9decine de famille Tinea capitis (teigne du cuir chevelu) La tinea capitis \u2014 commun\u00e9ment d\u00e9sign\u00e9e teigne du cuir chevelu \u2014 est une dermatophytose (infection fongique superficielle) du cuir chevelu + des follicules pileux + et des… <a href=\"https:\/\/cliniqueomicron.ca\/en\/teigne\/\" rel=\"bookmark\">Read More \"<span class=\"screen-reader-text\">Tinea capitis (ringworm): diagnosis, griseofulvin and antifungal treatment | Clinique Omicron<\/span><\/a><\/p>","protected":false},"author":1,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"om_disable_all_campaigns":false,"_monsterinsights_skip_tracking":false,"_monsterinsights_sitenote_active":false,"_monsterinsights_sitenote_note":"","_monsterinsights_sitenote_category":0,"neve_meta_sidebar":"","neve_meta_container":"","neve_meta_enable_content_width":"off","neve_meta_content_width":100,"neve_meta_title_alignment":"","neve_meta_author_avatar":"","neve_post_elements_order":"","neve_meta_disable_header":"","neve_meta_disable_footer":"","neve_meta_disable_title":"","_themeisle_gutenberg_block_has_review":false,"_metasync_otto_title":"Teigne (tinea capitis) | Brossard | Clinique Omicron","_metasync_otto_description":"Teigne (tinea capitis) Teigne (tinea capitis) est une condition m\u00e9dicale qui peut n\u00e9cessiter une \u00e9valuation et un suivi m\u00e9dical appropri\u00e9s. Nos professionnel...","_metasync_otto_keywords":"teigne, Clinique Omicron, clinique m\u00e9dicale Qu\u00e9bec, m\u00e9decin g\u00e9n\u00e9raliste Montr\u00e9al, Qu\u00e9bec","_metasync_otto_og_title":"Teigne | Clinique Omicron Qu\u00e9bec","_metasync_otto_og_description":"Teigne (tinea capitis) Teigne (tinea capitis) est une condition m\u00e9dicale qui peut n\u00e9cessiter une \u00e9valuation et un suivi m\u00e9dical appropri\u00e9s. Nos professionnel...","_metasync_otto_twitter_title":"Teigne | Clinique Omicron","_metasync_otto_twitter_description":"Teigne (tinea capitis) Teigne (tinea capitis) est une condition m\u00e9dicale qui peut n\u00e9cessiter une \u00e9valuation et un suivi m\u00e9dical appropri\u00e9s. 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Microsporum canis lampe Wood fluorescence T. tonsurans points noirs, gris\u00e9ofulvine Microsporum terbinafine Trichophyton, k\u00e9rion cortico\u00efdes au Qu\u00e9bec.","_metasync_seo_title":"","_metasync_seo_desc":"","_metasync_breadcrumb_title":"","_metasync_primary_category":0,"_metasync_primary_product_cat":0,"_metasync_otto_disabled":"","_metasync_hreflang":"","_metasync_plugin_sync_ts":"{\"aioseo\":\"2026-05-04T15:32:09+00:00\"}","_metasync_robots_advanced":"","footnotes":""},"class_list":["post-24997","page","type-page","status-publish","hentry"],"aioseo_notices":[],"_links":{"self":[{"href":"https:\/\/cliniqueomicron.ca\/en\/wp-json\/wp\/v2\/pages\/24997","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/cliniqueomicron.ca\/en\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/cliniqueomicron.ca\/en\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/cliniqueomicron.ca\/en\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/cliniqueomicron.ca\/en\/wp-json\/wp\/v2\/comments?post=24997"}],"version-history":[{"count":4,"href":"https:\/\/cliniqueomicron.ca\/en\/wp-json\/wp\/v2\/pages\/24997\/revisions"}],"predecessor-version":[{"id":32194,"href":"https:\/\/cliniqueomicron.ca\/en\/wp-json\/wp\/v2\/pages\/24997\/revisions\/32194"}],"wp:attachment":[{"href":"https:\/\/cliniqueomicron.ca\/en\/wp-json\/wp\/v2\/media?parent=24997"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}

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Microsporum Trichophyton, griseofulvin terbinafine itraconazole and school expulsion in Quebec.\">\n<meta name=\"keywords\" content=\"tinea capitis, teigne cuir chevelu, tinea capitis traitement, gris\u00e9ofulvine teigne, k\u00e9rion teigne, tinea capitis enfant, Microsporum canis, Trichophyton tonsurans, teigne antifongique, tinea capitis Qu\u00e9bec\">\n<link rel=\"preconnect\" href=\"https:\/\/fonts.googleapis.com\">\n<link href=\"https:\/\/fonts.googleapis.com\/css2?family=Cinzel:wght@600&family=Poppins:wght@400;500;600;700&display=swap\" rel=\"stylesheet\">\n<style>\n@import url('https:\/\/fonts.googleapis.com\/css2?family=Cinzel:wght@600&family=Poppins:wght@400;500;600;700&display=swap');\n\n.co-wrap * {\n font-family: 'Poppins', sans-serif;\n box-sizing: border-box;\n}\n.co-wrap {\n max-width: 1100px;\n margin: 0 auto;\n padding: 30px 0 60px;\n margin-top: 10px;\n}\n.co-label {\n font-family: 'Cinzel', serif;\n font-size: 14px;\n font-weight: bold;\n letter-spacing: 1px;\n text-transform: uppercase;\n color: #4D6577;\n margin-bottom: 14px;\n display: block;\n}\n.co-wrap h1 {\n font-size: 32px;\n font-weight: 500;\n color: #323C52;\n margin: 0 0 22px;\n line-height: 1.2;\n letter-spacing: 0.5px;\n}\n.co-intro {\n font-size: 16px;\n font-weight: 400;\n line-height: 1.75;\n color: #4D6577;\n margin-bottom: 36px;\n padding-bottom: 32px;\n border-bottom: 1px solid rgba(77,101,119,.2);\n}\n.co-wrap h2 {\n font-size: 20px;\n font-weight: 600;\n color: #323C52;\n margin: 32px 0 12px;\n letter-spacing: 0.3px;\n}\n.co-wrap p {\n font-size: 15px;\n font-weight: 400;\n color: #4D6577;\n line-height: 1.7;\n margin-bottom: 14px;\n}\n.co-list {\n list-style: none;\n padding: 0;\n margin: 12px 0 24px;\n}\n.co-list li {\n font-size: 15px;\n font-weight: 400;\n color: #4D6577;\n padding: 10px 14px 10px 38px;\n margin-bottom: 8px;\n border-radius: 6px;\n position: relative;\n background: rgba(77,101,119,.06);\n border-left: 3px solid #4D6577;\n}\n.co-list li::before {\n content: \"\u2713\";\n position: absolute;\n left: 12px;\n font-weight: 700;\n color: #4D6577;\n}\n.co-table {\n width: 100%;\n border-collapse: collapse;\n margin: 14px 0 22px;\n font-size: 14px;\n border-radius: 8px;\n overflow: hidden;\n}\n.co-table thead tr {\n background: #323C52;\n color: #fff;\n}\n.co-table thead th {\n padding: 11px 16px;\n text-align: left;\n font-weight: 600;\n font-size: 13px;\n}\n.co-table tbody tr:nth-child(even) {\n background: rgba(77,101,119,.06);\n}\n.co-table tbody tr:nth-child(odd) {\n background: #fff;\n}\n.co-table td {\n padding: 10px 16px;\n color: #4D6577;\n border-bottom: 1px solid rgba(77,101,119,.12);\n font-size: 14px;\n vertical-align: top;\n}\n.co-table td:first-child {\n font-weight: 600;\n color: #323C52;\n}\n.co-infobox {\n display: flex;\n gap: 12px;\n background: rgba(77,101,119,.06);\n border-radius: 8px;\n border-left: 4px solid #4D6577;\n padding: 14px 18px;\n margin: 18px 0 28px;\n font-size: 14px;\n font-weight: 400;\n color: #4D6577;\n line-height: 1.65;\n}\n.co-infobox .ico {\n font-size: 18px;\n flex-shrink: 0;\n}\n.co-urgence {\n background: #fff8f8;\n border-left: 5px solid #c0392b;\n border-radius: 6px;\n padding: 20px 26px;\n margin: 24px 0 32px;\n}\n.co-urgence .co-urgence-titre {\n font-size: 13px;\n font-weight: 700;\n color: #c0392b;\n letter-spacing: 1.5px;\n text-transform: uppercase;\n margin-bottom: 10px;\n}\n.co-urgence p {\n color: #5a2020;\n font-size: 14px;\n margin: 0 0 10px;\n line-height: 1.7;\n}\n.co-urgence p:last-child {\n margin-bottom: 0;\n}\n.co-disclaimer {\n font-size: 13px;\n color: #8a9aaa;\n font-style: italic;\n border-top: 1px solid rgba(77,101,119,.15);\n padding-top: 24px;\n margin-top: 40px;\n line-height: 1.6;\n}\n<\/style>\n<\/head>\n<body>\n<div class=\"co-wrap\">\n\n <span class=\"co-label\">Dermatology & Pediatrics & Family Medicine<\/span>\n <h1>Tinea capitis (ringworm of the scalp)<\/h1>\n\n <div class=\"co-intro\">\n Tinea capitis\u2014commonly known as scalp ringworm\u2014is a superficial fungal infection of the scalp, hair follicles, and hair caused by dermatophytes of the genus <em>Microsporum<\/em> (mainly <em>M. canis<\/em> - of animal origin: cats + dogs) and <em>Trichophyton<\/em> (mainly <em>T. tonsurans<\/em> - of human origin + inter-human transmission + predominant in North America + Africa + Afro-American and African populations) + which invade the keratin of the hair shaft + follicle + and sometimes the scalp itself. Tinea capitis almost exclusively affects prepubertal children (aged 3-12) - adult resistance being attributed to the long-chain fatty acids produced by post-pubertal sebaceous glands, which have fungistatic activity - and is the most common dermatophytosis in children worldwide + with a particularly high prevalence in African and African-American communities. Its fundamental therapeutic feature distinguishes tinea capitis from all other cutaneous dermatophytoses: topical antifungals alone are INEFFECTIVE because they don't penetrate the hair follicle sufficiently \u2192 systemic oral treatment is mandatory to reach the fungus in the hair shaft and follicle. Diagnosis is often delayed because the clinical presentation is polymorphous - ranging from simple, barely symptomatic scales (mimicking psoriasis or seborrheic dermatitis) to severe inflammatory alopeciating lesions (kerion) that can lead to permanent scarring alopecia if not treated promptly.\n <\/div>\n\n <h2>Clinical forms<\/h2>\n <ul class=\"co-list\">\n <li><strong>Microsporum moth (Microsporum spp.) :<\/strong> large single or few + well-defined circular plaques + diameter 2-6 cm + broken hair a few mm from the scalp + dull + greyish hair + whitish scales + green-yellow fluorescence under the Wood's lamp (characteristic of Microsporum - not found with Trichophyton) + moderate pruritus<\/li>\n <li><strong>Ringworm of the scalp (Trichophyton spp. \u2014 T. tonsurans):<\/strong> small, multiple, irregular, poorly defined patches + grey scales + broken hair flush with the scalp (black dots - \u00abblack dot tinea\u00bb = stumps of broken hair visible as black dots in the follicle) + little or no Wood's lamp fluorescence + variable pruritus + sometimes mildly inflammatory picture resembling seborrheic dermatitis or scalp psoriasis \u2192 frequent cause of delayed diagnosis<\/li>\n <li><strong>Inflammatory ringworm \u2014 Kerion of Celsus<\/strong> intense inflammatory reaction (hypersensitivity to fungal antigens) \u2192 erythematous + oozing + crusty + painful + suppurative plaque (pus draining from follicles on pressure) + alopecia of affected area + reactive cervical or sub-occipitaloccipital adenopathies + fever possible + may appear bacterial (impetiginized) but is mainly fungal + systemic antifungal treatment ++ + corticoids to reduce inflammation and prevent scarring alopecia<\/li>\n <li><strong>Favus (ringworm \u2014 Trichophyton schoenleinii):<\/strong> rare chronic form + scutules (cup-shaped yellowish crusts around the follicle) + characteristic mouse-like odor + scarring alopecia + endemic regions (North Africa + Middle East)<\/li>\n <\/ul>\n\n <h2>Pathogen agents by geography and source<\/h2>\n\n <table class=\"co-table\">\n <thead>\n <tr>\n <th>Agent<\/th>\n <th>Source<\/th>\n <th>Geographic zones<\/th>\n <th>Wood lamp<\/th>\n <\/tr>\n <\/thead>\n <tbody>\n <tr>\n <td>Trichophyton tonsurans<\/td>\n <td>Human (anthropophilic) \u2014 child-to-child transmission + sharing of accessories (combs + hats + pillows)<\/td>\n <td>North America ++ + United Kingdom + Sub-Saharan Africa + African American populations<\/td>\n <td>Negative (no fluorescence)<\/td>\n <\/tr>\n <tr>\n <td>Microsporum canis<\/td>\n <td>Animal (zoophile) \u2014 cats + dogs + kittens ++ + direct contact with animal<\/td>\n <td>Europe + Canada + Latin America + Mediterranean<\/td>\n <td>Positive \u2014 characteristic yellow-green fluorescence<\/td>\n <\/tr>\n <tr>\n <td>Microsporum audouinii<\/td>\n <td>Human (anthropophile)<\/td>\n <td>West Africa + Europe (in decline)<\/td>\n <td>Positive \u2014 yellow-green fluorescence<\/td>\n <\/tr>\n <tr>\n <td>Trichophyton violaceum<\/td>\n <td>Human (anthropophile)<\/td>\n <td>North Africa + Middle East + Central Asia<\/td>\n <td>Negative<\/td>\n <\/tr>\n <\/tbody>\n <\/table>\n\n <h2>Diagnosis<\/h2>\n <ul class=\"co-list\">\n <li><strong>Clinical examination + Wood's lamp :<\/strong> green-yellow fluorescence = Microsporum (darkroom examination) + absence of fluorescence = Trichophyton (majority in North America) \u2192 do not exclude tinea capitis on a negative Wood's lamp<\/li>\n <li><strong>Fungal sample collection:<\/strong> scalp scraping (scales + broken hair) + fresh state (KOH 10-20 %) \u2192 visualization of spores arranged in a sleeve around the hair shaft (ectothrix - Microsporum) or inside (endothrix - Trichophyton) + culture on Sabouraud medium (2-4 weeks) \u2192 species identification + antifungus if resistance suspected<\/li>\n <li><strong>Mycological PCR :<\/strong> available in certain reference laboratories \u2192 rapid identification + higher sensitivity than culture<\/li>\n <li><strong>Biopsy (kerion):<\/strong> rarely necessary + sometimes useful if there is any doubt about the diagnosis of a bacterial abscess or decalcifying folliculitis<\/li>\n <\/ul>\n\n <h2>Treatment<\/h2>\n <ul class=\"co-list\">\n <li><strong>Absolute rule:<\/strong> ORAL antifungal treatment is mandatory - topical antifungals alone (clotrimazole + miconazole + terbinafine cream) are INEFFECTIVE on tinea capitis because they do not penetrate the hair follicle where the fungi are located.<\/li>\n <li><strong>Griseofulvin (historical treatment of choice - particularly effective against Microsporum):<\/strong> 20-25 mg\/kg\/day (micronized) + or 10-15 mg\/kg\/day (ultramicronized) \u00d7 6-12 weeks (Microsporum) + or \u00d7 6-8 weeks (Trichophyton) + with a fatty meal (increased absorption) + effective on Microsporum canis ++ + less effective on T. tonsurans + monitoring: CBC + transaminases if prolonged treatment<\/li>\n <li><strong>Terbinafine (gold standard treatment for T. tonsurans \u2014 North America):<\/strong> 125 mg\/day if 40 kg \u00d7 4\u20136 weeks + more effective than griseofulvin on Trichophyton (meta-analyses) + less effective on Microsporum \u2192 adapt according to the identified species<\/li>\n <li><strong>Itraconazole (alternative - effective on both genders):<\/strong> 5 mg\/kg\/day \u00d7 4-8 weeks + or pulsed regimen (5 mg\/kg\/day \u00d7 1 week\/month \u00d7 2-3 cycles) + effective on Microsporum AND Trichophyton<\/li>\n <li><strong>Fluconazole (less well-documented alternative):<\/strong> 6 mg\/kg\/week \u00d7 8-12 weeks + or 6 mg\/kg\/day \u00d7 3-4 weeks<\/li>\n <li><strong>Adjuvant antifungal shampoo (ketoconazole 2% or selenium sulfide 2.5%):<\/strong> 2-3 times\/week \u00d7 all treatment times + reduces spore load + reduces contagiousness + reduces transmission to contacts + DOES NOT replace oral treatment<\/li>\n <li><strong>Kerion \u2014 specific treatment:<\/strong> systemic antifungal (terbinafine or griseofulvin depending on species) + prednisone 1 mg\/kg\/d \u00d7 1-2 weeks to reduce inflammation and prevent scarring + DO NOT incise-drain (aggravates) + DO NOT prescribe antibiotics alone (fungal, not bacterial cause)<\/li>\n <li><strong>Contacts - Decontamination Measures<\/strong> examine symptomatic contacts (brothers + sisters + classmates) + treat carrier contacts (possible asymptomatic carriage of T. tonsurans - prevalence 30-50 % in close contacts) with antifungal shampoo \u00d7 4-6 weeks + possibly oral antifungal if confirmed carriage + check and treat pet if Microsporum canis (veterinarian)<\/li>\n <li><strong>School expulsion:<\/strong> in Quebec - the child can return to school as soon as the oral antifungal treatment is initiated (no prolonged eviction) + but wearing a hat is not recommended (promotes heat + humidity) \u2192 information at school<\/li>\n <\/ul>\n\n <div class=\"co-infobox\">\n <span class=\"ico\">\u2119\ufe0f<\/span>\n <span>Celsus' kerion is often confused with a bacterial abscess or bacterial folliculitis, leading to inappropriate antibiotic prescriptions and delayed antifungal treatment. Kerion is a hypersensitivity reaction to fungal antigens within the follicle; it weeps profusely upon pressure, but bacterial cultures are typically sterile (or show secondary superinfection). Treatment should be with systemic antifungals plus anti-inflammatory corticosteroids to prevent scarring alopecia. Never incise a kerion.<\/span>\n <\/div>\n\n <div class=\"co-urgence\">\n <div class=\"co-urgence-titre\">Medical consultation recommended<\/div>\n <p>Consult a doctor if a child has scaly or hair-loss patches on the scalp that persist for more than 2 weeks, especially if black dots (stumps of broken hairs) are visible in the patches, or if a painful, oozing, crusted lesion of the scalp develops (kerion) \u2014 these conditions require systemic antifungal treatment to prevent scarring alopecia. Topical antifungals alone are insufficient. For diagnosis and prescription of oral antifungal treatment adapted to the species, Clinique Omicron offers medical consultations at its service points in Quebec and via telemedicine. To make an appointment, visit <a href=\"https:\/\/cliniqueomicron.ca\" style=\"color:#c0392b;font-weight:600;text-decoration:none;\">cliniqueomicron.ca<\/a>.<\/p>\n <\/div>\n\n <h2>Consult at Clinique Omicron<\/h2>\n <p>Clinique Omicron's physician assistants and nurse practitioners (PAs\/NPs) diagnose tinea capitis through clinical examination (Wood's lamp + mycological sampling), prescribe oral antifungal treatment appropriate for the suspected species (griseofulvin for Microsporum + terbinafine for T. tonsurans) plus an adjunctive antifungal shampoo, treat kerion with systemic antifungals + corticosteroids, inform about decontamination of contacts and pets, and specify conditions for returning to school. Consultations are available at several service points across Quebec and via telemedicine. To book an appointment, visit <a href=\"https:\/\/cliniqueomicron.ca\" style=\"color:#4D6577;font-weight:600;text-decoration:none;\">cliniqueomicron.ca<\/a>.<\/p>\n\n <p class=\"co-disclaimer\">The content of this page is for informational purposes only and is not a substitute for medical or dermatological advice. Topical antifungals are insufficient to treat tinea capitis\u2014systemic oral treatment is mandatory. Kerion should never be incised-drained nor treated with antibiotics alone\u2014it is a dermatological emergency requiring systemic antifungal treatment + corticosteroids.<\/p>\n\n<\/div>\n<\/body>\n<\/html>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>","protected":false},"excerpt":{"rendered":"<p>Tinea capitis (teigne du cuir chevelu) : diagnostic, gris\u00e9ofulvine et traitement antifongique | Clinique Omicron Dermatologie & P\u00e9diatrie & M\u00e9decine de famille Tinea capitis (teigne du cuir chevelu) La tinea capitis \u2014 commun\u00e9ment d\u00e9sign\u00e9e teigne du cuir chevelu \u2014 est une dermatophytose (infection fongique superficielle) du cuir chevelu + des follicules pileux + et des… <a href=\"https:\/\/cliniqueomicron.ca\/en\/teigne\/\" rel=\"bookmark\">Read More \"<span class=\"screen-reader-text\">Tinea capitis (ringworm): diagnosis, griseofulvin and antifungal treatment | Clinique Omicron<\/span><\/a><\/p>","protected":false},"author":1,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"om_disable_all_campaigns":false,"_monsterinsights_skip_tracking":false,"_monsterinsights_sitenote_active":false,"_monsterinsights_sitenote_note":"","_monsterinsights_sitenote_category":0,"neve_meta_sidebar":"","neve_meta_container":"","neve_meta_enable_content_width":"off","neve_meta_content_width":100,"neve_meta_title_alignment":"","neve_meta_author_avatar":"","neve_post_elements_order":"","neve_meta_disable_header":"","neve_meta_disable_footer":"","neve_meta_disable_title":"","_themeisle_gutenberg_block_has_review":false,"_metasync_otto_title":"Teigne (tinea capitis) | Brossard | Clinique Omicron","_metasync_otto_description":"Teigne (tinea capitis) Teigne (tinea capitis) est une condition m\u00e9dicale qui peut n\u00e9cessiter une \u00e9valuation et un suivi m\u00e9dical appropri\u00e9s. Nos professionnel...","_metasync_otto_keywords":"teigne, Clinique Omicron, clinique m\u00e9dicale Qu\u00e9bec, m\u00e9decin g\u00e9n\u00e9raliste Montr\u00e9al, Qu\u00e9bec","_metasync_otto_og_title":"Teigne | Clinique Omicron Qu\u00e9bec","_metasync_otto_og_description":"Teigne (tinea capitis) Teigne (tinea capitis) est une condition m\u00e9dicale qui peut n\u00e9cessiter une \u00e9valuation et un suivi m\u00e9dical appropri\u00e9s. Nos professionnel...","_metasync_otto_twitter_title":"Teigne | Clinique Omicron","_metasync_otto_twitter_description":"Teigne (tinea capitis) Teigne (tinea capitis) est une condition m\u00e9dicale qui peut n\u00e9cessiter une \u00e9valuation et un suivi m\u00e9dical appropri\u00e9s. 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Microsporum canis lampe Wood fluorescence T. tonsurans points noirs, gris\u00e9ofulvine Microsporum terbinafine Trichophyton, k\u00e9rion cortico\u00efdes au Qu\u00e9bec.","_metasync_seo_title":"","_metasync_seo_desc":"","_metasync_breadcrumb_title":"","_metasync_primary_category":0,"_metasync_primary_product_cat":0,"_metasync_otto_disabled":"","_metasync_hreflang":"","_metasync_plugin_sync_ts":"{\"aioseo\":\"2026-05-04T15:32:09+00:00\"}","_metasync_robots_advanced":"","footnotes":""},"class_list":["post-24997","page","type-page","status-publish","hentry"],"aioseo_notices":[],"_links":{"self":[{"href":"https:\/\/cliniqueomicron.ca\/en\/wp-json\/wp\/v2\/pages\/24997","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/cliniqueomicron.ca\/en\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/cliniqueomicron.ca\/en\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/cliniqueomicron.ca\/en\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/cliniqueomicron.ca\/en\/wp-json\/wp\/v2\/comments?post=24997"}],"version-history":[{"count":4,"href":"https:\/\/cliniqueomicron.ca\/en\/wp-json\/wp\/v2\/pages\/24997\/revisions"}],"predecessor-version":[{"id":32194,"href":"https:\/\/cliniqueomicron.ca\/en\/wp-json\/wp\/v2\/pages\/24997\/revisions\/32194"}],"wp:attachment":[{"href":"https:\/\/cliniqueomicron.ca\/en\/wp-json\/wp\/v2\/media?parent=24997"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}