Tinea capitis, commonly known as ringworm of the scalp, is a superficial fungal infection caused by dermatophytes. This fungus feeds on keratin, the main protein component of hair, frequently causing patches of hair loss. The hair loss resulting from this infection is typically non-scarring and temporary. When the underlying fungal infection is treated promptly, the hair follicle recovers its normal function, allowing hair to grow back fully.
Understanding Ringworm and Hair Loss
The hair loss seen in tinea capitis is a direct result of the dermatophyte fungus invading the hair structure. These fungi penetrate the hair shaft and weaken the protein matrix. This invasion leads to a compromised hair shaft that becomes brittle and fragile.
The weakened hair breaks off easily, often right at or just below the scalp surface, creating visible patches of alopecia. This breakage is sometimes referred to as the “black dot” pattern when the remnant of the hair shaft is left in the follicle opening. Since the infection primarily targets the hair shaft and does not typically destroy the hair-producing structure beneath the skin, the follicular unit remains intact. The hair follicle is merely in a temporary state of rest or damage.
The Typical Timeline for Hair Regrowth
Hair regrowth is a gradual process that begins once the fungal infection has been successfully cleared with prescription antifungal medication. Treatment must eradicate the dermatophytes from the hair shaft and scalp tissue. Once the fungus is gone, the hair follicles, which were in a resting phase due to the infection, can re-enter the active growth cycle.
Initial signs of regrowth may appear as fine, colorless “fuzz” within a few weeks to a couple of months following the completion of treatment. While the timeline for a noticeable return to normal density is variable, most individuals see significant improvement within three to six months. Complete restoration of the hair’s original texture and density can take up to 12 months. The newly grown hair may temporarily differ slightly in color or texture from the surrounding hair until it fully matures.
The speed of recovery depends on the severity of the initial infection and how quickly treatment was started. Consistency with the prescribed oral antifungal medication is necessary to clear the infection and initiate the healing process. Hair only grows about half an inch per month, dictated by the natural hair growth cycle.
When Regrowth Might Not Happen
While most cases of tinea capitis result in full hair recovery, a severe inflammatory reaction can lead to permanent hair loss. This complication is associated with Kerion, a rare, intense immune response to the fungal infection. Kerion presents as a boggy, painful, and highly inflamed plaque on the scalp, often accompanied by pus-filled lesions.
This profound inflammation can extend deep into the dermal layer of the scalp, causing irreversible damage to the hair follicle’s stem cells and structure. When the follicle is destroyed by this scarring, the resulting hair loss is classified as scarring alopecia. In these patches, the hair will not regrow.
A lack of hair regrowth several months after the infection has been successfully treated indicates potential scarring. Persistent pain, significant pus drainage, or a firm, smooth patch of skin replacing the hair-bearing area require immediate consultation with a dermatologist. Early recognition and aggressive anti-inflammatory treatment, often involving corticosteroids alongside antifungals, help minimize the risk of permanent scarring in cases of Kerion.