What is the difference between tinea capitis and kerion?

Fungal infection is not a new disease. We often heard about this infection affecting the body such as feet, body and nails. Do you know that this infection may also affect the scalp? We may often associate scalp problems with dandruff and lice or fleas but we may not be familiar with fungi infecting the scalp or known as tinea capitis in medical terms. The question now is, what is the difference between tinea capitis and kerion? No matter what kind of infection affects a person, he or she should ask a doctor to get treatment especially when over-the-counter (OTC) medication or remedy does not help to alleviate symptoms.

Tinea capitis is also known as ringworm or herpes tonsurans infection. Although it is called a ringworm, it has nothing to do with worms as you know in general. As a matter of fact, it is commonly caused by fungal species of Microsporum, Epidermophyton and Trichophyton. These fungi are able to penetrate the hair follicle and grow downwards toward the scalp skin. It invades the keratin found in the scalp. This led to the hair becoming brittle and easily breaking as the hair structure became weak.

Tinea capitis cases can be seen almost everywhere in the world but is most common in hot and humid climates which includes Southeast Asia. Tinea capitis often affects children more than adults although the severity of infection is the same in both children and adults. Those at higher chance to develop tinea capitis include people with immunosuppression status such as those with diabetes, cancer and usage of immunosuppressant or long-term steroid use. This is because these people already have impairment of the hair growth and strength which makes tinea capitis mush more likely to affect them. Infection of tinea capitis is easily transmitted through human skin contacts and sharing personal objects such as hairbrushes, towels or bedding. Infection may also occur through touching animals or dirty ground.

Infection of tinea capitis often begins as red bumps on the scalp that can be mistaken as acne but these red bumps gradually affect the whole scalp. Other symptoms include redness, itching scalp, formation of scale similar to severe dandruff appearance and patches of hair loss (alopecia). Apart from scalp, tinea capitis may also affect the eyelashes or eyebrows. In some cases, the appearance of cervical lymphadenopathy (swelling of the lymph node around the neck) can be seen. Symptoms vary according to the fungal species affecting it.

Now, what is the difference between tinea capitis and kerion? Tinea capitis is an infection of the scalp caused by dermatophyte fungi whereas kerion is a severe inflammatory form of tinea capitis with hypersensitivity reaction against dermatophytes. In kerion, the patient is typically presented with spreading of multiple small inflamed pus-filled pustules and is often painful. Hence, the differences between tinea capitis and kerion lies in the symptoms and the extent of damages. Furthermore, tinea capitis does not involve the immune system to become overreact towards the ringworm infection such as in kerion.

Tinea capitis or kerion, one thing for certain, these conditions can cause great discomfort and possibly lead to permanent hair loss. Hence, it is best to get the right treatment to alleviate symptoms and to avoid spreading of the infections. Antifungal medications are the best medication to help these conditions. This can be in the form of griseofulvin, itraconazole and fluconazole. These antifungal medications are usually in tablet form and often combined with antifungal shampoo. Treatment can take weeks and even up to months. Thus, it is necessary for patients to use the medicine regularly and as instructed by the doctor because these medications only after a long-term and continuous medication to be effective against fungal infection. Beside medication, an additional step of making sure infection is not spread is important. This can be done by cleaning or disinfecting the hair tools. It is best to replace these hair tools to avoid re-infection. When there is a person diagnosed with infection of ringworm, all household contacts should be screened for the infection. Patients are advised to not share their individual objects such as hairbrushes, combs, pillows and caps with others to avoid spreading infections. Since the fungus causing kerion or tinea capitis often resides on a household pet and may infect those in direct contact with the animal, patients have to ensure that the pet is free from the infections by bringing them to the vet clinics for further evaluation.

In essence, the differences between tinea capitis and kerion is the stage of the infection and the damages it causes. It is prudent to treat fungal infection to avoid permanent complications that not only cause discomfort but also affect a person’s appearance and their quality of life. Antifungal medications are common medications used to treat the infections. Taking preventative steps help to curb spreading of the infection and prevent re-infection in patients with previous history of the fungal infections.

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