The History of Tinea Capitis

Tinea capitis, or ringworm of the scalp, is one of the earliest human infections to be documented in medical literature. It can be traced back to ancient Rome, where the writer Celsus (De medicinia) described the disease as "an acute inflammatory scalp condition that drained purulent fluid."

Tinea capitis has been referred to as a scourge of the last century. Europeans with the infection were barred at Ellis Island as they attempted to immigrate to America. Yet, the scalp-invading organisms that cause ringworm of the scalp managed to find their way to this country, and by the 1940s and 1950s, tinea capitis had reached epidemic proportions.

This initial epidemic was caused by Microsporum audouini, an organism that was easily detected in the large populations it infected because it produced a bright yellow-green fluorescent glow when the patient's head was illuminated by a Wood's lamp (a lamp used to detect fluorescent materials in the skin and hair in certain disease states).

A second U.S. epidemic of tinea capitis began in the 1970s and continues to intensify today. The chief organism in this current epidemic is Trichophyton tonsurans. Tinea capitis caused by T. tonsurans now accounts for more than 90 percent of all scalp ringworm infections. Unlike its predecessor, T. tonsurans does not fluoresce under a Wood's lamp, making detection by screening more difficult.

Tinea capitis caused by T. tonsurans is more common in African-American children, especially those in urban areas, than in Caucasian children. This is in contrast to the M. audouini-caused tinea capitis of earlier decades, which was far more prevalent in Caucasian children.

Treatments through the years

Today, ringworm of the scalp can be safely and effectively treated-a far cry from the treatments our ancestors endured. In the 1700s and 1800s, for example, people with tinea capitis were advised to shave their heads daily, apply mercury and then anoint their scalps with grease. Patients were also advised to apply tar to the scalp and to consume a diet high in fat and cod liver oil.

Sulfur became the treatment of choice in the later 1800s and remained so until the early 1900s, when X-ray therapy was introduced. This treatment usually rid the scalp of infection, but also caused total hair loss from the root.

In the 1950s, a safe, effective treatment, griseofulvin, became available. Griseofulvin is effective in eradicating the fungus that causes ringworm, and it has remained the standard of treatment for the condition for nearly 50 years. One form of griseofulvin, is GRIFULVIN V^® (griseofulvin) microsize.

Daily treatment usually lasts anywhere from four to six weeks and, in some cases, longer courses of treatment may be required. GRIFULVIN V^® should be taken for the complete amount of time prescribed by the doctor, without regard to whether symptoms have improved. When side effects occur they are most commonly of the hypersensitivity type, such as skin rashes and hives.