Getting to the Root of Ringworm
Dr. Amy McMichael

The nurse at my son's school called yesterday to inform me that she thinks he has something called ringworm of the scalp, and that I should bring him to a doctor. I had noticed that he had some irritation and some flakes on his scalp, but I thought it was dandruff. What is ringworm? Is it an actual worm, or is it something like head lice? Is there something that I buy in the drugstore to treat this, rather than going to the doctor? Is this a very contagious condition, and can my son pass this on to adults as well?

Most importantly, what can I do to make sure that he doesn't become infected again?

Sincerely, Worried about Ringworm

Amy McMichael, M.D., an assistant professor in the Department of Dermatology and Director of the Hair Disorders Clinic at the Wake Forest University School of Medicine in Winston-Salem, responds: Dear Worried, You are definitely not alone in your confusion about ringworm. Although it is a serious problem that affects almost a million children each year, it is an underdiagnosed and misdiagnosed disease. Ringworm of the scalp, or tinea capitis as it is known in the medical community, is not a worm - but it's not like lice either. It is a highly contagious fungal infection that can pose serious consequences - such as extreme pain and permanent hair loss, if not treated properly.

Although anyone can be infected with ringworm, children are at highest risk, especially those between four and six years old. In fact, ringworm accounts for over 90 percent of fungal infections of the skin in children under age 10 in the U.S.

Ringworm is highly contagious, and can infect people either through direct contact with another infected person or through contact with combs, hats, articles of clothing, mats, etc. You should encourage your children not to share each other's things, and you should wash anything that has come in contact with an infected child in the family in hot water and detergent.

The only way to successfully treat ringworm of the scalp is by taking an oral antifungal, only available by prescription. A medication called griseofulvin is effective in removing the fungus that causes this form of ringworm, and it has remained the standard of treatment for the condition for nearly 50 years. One form of griseofulvin, available in an oral liquid suspension form for children, is GRIFULVIN V (griseofulvin oral suspension).

Most doctors recommend treatment for 6 to 8 weeks, however, in some cases, a doctor may advise a longer course of treatment. The drug must be taken for the entire time recommended by the doctor to ensure the infection is completely cured.

Dosage recommendations for GRIFULVIN-V are determined by the prescribing physician. Parents/caregivers may find that the liquid suspension form of GRIFULVIN-V is easier and more pleasant for children to take, which may increase the likelihood of compliance with the full regimen. The full course of treatment must be continued until the infecting organism is completely eradicated as indicated by appropriate clinical or laboratory examination.

When side effects occur, they are most commonly of the hypersensitivity type, such as skin rashes and hives.