Barbers and hairdressers…a potential source of scalp ringworm!

Being a mother, I have been experiencing several of my kids’ “firsts” with them; unforgettable events that I enjoy and cherish. But unavoidably, I have had to experience their unpleasant ones, too.

I still recall the day my young son had his first haircut…It was an ordeal! It happened at a barbershop in the middle of a shopping center. People literally stopped shopping and curiously gathered to find out who was this hysterically crying little kid. I can never forget the exhaustion I felt that day; I was more energy-depleted than I would have been after a 3-hours extensive workout!

After that day, I decided to take my son to a barber that works from home to avoid this public embarrassment, but at what cost!?

Recently, while my son was -again- having a haircut I spotted a little red ring on his scalp that looked like boggy swelling with thickened, dry skin. Most importantly, the hair covering this area had fallen, but was not obvious until his hair was cut shorter. It freaked me out, so I rushed him immediately the doctor who confidently nodded after examining his scalp  saying, “It is a fungal infection”. He, however, requested a culture for more certainty.

 

A baldy patch resulting from hair fall due to a fungal infection. Source Wikipedia

 

As expected, the culture came positive and the doctor started the treatment process immediately.

As a microbiologist myself, I requested a copy of his lab test and wanted to know more about the fungus responsible for this worrying, ugly-looking infection. It was Trichophyton violaceum.

A culture of a Trichophyton fungal growth. Image by Microbe World via flickr

 

Here’s Trichophyton violaceum for you!

Trichophyton violaceum is the causative agent of a condition known as Tinea capitis. It also has many other names such as “herpes tonsurans” or “scalp ringworm”. It infects any area of the body with hair growth with the scalp being the most vulnerable body area.

A microscopic shot of a Trichophyton species. Source Wikipedia.

 

Weeks after the start of the infection, the hair becomes brittle in the infected area and starts to fall, leaving baldy reddish patches on the scalp. The infection is, more worryingly, highly contagious.

Trichophyton violaceum belong to the group of Dermatophyte. This group includes forty species belonging to three fungal genera namely Microsporum, Epidermophyton and Trichophyton.

 

How does the nasty bug cause the hair to fall?

All dermatophytes possess the ability to break down and grow on keratin. We are probably all familiar with keratin, the main protein that enters in the composition of our hair. As a dermatophyte itself, Trichophyton violaceum produces an enzyme called keratinase, which breaks down the keratin in the hair and uses it as a growth substrate. Hence the resulting hair fall and the baldy patches that we observe in Tinea captitis.

Can it be treated?

Fortunately yes! The doctor prescribed an antif-ungal oral medication known as Lamisil for my son. The treatment should last for 6 weeks to guarantee a complete eradication of the fungi.

The scientist in me could not resist but investigate how this medication works.

The active ingredient is known as terbinafine; an anti fungal that targets the fungal cell by inhibiting the synthesis of ergosterol, which is an essential constituent of the cell membrane of fungi (similar in structure and function to cholesterol in humans). Without ergosterol, Trichophyton violaceum becomes unable to build the cell membrane. As a result, the fungus stops growing and starts to disappear, and symptoms fade away progressively.

 

According to the doctor, my son could have got the infection from the non-sterilised tools that the barber used to cut his hair! His statement left me shattered and self-tortured for weeks. However, at least I now know that the public embarrassment caused by my son crying is a thousand times better that seeing him suffering from this bug at such a young age!

Oh…and certainly a million times better than the daily tantrums I have to deal with when trying to make him swallow the antifungal tablet (I will leave it to your imagination)!