Fungal infection at the back of the head is most often considered to be tinea capitis, which is a common disease caused by dermatophytes (mainly of the genus Microsporum) infecting the hair and scalp, and is somewhat contagious; its most common clinical presentation is single or multiple alopecia patches accompanied by scaling, and in severe cases, scarring or permanent alopecia may occur, which is often accompanied by varying degrees of itchiness.
Treatment of tinea capitis is aimed at removing the fungus, curing the patient, minimizing scarring, and interrupting transmission; patients can begin treatment based on clinical assessment and diagnosis of tinea capitis by fungal microscopy without waiting to obtain fungal culture results, which may delay treatment and lead to progression of the disease, increasing the risk of permanent alopecia and transmission of the disease.
Treatment of tinea capitis is based on oral antifungal medications, which may be supplemented with topical topical medications. In addition, contaminants and contaminated environments need to be disinfected and decontaminated to prevent reinfection and transmission. Family members of patients diagnosed with tinea capitis should undergo a physical examination for signs of tinea capitis, which also needs to be treated when detected.