Kerion (Inflammatory Scalp Ringworm) - Symptoms, Causes & Treatment
Medically reviewed by Dr. Anand S. Urhekar, MD, MD Pathology, Clinical Advisor · Last updated July 2026
A severe inflammatory reaction to scalp ringworm (tinea capitis), forming a boggy, tender, pus-oozing swelling with hair loss. It is frequently mistaken for a bacterial abscess and treated with antibiotics, which do not work — untreated, it can cause permanent scarring alopecia.
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Quick Answer
A kerion is a boggy, tender, pus-discharging swelling on the scalp caused by an intense immune reaction to a fungal infection. It usually affects children and is often misdiagnosed as a bacterial abscess. Antibiotics alone fail. Treatment requires several weeks of oral antifungal medication such as griseofulvin or terbinafine; prompt treatment prevents permanent scarring hair loss.
Symptoms
- Boggy, soft, painful swelling on the scalp
- Pus oozing from multiple follicular openings
- Hair loss over the affected area, hairs easily pulled out
- Crusting and matted hair
- Swollen lymph nodes at the back of the neck, sometimes fever
Causes & Risk Factors
- Dermatophyte fungi, commonly Trichophyton and Microsporum species
- Spread from other children, pets, or shared combs and hats
- Most common in children aged 3–10
- Strong host immune reaction to the fungus
Treatment & Management
- Oral antifungal therapy for 6–12 weeks (griseofulvin or terbinafine)
- Antifungal shampoo to reduce spore shedding
- A short course of oral corticosteroid in some severe cases
- Antibiotics only where genuine bacterial superinfection is confirmed
- Screening and treating household contacts and pets
When to See a Doctor
See a doctor promptly about any boggy, painful scalp swelling with hair loss, especially in a child. Ask specifically about fungal testing if antibiotics have already failed.
Frequently Asked Questions
Why didn't antibiotics work?
Because the cause is fungal, not bacterial. The pus is an inflammatory response, not a bacterial abscess. Only systemic antifungal treatment eradicates it — topical creams also fail because the fungus lives inside the hair shaft.
Will the hair grow back?
Usually yes if treated early. Delayed treatment allows follicles to scar, causing permanent patchy hair loss — which is why prompt antifungal therapy matters.
Related Conditions
Medical References
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Medical Disclaimer: This information is for educational purposes only and is not intended as medical advice. The content on this page should not be used to diagnose or treat any health problem. Always consult with a qualified healthcare professional for proper medical evaluation, diagnosis, and treatment of your condition.