Routes of infection, symptoms and treatment of scalp lichen in adults and children

General principles of treatment for ringworm

For the treatment of all forms of ringworm in humans, antifungal drugs are prescribed by mouth and local therapy with ointments, gels, and drug solutions. A dermatologist should select a treatment regimen; self-medication is strictly prohibited. The most effective drugs in the treatment of ringworm are miconazole, ketoconazole, clotrimazole, mycoseptin and medications with the active substance terbinafine (Lamisil, Terbizil). After all symptoms of the disease have disappeared and the structure of the skin and hair has normalized, it is advisable to continue taking antifungal drugs for a week to avoid recurrence of the infection.

Before starting a course of treatment for ringworm, the hair on the body and head must be shaved. In this case, hair shaving is recommended to be carried out during the entire course of treatment at intervals of once a week. Griseofulvin is considered one of the most effective systemic drugs that eliminates fungal infections of the scalp and smooth skin. Its dosage is calculated depending on the patient’s weight: 15 mg per day per 1 kilogram of weight. The drug must be taken three times a day. The course of therapy with griseofulvin lasts about 15 - 25 days. In this case, once a week a bacterioscopic analysis is required to determine the presence of fungus in the scraping. After the fungus disappears in the scraping analysis, you need to continue taking the drug every other day for 2 weeks.

Diagnostic features

If lichen asbestos is suspected, a thorough and comprehensive diagnosis is carried out in a modern laboratory. This is due to the strong similarity with eczema, psoriasis or other dermatitis. Therefore, an additional examination by specialized doctors: a surgeon, dermatologist, and neurologist becomes an important component.

When biological scrapings or flaky particles are taken for analysis, fungi may be detected. Their identification helps to correctly determine the treatment and prevention of the disease.

Local treatment of ringworm

In addition to taking oral antifungal drugs, treatment for ringworm involves local treatment of the lesions. It is advisable to treat inflamed skin areas with a 3-5% iodine solution every morning. Before going to bed, the lesions are treated with sulfur-salicylic acid or a solution of pure salicylic acid, sulfur-tar ointment or 10% precipitated sulfur. Local therapy is also recommended if, for some reason, the patient cannot be prescribed griseofulvin.

To do this, remove hair from the source of inflammation using a 4% epilin patch or x-ray epilation (before irradiation, it is recommended to shave the hair or cut it short (no longer than 2 cm). Then the doctor, using oil dressings, removes all the crusts and dries the ulcers with special preparations. the next stage is irradiation - the entire dose of x-ray hair removal is recommended for adults, and for children it is divided into 2, 3 or 4 equal parts. After the procedure, the hair completely falls out after 2-3 weeks. Only after all the hair has been removed, the doctor proceeds to external treatment of the disease.

Ointments for ringworm

Compared to other drugs for topical treatment of lichen, such as gels and creams, ointments have a thicker consistency. Thanks to this, they can remain on the patient’s skin much longer and penetrate deeply into it. That is why such drugs have a stronger effect than others. Often the use of ointments is combined with the use of iodine tincture.

This drug effectively disinfects areas affected by lichen, destroys fungi and bacteria that provoke suppuration. In the morning, ringworm should be lubricated with iodine, and in the evening, ointment should be applied to its surface. Before applying ointment to the skin, you must first clean it. It is advisable to do this not with ordinary water, but with disinfectant solutions: rivanol, furatsilin, potassium permanganate. The following ointments are often used to treat lichen:

• Sulfur ointment (10-20%) - kills fungi and other microorganisms, accelerates wound healing and dries out pimples. Apply it to areas of lichen once a day.
• Salicylic ointment is effective in fighting fungi and eliminating inflammation. Foci of inflammation are smeared with this ointment and then covered with a sterile napkin.
• Sulfur-tar ointment - it contains active substances that disinfect the skin and kill fungi. The ointment must be applied directly to the ringworm itself and to areas near it, gently rubbing into the skin.
• Lamisil - this cream inhibits the growth of fungi and then completely destroys them. After starting to use the cream, improvement occurs already on the 5th day. The course of treatment with the drug is 5-6 weeks.
• Mycospor ointment - effectively destroys fungal cells. Apply this ointment in a thin layer and then rub it into the skin.

Gels against ringworm

Medicines in the form of gels are quickly absorbed into the skin, do not leave marks on it and do not stain laundry. Such drugs contain high concentrations of drugs that can effectively destroy the fungi that caused the disease. Patients with ringworm may be prescribed Exifin 1% or Mycogel-KMP to be applied to the skin for 3-4 weeks. By the way, both drugs act on both fungi and bacteria. In order for the drugs to be better absorbed into the skin, it must first be cleared of keratinized epidermis by applying lactic or salicylic acid. Also, the treated area must be disinfected with iodine so that the remaining mushrooms do not provoke a relapse of the disease.

Main causes of the disease

The first mention of asbestos-like lichen dates back to 1806, when this form was completely separated from the ringworm variety of the fungal disease. According to experts, inflammation can begin due to:

• manifestations of the initial stage of psoriasis;
• complications due to seborrheic eczema;
• seborrheic dermatitis;
• atypical course of streptococcal infection;
• individual manifestations of allergies to various diseases;
• head or skin injuries.

In some cases, even serious laboratory tests do not help to establish the root cause of this disease with 100% accuracy. Sometimes lichen asbestos can develop as a complication after simple fungal inflammation. Most often it affects children and adolescents, as well as people with weakened immune systems.

Solutions for the treatment of ringworm

Treatment with solutions is used if you need to treat the scalp, as they do not stain the hair and penetrate the skin well. On areas covered with hair and smooth skin, solutions are used before applying the ointment. For faster peeling of scales and wound healing, ioddicerin is recommended. Vokadin effectively destroys fungus and has a bactericidal effect. Nitrofungin is also considered an equally effective antifungal solution. If the fungus has managed to penetrate deeply into the hair, complex treatment will be required, which also includes taking systemic medications.

Treatment methods for chronic ringworm

Therapy for chronic ringworm involves taking the antifungal drug griseofulvin, local treatment, as well as taking medications that eliminate predisposing factors (vitamins, hormones, agents to improve microcirculation and strengthen blood vessels, immunomodulators). The dosage of griseofulvin and the duration of therapy are similar to those prescribed for superficial ringworm.

As for local therapy, it is also identical to that used for ringworm (apply iodine solution in the morning, and sulfur-salicylic or sulfur-tar ointment in the evening). Often, chronic ringworm is easily treated, but relapses of the disease occur, the treatment of which requires a course of antifungal treatment. Chronic ringworm often affects the nail plate, which then needs to be partially or completely removed. Treatment of chronic nail lichen is carried out using the detachment method, the Arabian or Andriasyan method.

The nail detachment method involves applying bandages with salicylic-milk or benzoin ointment. Apply such ointments to the nail twice, leaving it for two days each time. Afterwards, salicylic Vaseline is applied to the nail plate for another two days. Then the softened nail plate is carefully scraped off with a scalpel. If it is not possible to remove the entire nail, then repeat the procedure, and after it is completed, try again to scrape off the softened nail. The removal of horny deposits on the nail is also carried out. At the next stage, the free nail bed is treated with iodine solution. At the end of the course of therapy, you need to take a break for a couple of days, and then repeat the course of therapy. Similar courses of treatment for ringworm of the nail fungus must be completed three times.

The Arabian method consists of using an ointment that contains equal amounts of potassium iodide and lanolin. This ointment is applied to the nail plate for ten days to soften it well. Afterwards, the soft nail is completely removed, and the nail bed is treated daily with Arabian ointment, to which a 2% iodine solution is added. You can apply the ointment to the nail several times a day.

Andriasyan's method involves removing the nail using onycholysin, which contains 15% barium sulfide. First, onycholysin is diluted with water until a homogeneous paste is obtained, and then applied to the nail. After half an hour, onycholysin is washed off well with water, and the softened layer of the nail is scraped off with a scalpel. Application of onycholysin followed by scraping of the softened part of the nail is carried out until the nail plate is completely removed. An ointment is applied to the vacated bed, which includes resorcinol, salicylic and benzoic acids, and petroleum jelly. Then a gauze bandage is applied over the ointment, which is left for 2 days. In total, during therapy you will need to apply three bandages in a row, replacing one with another. After the doctor removes the third bandage, salicylic petroleum jelly is applied to the nail bed for three days.

Surgical nail removal involves pre-treating it with soda. For this purpose, first prepare a soda bath (2 teaspoons of soda per 200 ml of water). Then the nail affected by lichen is immersed in the bath. As the nail plate softens, it is carefully scraped off with a scalpel. After removing the nail, salicylic-milk ointment is applied to the nail bed and treated with iodine solution.

Water treatments

Previously, doctors agreed that swimming with ringworm is undesirable. Water procedures contribute to the spread of fungus throughout the body. But now there is no single answer to the question of whether it is possible to wash with lichen.

Water procedures are permitted:

• If you do not use a washcloth, cosmetics that injure the skin;
• If the patient uses a shower instead of a bath;
• If there is no inflammation, high temperature.

It is strictly forbidden to visit public swimming pools, saunas, baths.

Treatment methods for deep ringworm

Therapy for deep ringworm involves taking griseofulvin orally, as well as local therapy of the affected areas. As for griseofulvin, it is taken at the rate of 15 mg per 1 kg per day. The duration of taking griseofulvin is about 1-1.5 months. It is worth noting that local therapy for deep lichen is much more complex than for chronic or superficial lichen. During the period of acute inflammatory process, lotions with Boer's fluid, 0.25% silver nitrate, 2% boric acid or 10% aqueous ichthyol are applied to the plaques. After the inflammatory process subsides, sulfur, Wilkinson or sulfur-salicylic ointment is applied to the affected areas. Often, complete recovery of the patient occurs after 1-1.5 months of therapy.

Swimming at sea

Most patients are also interested in such questions as the possibility of swimming in sea water and sunbathing. This largely depends on the characteristics of the patient’s body and the type of disease.

In the case of ringworm or shingles, it is better to avoid sunbathing and swimming in sea water. At least until the inflammatory process subsides. In the case of pityriasis rosea, a positive trend is noticed after such water procedures, but in some cases there is also a deterioration in the condition due to an individual reaction to sea water.

The effect of ultraviolet rays on the epithelium of patients suffering from tinea versicolor is also negative and leads to exacerbations. They are advised to temporarily refrain from going to the beach.

Hygiene during ringworm treatment

Following several recommendations will help speed up the cure of the disease and prevent its relapse. It is advisable to take griseofulvin tablets with foods that are rich in fat. This is necessary for good absorption of the medication. For the same reason, it is recommended to take griseofulvin with milk or ice cream. If deep ringworm has affected the hair, then after removing it, the head should be washed daily with tar or any other antifungal soap. You can also wash your hair with lotions and shampoos containing selenium sulfide. Selenium is able to effectively destroy fungal spores, thereby promoting rapid recovery. But it is worth remembering that preparations with selenium can only be used if there are no crusts or suppurations on the skin.

If a patient is diagnosed with a severe form of the disease, then he should wash his hair with selenium shampoo daily. For mild forms of lichen, treating the scalp two to three times a week will be sufficient. Any family members who live in a household with ringworm should also be sure to wash their hair with selenium-containing shampoo to prevent possible fungal infection. It is advisable that all personal belongings of a patient with ringworm (combs, hats, combs, towels, bed linen) be stored separately. Particular care must be taken to ensure that potentially infectious items are not grabbed by children.

Also, other healthy family members should not be allowed to play or be in close contact with the patient. Patients with lichen are advised not to scratch areas of inflammation, even if they really want to. To do this, you can try to be distracted by doing things that require increased concentration. A child, for example, can be distracted by games. However, it is worth considering that during sleep it will be unbearably difficult to avoid scratching the inflamed skin. That is why it is recommended to wear protective gloves on your hands while sleeping to prevent damage to the skin by nails when scratching.

If ringworm is detected in one of the family members, it is advisable for all relatives who live in the same house to be tested. When treating deep lichen on smooth skin, you can additionally use ointments containing clotrimazole or miconazole (micatin, lotrimin). These ointments significantly alleviate the patient’s subjective condition. It is advisable not to use ointments with hormonal components (for example, cortisone) to treat the disease. The fact is that hormones do not speed up treatment, but on the contrary can aggravate the course of the disease. Hormonal drugs relieve inflammation on the skin, so after their use, redness on the skin disappears, which many patients consider a criterion for successful recovery and the disappearance of signs of infection. But therapy should be continued further, because if you stop, then after some time a recurrence of ringworm will occur.

Therapy for deep forms of lichen must be carried out until there is complete absence of fungus in the scraping and the symptoms of infection are eliminated. The main signs of recovery are drying of abscesses and flattening. In this case, the skin is often completely covered with scales and then begins to peel off severely. The onset of complete recovery of the patient can be determined as follows - close your eyes, and then run your finger over the place where the lesion was localized. If the skin feels flat to the touch and has the same texture as the surrounding tissue, then a complete cure can be stated.

During the course of treatment, a person with ringworm can attend school or go to work. You also need to carefully observe all the rules of personal hygiene and not allow colleagues and classmates to touch the inflamed areas of the skin. It is strictly not recommended to give clothing, combs, shoes and other personal items to healthy people, as they can be contagious.

Consequences of the disease

Absestosis lichen - a chronic disease, weakened immunity and other reasons can provoke its secondary appearance. Therefore, you need to monitor your health, not succumb to stressful situations and adhere to the rules of hygiene. A completed course of treatment will help you get rid of painful, discomforting symptoms. After an illness, the patient may be left with bald patches or abrasions; various methods are used to restore hair; they can be prescribed by a trichologist.

Advanced asbestos-like disease will subsequently lead to the development of seborrheic dermatitis.

Treatment of ringworm in children

If a child has been diagnosed with a small area of ​​ringworm, then treatment can be carried out at home. Antifungal creams are recommended for this purpose: Lamisil, Travocort, Nizoral, Clotrimazole. Apply such preparations to the baby’s skin at least twice a day. Once a day, the affected area is lubricated with iodine tincture. If the fungus grows in vellus hair, before its treatment it is necessary to get rid of them using a colloidal film. It contains collodion, resorcinol, salicylic and lactic acids. You need to apply this product for three days, after which the hair is easily removed.

If a child is infected with ringworm, topical medications will not work. Therefore, the child is prescribed oral antifungal drugs. Antifungal antibiotics are often prescribed. Suspensions are recommended for children under three years of age, and tablets for older children. Take this drug four times a day along with one spoon of vegetable oil. The doctor may also prescribe the parallel use of medications that protect the liver (Carsil, Heparsil, Galstena).

It is worth considering that griseofulvin is strictly contraindicated for children with impaired liver, kidney, peripheral nerve function or patients with peptic ulcer disease. In this case, this drug is replaced with Lamisil tablets, since it has a small number of contraindications and rarely provokes side effects. The dosage of Lamisil for children depends on their weight. For the treatment of scalp lesions, washing with antifungal shampoos (nizoral, sebozol, dermazol) is indicated. Severe itching in areas of inflammation can be eliminated with the help of antiallergic drugs (Claritin, Zyrtec). You can strengthen your immune system by taking vitamins B and C.

Prevention of ringworm

• You can prevent ringworm infection, or in case of recovery, its recurrence, by following a few simple recommendations from doctors.
• Since children are most often infected with ringworm, it is necessary to remind them more often to wash their hands after going outside, playing with pets, or before eating. Adults also need to practice good hygiene.
• Children should be taught not to come into contact with stray cats and dogs. In addition to the fact that a stray animal can cause serious harm to your baby, it can also be infected with ringworm. You can suspect an animal has ringworm if it has noticeable bald patches on its skin.
• If someone in the household is sick, they should use personal eating utensils and not exchange items for personal use. A patient with lichen must have his own towel, bed, comb, and clothing. It is advisable to exclude any contact with healthy people.
• If there is a person with shingles in the house, all surfaces must be disinfected periodically. It is also necessary to keep the house clean and regularly carry out wet cleaning.
• The patient's bed linen and underwear must be washed at high temperatures and must be ironed afterwards.
• After visiting the bathhouse or swimming pool, you need to take a shower and wash your swimsuit.

The disease can be prevented by increasing resistance to harmful microorganisms. Good health does not allow fungal microflora to settle on the skin. This is due to the fact that the skin has a number of protective properties that are activated only with a strong immune system. In order for the body to resist not only skin infections, but also other infections, the following principles must be observed:

• walks in the fresh air - even if you are constantly busy, you need to find time at least on weekends to visit recreation areas and parks, walk more, take a walk outside before going to bed, run in the morning;
• proper healthy nutrition is the optimal combination of proteins, fats and carbohydrates in the diet, which is calculated for each person individually (it is permissible to simply eliminate smoked foods, fatty foods, high-calorie foods, spicy and too salty foods from the diet, and include more vegetables, fruits, dairy products and lean meat);
• sports - exercise, jogging in the morning or basic gymnastics can significantly strengthen the immune system, as well as improve mood and prevent stressful situations;
• positive emotions allow you to get sick much less often, since they eliminate stress, which often becomes the cause of many diseases;
• It is advisable to sleep for at least eight hours and only at night, and you need to go to bed no later than 23-00;
• maintain a drinking regime - water has a positive effect on health, the body’s defenses, general condition and mood;
• taking vitamins taking into account age, lifestyle and other individual factors, especially in autumn and spring, when the human body lacks them.

Attention!

This article is posted for informational purposes only and under no circumstances constitutes scientific material or medical advice and should not serve as a substitute for an in-person consultation with a professional physician.
For diagnostics, diagnosis and treatment, contact qualified doctors! Number of reads: 2402 Date of publication: 08/06/2018
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