The scalp, like other parts of the skin, is subject to many and various affections. Some of these may" be traced to hereditary tendencies; others are due to contagion, while many are caused by neglect.
One of the most common scalp affections is ringworm. This generally attacks children, although it is sometimes seen in adults. It is so contagious that one child may infect a whole school, and it is unfortunately one of those diseases of the scalp which does not readily yield to treatment unless taken in the first stage.
There is a popular idea among ignorant people that ringworm is an affection caused by a small worm which burrows under the skin, travelling in circles, hence the name " ringworm." As a matter of fact the disease is caused by a vegetable parasite or fungus which consists of spores and tubes. The favourite, if not exclusive seat of the parasitic growth is in the hairs and hair-roots. After it has gained a lodgment in the follicle, it almost immediately invades the hair-root, infiltrating it among and between the fibres of the hair.
There are three stages of ringworm. The first is characterised by small round patches or rings of a pinkish colour, and rather rough surface, the margin being of a brighter pink than the central part. Occasionally, little rings of vescicles are developed, but these last but a short time, and may easily escape notice. The second stage is of longer duration, and corresponds with changes in the structure of the hair and the development of the parasite on the surface of the skin. It shows itself on the broken hairs in the form of an asbestos-like covering of a dull white colour.
These sheath-like coverings more or less surround the broken hairs, and when the covering is complete the hairs are entirely hidden and can only be recognised by the little prominences produced; when these are numerous the surface looks as if covered with white frost. The third stage, which, happily, is not often reached, is a serious development, as acute inflammation occurs in the minute tress, or follicles, in which the hairs are set. This leads to the destruction of the hair and the formation of permanent bald patches.
The disease seems to originate spontaneously in some children of weak constitutions and debilitated health, but it is principally propagated by contagion. Treatment should commence by washing the head with hot water and carbolic soap. If the affection has made much headway it is generally best to cut the hair close to the scalp. In quite young children very strong remedies are not advisable. As a rule, if in the first stage, it will only be necessary to paint the parts affected with a little tincture of iodine for a few days, and this should be followed by the application of white precipitate ointment. Extraction of all the diseased hairs is often advocated, but this is not very easy, and breaking them off at the roots is, of course, useless.
In older children stronger treatment may be applied than in the case of those who are very young. One of the best known remedies is oleate of mercury combined with lanoline. The following is a good formula:
Lanoline q.s. ad.
This should be applied twice daily.
Another excellent remedy is made up as follows:
Ung. aqua rosae...................
Apply with a fine, soft brush to the diseased part once a day until the skin becomes inflamed; then wash off with brown Castile soap and dress with olive oil or simple cerate. Be careful to keep this preparation out of the eyes. A preparation which has recently been greatly extolled is a four per cent, solution of formalin in glycerine. First remove all grease with oil of turpentine; then apply the formalin-glycerine several times for about an hour.
It is claimed that, in the first stage of ringworm one treatment of this kind generally suffices. If the system is in a weak condition, cod-liver oil should be given, and, in some cases, an iron tonic is advisable. The diet should be nutritious; good milk and fresh butter should be given generously, and the child should have as much opportunity as possible for open air exercise.