Fungal(?) infection that hasn't cleared in 8+ months

[TTCJJB]

Hello,
I'm hoping someone can offer some advice on this fungal(?) infection that seems predominantly confined to various patches on the scalp.

We have been back and forth to the GP for 8 months now (since December 2024). Initially it looked like ringworm, perfectly circular and in one patch. The GP has since said its not ringworm and a fungal infection but no creams or steroids are clearing it. We've had a swab taken and nothing came back on it, still waiting results of a scraping.

Pictures attached of the 3 current sites of infection.

I dont see a picture
Do they get eczema?
There's a type of eczema that looks like ringworm
Ringworm is a fungal infection

The images are currently under review, hopefully approved soon...

No, has never suffered from eczema.

That looks awful
Could it be a type of psoriasis rather than ringworm? Ringworm usually has a redder ring with normal skin colour in the middle.

Maybe should see a dermatologist

Thanks - It could be, but that's never been suggested.

GP very reluctant to refer to dermatology as it'd mean various blood tests which they're reluctant to do on someone so young. Back at the GP on Friday with no improvements again, so will push for a referral.

I think your GP should be asking Infectious Diseases for advice too. There's a fungus/yeast that infects scalps called Trichophyton tonsurans (presumably because it causes bald patches!). Also Microsporum which used to be rare in Europe but it's spreading in bigger cities. They cause outbreaks in nurseries so happily spread child to child.

All this is probably beyond your average GP as they have to know a bit of everything; depending on what swab they sent off, it may not have been the right swab to detect these fungi. There's also common fungi like Candida. Can be really hard to diagnose and an antifungal won't necessarily work unless it's the right type for that particular fungus. Best of luck, your poor LO.

Thank you for these suggestions, I will pass them on at the next appointment.

The strange thing is that it has spread to both parents but it cleared up with the same anti fungal cream in less than a week each. For some reason it seems resistant (and getting worse) for the LO.

It could be a fungal infection that has now got infected, has the GP suggested that infection could be exacerbating it? I think if the GP has no other answers and it’s spreading then a dermatologist definitely needs to be consulted, I would be considering going privately if they won’t do it. It’s for the dermatologist to decide whether they recommend blood tests or not, not for the GP to avoid resolving an issue because of that.

Also - https://pmc.ncbi.nlm.nih.gov/articles/PMC7815080/

What is the link please?

It’s a very long shot about scabies. Basically you need to see a dermatologist if the GP is out of ideas.

Why are blood tests an issue? Both of mine had them as babies/toddlers and it was a total non event. With numbing cream I don’t even think they were aware. Sounds like the GP is fobbing you off… Maybe ask to see a different one next appt?

Thanks. We've actually seen a variety of GPs and seemingly a skin specialist. Will be seeking a referral.

Update- Had an appointment yesterday, GP said they wouldn't prescribe anything else and wanted to wait for scraping results to come back (2+ weeks now). I stressed that I wanted a referral to dermatology - They wouldn't do this.

I requested a second opinion and was booked in with a more senior practitioner that afternoon. Since been prescribed oral medication to try and clear it.

@TTCJJB
OP, do you have an update about this?
My dd, 16, has very similar on her face. GP says ringworm but nothing is clearing it. She's so self conscious about it. We are going back next week if I can get an appointment.

Sorry, I missed this. The infection did eventually clear in the sense it's no longer red, angry and full of pus. The tone is still quite pink and hair hasn't returned to the three parts pictured.

Should be seeing a dermatologist. I have a type of scarring alopecia that presents exactly like that if it gets a secondary infection. Your GP is horribly negligent. Punch biopsies need to be done.