A woman holding up her hair with a scalp fungal infection

Do Fungal Infections Cause Hair Loss?

If you are suffering from a fungal infection that is causing hair loss, or making you worried about losing hair then you need to take immediate action to stop the infection spreading.

In this article you’ll learn about the different types of infection.

At the end of the article I’m going to share how to get rid of the fungus (and stop it ever coming back!) and re-grow your hair, using homemade shampoos and changes to your diet.

There is plenty of research has revealed that fungal agents are one of the major causes of alopecia.

​​By the way, if you want to find out ​about my hair regrowth story and the 10 steps that made my hair grow again you can click on my photo further down this article.

What Are Fungi?

A man with a fungal infection on his scalpFungi (singular-fungus) are eukaryotic single celled or multinucleate organisms that decompose and absorb the organic material in which they grow. They include yeasts, mushrooms, molds, smuts, rusts and mildews.

Hair infection by fungal agents is scientifically known as trichomycosis. The study of fungal hair infections has gained importance over the last couple of years due to the following reasons:

  • Human trichomycosis is a major concern due to cosmetic hair loss
  • Severe infection by fungi can cause inflammation which may result in disability
  • Vellus hair infection in other parts of the body other than the scalp may cause chronic recurrent infections that can make life difficult for victims

How Many Types of Fungal Infections Can Cause Hair Loss?

Fungal infections that cause hair loss can be broadly categorized into 3 main types. These are:

  • Dermatophytes
  • Malassezia spp
  • Agents causing piedra


Dermatophytes directly invade the hair where they can inhabit the scalp and grow. Their ability to inhabit and grow on the hair can be demonstrated by the hair bait technique.

This involves placing sterile hair in a container with soil, where the Dermatophytes present in the soil show their affinity for hair by immediately evading it and producing colonies using hair as a substrate.

Some Dermatophytes can also produce perforating organs in the hair shaft.

How Do Dermatophytes Invade the Human Hair?

Dermatophytes invade the hair stratum corneum, elongate and multiply, and then enter into the hair cortex as intrapilary hyphae. The hyphae cannot go beyond the keratogenous zone of the hair and remain there in form of a fringe called Adomson’s fringe.

It is within the keratogenous zone that hypha produce spores that appear as crusted plaque-likelesions on the scalp.

Fungal Infection Due to Dermatophytes:

Tinea Capitis

Tinea capitis is the most common fungal infection of the scalp, which is also called ringworms. Though the condition usually attacks children between 5-10 years, it is present across all age sets, especially in males.

A woman presenting with tinea capitis

Is Tinea Capitis Associated With Worms?

No. Contrary to popular belief, the condition has nothing to do with worms but it’s actually a fungal infection caused by dermatophytes in the Trichophyton and Microsporum genera. Other fungi that are linked to tinea capitis are Microsporum gypseum, which uses animals (pets) as hosts.

The term “ringworm” was first used to describe hair conditions that assumed a “ring form” in the early part of the 16th century. According to the world heath organization, tinea capitis accounts for more than 90% of fungal infections in Europe and the Americas.

Is Tinea Capitis Contagious?

Yes. The disease easily spreads when one has physical contact with an infected person, especially contact with the hair. The reason the condition is so prevalent among children is because children are generally very close and tend to have a lot of physical contact with each other, especially while at school.

What Are the Risk Factors for Tinea Capitis?

  • Sharing hair shave blades with a large number of people in pilgrimage centers, mostly in unhygienic conditions
  • Sharing of fomites like combs, towels, hair brushes and theater seats with infected persons
  • Physical contacts with pets that serve as habitats for zoophilic (animal) dermatophytes
  • Having wet hair for long periods of time. Fungi thrive best under moist conditions
  • Major/minor scalp injuries


  • Round bald patches on the scalp
  • Sever itching of the scalp. The natural reaction is most likely to be scratching, leading to hair loss
  • Brittle, broken hairs that are shorter than the rest
  • The bald patches may appear red and scaly in serious cases
  • Bald patches may blister and ooze
  • Gray patches
  • Thickened boggy swellings, especially in adults

How to Distinguish Between Tinea Capitis and Other Scalp Conditions

Most scalp conditions are associated with similar symptoms, which make it very difficult to identify a particular condition just by taking a look at the affected hair and scalp.

Although an experienced dermatologist may be able to easily diagnose ringworms, the best approach involves scrapping the affected area with a blunt scalpel.

The harvested hairs are subjected to microscopic viewing. The presence of spores is considered as positive diagnosis.

Ringworms Treatment

(1) Topical treatment:

Topical treatments applied in the right amounts have been found to effectively get rid of ringworms. They include shampoos containing:

It is important to note that topical treatment by itself is not considered to be sufficient. However, any commercial shampoo that contains 0.02 parts of ketoconazole has been found to be very effective.

The shampoo should be used for a period of up to 8 weeks. Topical treatment has been very successful, especially in children.

(2) Systemic Treatment:

Systemic treatment is often required so as to cure tinea capitis within the shortest time possible. The drug most commonly used in this category is Griseofulvin. Physicians recommend doses of 10-20 mg/kg.

Just like with topical treatments, Griseofulvin should be used for a minimum of 8 weeks, though your physician may dictate otherwise depending on severity of your infection. There are two main reasons why Griseofulvin is the most preferred systemic drug:

  • It’s the only licensed drug, besides being easily available in most dermatological clinics
  • It can be converted into a syrup, perfect for children

However, Griseofulvin is gradually being replaced by more recent, safer options because of the following reasons:

  • It must be taken for relatively longer time periods compared to more recent options
  • The drug is not appropriate for pregnant women
  • It has its own side effects that can cause additional stress and social disruption among users

The other systematic treatments that have been introduced include:

  • Terbafine – Besides being associated with less severe side effects, terbafine only needs to be applied for up to 4 weeks. These factors have elevated it above griseofulvin in terms of effectiveness. The recommended dosage is 5 mg/kg of body weight.
  • Fluconazole – It is given in the dosage of 6 mg/kg body weight and treatment takes just 4 weeks

Among all the drugs we’ve looked at, Griseofulvin remains the only licensed drug.

What Can Be Done to Minimize the Risk of Tinea Capitis?

  • It is imperative to avoid sharing of fomites like combs, hair brushes and hair clothing even if no one has been infected by tinea capitis in your family.
  • Pets like cats and dogs serve as hosts to ringworm-causing fungi and should therefore be kept clean at all times.
  • Avoid sharing hair brushes and combs with anybody suffering from a fungal infection
  • You should purpose to wash your hair with the approved shampoos at all times. They contain ingredients that can kill most fungi.

Malassezia Infections

Malassezia spp. are lipophilic yeasts that derive their name from their discoverer, Malassez, who successfully isolated them from dandruff in 1889. They have been found to play an important role in the pathogenesis of pityarisis capitis, a mild form of seborrheic dermatitis of the scalp that accounts for 75-85% in seborrheic individuals.

There is also definite evidence that Malassezia can cause hair loss and exacerbate androgenic alopecia. A simple mechanism would be to increase chronic inflammation in the scalp. Treating with ketoconazole helps eliminate dandruff and reduce hair loss.


Currently, there are 12 known species of Malassezia:

  • Pachydermatis
  • Furfur
  • Globosa
  • Restricta
  • Obtuse
  • Slooffiae
  • Sympodialis
  • Dermatis
  • Equi
  • Nana
  • Yamatoensis
  • Japonica

pachydermatis is the only non-lipid dependent species with all the others being lipid dependent. The main fungal condition in this category is pityriasis capitis, commonly known as dandruff.

Pityriasis Capitis

Molecular Studies have suggested M. globosa as the most common pathogen responsible for pityriasis capitis.

Dandruff manifests itself as itchy, reddish brown patches on the scalp. Statistics collected by the National Institute of health indicate that pityriasis capitis has a worldwide prevalence of between 2% and 5%.

Large numbers of Malassezia yeasts invade hair follicles distended with keratin. Confirmation of an attack by pityriasis capitis can be done by experienced dermatologists. Demonstration of spores in the scalp is considered confirmatory.

Special stains are used to visualize the spores. These include Periodic acid schiff’s or Gomari’s methane amine silver stains.

Does Pityriasis capitis/Dandruff attack both Men and Women equally?

Though the condition affects both sexes, it’s more prevalent in men and usually attacks them soon after puberty. Dandruff scalps lose two to three times more hair than non-dandruff scalps.

Risk Factors for Pityriasis capitis/Dandruff:

  • Extreme weather
  • Poor hair hygiene
  • Stress and fatigue
  • Recovery from cardiovascular conditions like heart attack or stroke
  • Age- the condition usually sets in after puberty
  • Having a very oily scalp – a moist environment provides M globosa with the perfect ground for multiplication and growth

What Are the Symptoms of Pityriasis capitis?

  • Itching followed by scratching hence hair loss
  • Flaky white or yellowish scales in the hair and areas next to the hair, like shoulders
  • A scaling rash on the scalp
  • In serious cases, red patches may develop on the scalp after obliteration of hair

Pityriasis Capitis Hair Loss Treatment

Treatment of pityriasis capitis mainly involves the use of antidandruff shampoos that contain active ingredients such as:

  • Zinc pyriothine
  • azole antifungals,
  • coal and tar
  • Selenium sulfide

In addition, effective topical treatment may include lotions, terbinafine, mousses containing azoles, ciclopiroxolamine, and buteneafine. If the condition is very serious, systemic antifungal agents must be combined with one of the various azoles like ketoconazole, itraconazole, and fluconazole.

To date, the mainstay dandruff treatment is ketoconazole 2% shampoo: It persists in the hair for up to 72 hours after application and is safer in infants. Other studies have proposed a combination of 2% ketoconazole with 1% Zinc pyriothine to be very effective treatment.


Piedra is a Spanish word meaning stone. The condition is characterized by black and white nodules located near the base of the hair follicles. In serious cases, the hair breaks into small bits. It was first described by Biegel in 1865, and has been classified into two types:

  • Black piedra: This type thrives best in tropical conditions. It is caused by a fungus called piedraia hortae. Its unique symptoms include:
  • Dark, stony nodules at the base of the hair
  • In severe cases, a metallic sound is produced by the nodules during normal combing of the hair.
  • White piedra: It is caused by a species of fungus known as Trichosporon beigelli. Unlike black piedra, white piedra can attack other haired areas of the body, not just the scalp. The disease has been diagnosed around the pubic area in both men and women. It’s unique symptoms are:
  • creamy whitish nodules located at the base of the hair follicles
  • Hair on the affected section of the scalp appears shorter and brittle

There are two main favorable factors for piedra infection:

  • Applying plant oils on wet or semi-dry hair
  • High humidity

How is Piedra Diagnosed?

Under black piedra, diagnosis is considered positive if brown spores are found in the hair. Mature nodules have eight visible ascopores characterized by presence of a flagellum at each tip.

On the other hand, a positive diagnosis for white piedra is confirmed if the hair contains groups of spores located on the affected area of the scalp. The spores can have varying sizes.

Treatment of Piedra

Topical application of terbinafine, azoles and tolnaftate can be effective in curing fungal infections. Your physician should be in a position to recommend the most appropriate choice.

Black piedra can be successfully cured by oral usage of terbinafine. On the other hand, oral itraconazole provides effective treatment of white piedra. Physicians may also advise you to clip the affected hair so as to facilitate penetration of drugs into the scalp. You should also avoid moisture as much as possible.

Homemade Remedies for fungal Hair Infections

Besides topical and systemic treatments, there are several homemade solutions that have been found to be equally effective in treating and/or avoiding fungal infections. We now discuss the main ones:

I recommend looking at my complete guide to homemade shampoos for hair loss here.

Castor Oil

Castor seeds and oil in a wooden bowlApplying castor oil all over the scalp can treat and reduce fungal infections. You should note that for efficacy, castor oil needs to be applied regularly as it is not a quick fix.

You should avoid applying the oil directly on the affected area with your bare hands. Instead, use latex gloves for this purpose. Be sure to rinse off all the oil after 15 minutes. You should ensure that all hair strands are washed properly with plenty of cold water.

The reason why you should remove all the oil is because an oily scalp is itself a favorable factor for fungal infections. You should always remember fungi thrive well under oily, moist conditions

Anti-fungal shampoos

Shampoos containing zinc pyrithione and selenium sulfide are also effective fungal treatments. You should apply the shampoo and then embark on massaging the hair strands and the scalp.

Remember to give the scalp a gentle touch to avoid scratching off the already loose hairs or causing injury to the scalp. 5 to 8 minutes are considered enough for this form of therapy, although the time spent in this exercise might depend on the extent of infection.

Again, anti-fungal shampoos do not offer you a quick fix and hence should be applied regularly until the infection is secured. Preventive use can be less frequent.

Find out why I don’t recommend Head and Shoulders.

Tea tree oil

Tea tree oil can help reduce fungal infections on the scalpApplying tea tree oil is also an effective anti-fungal solution. A mixture of tea tree oil, grapes and black walnut should be applied on hair on a daily basis and can be allowed to remain for up to 6 hours.

The important thing is to give the ingredients ample time to penetrate the scalp. As such, you should avoid disturbing the hair during this period.

At the end of the exercise, be sure to rinse the hair with cold water. You should then use a towel to drain out the water because it’s imperative to have your hair as dry as possible.

Quick Tips For Getting Rid Of Fungal Infections From The Inside Out

Optimising your diet is practically the only long term solution to regrowing lost hair caused by fungal infections. The first thing you can do is to remove any yeasty foods from your diet. This includes:

  • Alcohol
  • Bread
  • Anything fermented
  • Mushrooms

Also, remove any processed carbohydrates from your diet. These typically ferment in the stomach causing a host of other problems.

Ideally follow the rules of food combining when eating meals. This means your food will digest much more easily.

Take a good probiotic and learn how to get a better balance of good and bad bacteria in your gut.


As you’ve have seen from the research data above, fungal hair infections are real and actually cause hair loss. Dermatophytes and Malassezia spp. could be considered the main causes of fungal infections compared to piedra.

In most cases, these infections do not directly cause hair loss: It is the intense itching and irritation that may tend to force you to scratch you hair.

Diagnosis of all these infections should involve a dermatologist as some of the symptoms appear across the board, therefore making it quite difficult to undoubtedly identify and confirm a particular infection by just physical inspection.

Apart from clinical treatment, there are several homemade solutions that you can turn to that can help you fight fungal infections. I cannot stress enough the importance of good hair hygiene.

*This article was reviewed by Dr. Anil Simhadri

29 thoughts on “Do Fungal Infections Cause Hair Loss?”

  1. Hey will, I’m 16 and I fear that ill lose my hair as I think that my hairline is receding.. Is it normal?? And I have a long history of balding in my genes.. Do kindly help me

  2. I have a very itchy scalp and am experiencing hair loss, I’m guessing the itch is from a fungal infection. When I see the fallen hair though, I can see the follicle at the end so I know the hair fell out, it didn’t just break. Can a fungus do this or is my itch caused by something else? Or maybe I do have a fungus but the hair loss is from something else?

    • I wouldn’t use any kind of shampoo with chemicals in it. Ultimately the chemicals in shampoos can damage the health of the scalp which could leave it more vulnerable to infection. Use apple cider vinegar shampoo instead. And optimise your diet to reduce yeasty foods.

  3. Hi Will. I have been battling White Piedra for at least a year. My dermatologist didn’t know how to treat it because it is so rare. Finally we got on a plan of econozol cream applied and left on over night and then washed out with 2% ketoconazole shampoo as a daily routine. . She also has me on Fluconazole orally 3 times a week. Finally there has been progress made and the fungus seems to be going away. I told the doctor that my hair was thinning significantly around my face and a little on the top of my head which is where most of the infection presented itself. She told me it was female pattern baldness. I am devistated. I am 48 and have not hit any part of menopause yet. If my hair is this bad now I am concerned that it will nearly go away completely when I do. Is there any documentation of White Piedra causing hair loss? It seems like too much of a coincidence but no one has any answers because it is so rare. Thanks so much for any help.

    • Hi Tami, I’ve don’t know anything about White Piedra, so I don’t think I can answer your question is a useful way, but I think there could be a connection. I would say that you shouldn’t worry too much, there is a lot you can do to reverse female pattern hair loss. Focus on your diet first and make sure that everything is optimised to reduce fungal infections (remove yeasty foods etc) and help with hair growth. I am not really a fan of treating skin problems with topical applications because they always seem to come back. Fix it from the inside-out.

  4. Hello everyone! I hope you are all doing well. I will like you I share my experience with fungus infection. It all started with scalp or dead skin falling of my head when ever I scratched it.

    When the infection was at it’s worse my scalp used to be very oily all the time, and when ever I ran my hand through my head a handful of hair would come off. Every morning that I woke up, my pillow was full of hair. I lost all my top hair I was (still) so embarrassed. in my early 20s and I was bald. I had already given up. I tried all type of healthy scalp shampoo but nothing, until a family member suggested that I’ll use tea tree oil. By this time I was already bald and the infection was spreading to the sides of my face.. It was horrible.

    I had gone bald and now the infection was spreading to my face. I not only had to be embarrassed about my bald head which I tried to disguised any way I could. but now I had to worry about my face. I was kind of like the same symptom with my head. My face Was becoming very irritated. It looked like if I trew white powder on my face. I tried to use lotion which it helped a little. But had to have it with me all the time so I could keep on putting it on my face… anyways, the first time I used tea tree oil, I immediately felt it work.

    I used as suggested. I added 3 to 5 drops with my regular shampoo. After showering I applied a few drops on a piece of paper towel ( I was told to use cotton but i didn’t have any) then I rubbed on my face and as I was applying it I felt I kind of like burning and itchy sensation. Whining he following days my oily scalp was reducing and my face was getting better as well.

    I can’t remember exactly but after about a month my scalp and my face were back to normal, no my oily scalp or no more hair in my pillow. It has been more than two years since the infection in my head went away and my hair as very slowly starting to regrow. The infection however didn’t go away completely. One of my ears is still infected I’m still using the tea tree oil when showering, and I also treat my ear, but the infection in my ear just won’t go away.

    • Thanks for sharing your experience Raul. I’m glad to hear you had some good results using Tea Tree Oil.
      I wonder what your diet is like? Perhaps this is something you could optimize to help get rid of the infections for good?
      For example, have you tried drinking raw goat’s milk kefir? It is amazing for skin problems.

      • I started making Kefir 7 months ago and about 5 days in I started having horrible itching all over my head. That’s when I realized I had head fungus. The itching was so bad that I didn’t know what to do so I stopped the Kefir because I couldn’t find any info about this happening. I did read that the good fungus fights with the bad fungus but other than that, that’s all I could find. Maybe that’s what was going on?

        • I wouldn’t thought it was the kefir, I would think that it helps. But of course there are many different kinds of kefir, some may not be as high quality as others or use the right source of bacteria. I would make sure you are getting the most high quality and trusted source as you can.

    • Ivermectin Horse paste from Big R or any farm supply store, and I’ve been taking it twice a day every day, and goting off my weight for how much to give myself

  5. Hello everyone I also have been dealing with hair loss skin issues itchiness ear problems some acne. I’ve also had major brain fog fatigue aches joints. I recently discovered yes it is fungal but also mite related if you have lived anywhere where there has been mold or black mold you are prone to all of this there are tiny mites that live and fees off fungus they will do the same on your body if you have any fungal going on.

    They live in your bed clothes carpet couches anything porous. Rubbing alcohol, white vinegar, black seed oil, grape seed oil gets rid of them, but not the eggs so you have to do extreme cleaning for a while and get rid of the mold they can live in the shower ceiling wall floor towels brushes toothbrush under bathroom sinks, kitchen sinks under them anywhere dark and damp or humid.

  6. Hi all, so I’ve had my problem over 2 years now. I get pimple like sores on my head some hurt and some dont. I’ve been using nizoral and it does help but still there. Only thing I can tell it helped with was dandruff. Looking for anything?

    • Hello Sam, it’s hard to say from your description. How is your diet and have you tried removing yeasty foods? That would be a good place to start.

  7. For 2 years I’ve been living in a house with severe black mold problems. There’s nothing to be changed about this, I couldn’t even move out. I can in a month, though.
    I have developed several health problems. Joint pain, respiratory problems and also a LOT of hair thinning. I’ve had a receding hairline for a while, but now it’s pretty much all thinned out.
    What should I do now? Will it grow back? Or is it gone for good?

  8. Hi, I am 21. I got this problem since I was 18. My head started loosing hair gradually. I still have this problem and I never knew what it was. I went so money doctors but they couldn’t help. I have oily head and it actually itches a lot. Whenever I stcretch it it burns. I wash my head everyday and it still stinks. I feel weird pain on front of my head, around my eyes and inside my noise. I have to many pimples around my face , and I have oily face too. When I shave my hair I see things that are circled like a continent. In week or two weeks it disappear. I need help please I lost a lot of my hair and I don’t wanna loose more, and i am in pain all the time please help……

    • Hi Aziz,

      I’m sorry to hear that this has been your experience.

      You mentioned you’ve been to many doctors, but I do think that an experienced dermatologist would be your best course of action.

      There are some fungal infections that are more difficult to treat than others. And it will take some testing to determine what species of fungus you’re dealing with so you can properly treat it.



  9. Hi Will, thanks for this educative piece. Its really helpful. I’ve been battling with hair loss for some time now. I’ll try some of your recommendations.
    Thanks so much.

  10. Hi.
    My husband had a haircut June 2018. A few days later he bent over to pick up our baby and I noticed he had a severe (nearly bald) spot (typically where you see male patterned baldness). He then started complaining about it being itchy. And he actually had scabs, I think from scratching in the night.

    Newly a year later and it has only got worse. He is now thinning all over the top and it’s receding. Right before this haircut his hair was thick and very full. Now he’s thinning out and going bald. What could it be and what do we do? He isn’t even 30 and no family history. He’s switched shampoos but no luck. Doctors didn’t say much other than his scalp is dry (we have long, dry winters). Don’t want to just sink money into trying random things.

    At a loss and very concerned.

    • Hi Aly, thanks for your comment. Seeing a specialist dermatologist to take a close up look of the his scalp might be a good place to start. If there is no kind of infection then it could be something else instead. Perhaps stress, from your new child? Itchiness could be a sign of low quality water, either drinking or showering water, or sometimes can be caused by dehydration. There’s no easy answer but it could help to get possible causes ticked off your list. If there’s no history of baldness in his family then it does suggest something other than genetically predisposed alopecia.

  11. I think ive been having an ongoing problem with fungus of my scalp causing hair loss ,I wore a hard hat for years working construction but ive also been around cats for the last 30 years, some of which have a fungal ear infestation that never completely clears up.. I am now using a pet shampoo containing ketoconazole and also a tea tree oil soap ,the sores on my head have started to go away after just a few treatments ,and the itching has gotten a lot better, but I think im going to stay with tea tree oil soap mixed with braggs cider vinegar ,I think it may be safer than the shampoo meant for animals

  12. Wow so much info for free. Thanks bud. I am going to see a doctor but after coming across this, I wanted to ask for your advice first. My problem is I had an infection (cant remember if its fungal or yeast?) on my head in my childhood and as a child I didn’t eat the medicine or apply ointments on the infection as prescribed by the doctors. Now that I have grown I regret it because my hair is not growing back on the scalp where I had the infection. And since I have fine hair the little patch of baldness is very visible. Can you shed your wisdom on my predicament?


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