What Is Kerion

Overview

Kerion is a medical condition that most people have never heard of, but it can be a source of discomfort and concern for those who experience it. This fungal infection of the scalp is not as common as other dermatological conditions, but it can be a significant health issue for those affected. In this article, we will explore what Kerion is, its causes, symptoms, treatment options, and prevention strategies.

Causes of Kerion

Kerion is not a disease on its own, but rather the manifestation of another disease process. It is a collection of pus under the skin due to the immune system’s reaction to a fungal infection. It often occurs on the scalp, but may also form on the face. The fungi that lead to kerion formation are called “dermatophytes” or “tinea”. Dermatophytes are a group of fungi that require keratin to grow and thrive in warm, humid environments. Because your skin, hair follicles, and nails contain keratin, these are the most common areas of the body affected. The most common dermatophytes that cause diseases in humans are Epidermophyton, Microsporum, and Trichophyton species.¹

Signs and symptoms of Kerion

A kerion may appear as a large boggy mass on the scalp and can have some crusting around it. A kerion often leads to scarring of the affected area. Other symptoms that could appear are: 

• Itching: Kerion is an inflammatory process which can cause severe itching leading to scratching and further worsening of the condition, scarring and permanent hair loss
• Hair loss: Hair loss is a common symptom of kerion, especially following a tinea capitis or ringworm infection of the scalp. Sometimes this hair loss is accompanied by scarring
• Red, swollen lesions: The most obvious sign of a kerion is the appearance of red, swollen, and inflamed areas on the skin or scalp. These lesions may vary in size and produce pus that could cause blisters which later rupture and appear crusty around the edges. These blisters can be warm and tender to the touch
• Enlarged lymph nodes: Sometimes, the lymph nodes in the neck may become enlarged and tender if there is a kerion on the scalp. This is because lymph nodes filter the blood and expose infectious organisms to our immune cells to fight them²

Management and treatment of Kerion

The treatment of kerion typically involves a combination of medication to contain and eliminate the fungal infection and manage the symptoms. The treatment may include the following:

• Oral antifungal medications: Healthcare providers often target the causative organism by prescribing oral antifungal medications. Antifungals such as griseofulvin, terbinafine, or itraconazole target the underlying fungal infection and help prevent its spread
• Topical antifungal creams: Topical antifungal creams are used in addition to oral therapy. These creams or ointments may be recommended to apply directly to the affected area. Antifungal shampoos are also available for lesions on the scalp
• Corticosteroids: Corticosteroids are a class of medication that suppress the symptoms of inflammation. This provides relief for some of the more uncomfortable symptoms of kerion, like swelling and itching. Topical steroids are mostly prescribed but oral corticosteroids like prednisone may be prescribed for a short period
• Pain relievers: Over-the-counter painkillers like acetaminophen or ibuprofen are non-steroidal ways of managing inflammation, pain and discomfort associated with the condition
• Antibiotics: Secondary bacterial infections may develop in some cases due to the patient scratching or touching the area. In such situations, antibiotics may be prescribed to treat the bacterial infection

Fungal infections often take weeks to clear and antifungal therapy is usually recommended for a period of time even after the lesions have resolved. It is important to follow the recommendations of your healthcare provider regarding the duration and dosage of the prescribed medications. It is crucial to complete the full course of treatment to ensure the infection is completely eradicated.

Diagnosis

Kerion is typically diagnosed in clinics after a thorough examination by your healthcare provider, often a dermatologist. The affected area will be examined for the characteristic signs and symptoms mentioned above. Additionally, your healthcare provider may take skin scrapings from the affected area, to confirm the presence of dermatophytes under a microscope. This diagnostic process helps distinguish Kerion from other scalp conditions, such as psoriasis or eczema.

FAQ’s

How can I prevent kerion?

Maintaining good hygiene: Regular scalp and hair washing with mild shampoo can help prevent the buildup of oil and sweat, which is an ideal environment for fungal growth.

Avoid sharing personal items: Avoid sharing personal items like combs, brushes, hats, and towels, as these can harbour fungal spores and facilitate the spread of infection.

Educate children: Teach children about the importance of personal hygiene and the risks of sharing personal items with others.

Regularly inspect pets: If you have pets, especially cats, make sure to check for signs of fungal infection in their fur. If they show any symptoms, consult a veterinarian for proper treatment.

Prompt treatment: If you suspect your child or yourself has been exposed to an infected individual, seek prompt medical attention to prevent the infection from worsening.

How common is Kerion?

It is difficult to say how common Kerion is. It is a possible complication of a fungal infection of the skin. Not every person that has a fungal skin lesion will develop a Kerion. 

Who is at risk of Kerion?

It has been observed that most Kerions affect children between 2 and 9 years of age. ³

What can I expect if I have a Kerion?

Kerion is a subtype of tinea capitis; it will appear at the site of an existing fungal infection and will often present with signs of inflammation like swelling, pain, and itching. 

Is Kerion contagious?

A kerion itself is not contagious. However, the underlying fungal infection could be transmitted from one person to another.

When should I see a doctor?

It is important to seek the advice of your healthcare provider as soon as you notice any lesions on your scalp or skin. Kerions and the underlying fungal infections that lead to them have a good prognosis if treated early. However, if they are not treated immediately, they may lead to superimposed bacterial infection, scarring, permanent hair loss, and sometimes systemic infections.

Summary

Kerion is a skin condition that arises as a result of the body's response to a fungal infection. It is an inflammatory response to an infection by a dermatophyte. It often occurs on the scalp or face but it can appear anywhere there is hair, skin or nails. These sites contain keratin which is a protein necessary for the survival of dermatophytes. They also require a warm, humid environment to thrive. Kerions are pus-filled and can cause discomfort, itching, temporary or permanent hair loss, and scarring. Some of the symptoms of Kerion are itching, pain, swelling, and sometimes enlarged lymph nodes. Diagnosis is often clinical after a doctor examines the lesion. Skin scrapings may be taken to confirm the presence of a fungal infection and to recommend treatment accordingly. Treatment options include topical or systemic steroids to help suppress inflammation, oral and topical antifungal medications to treat the underlying fungal infection, and over-the-counter pain relief medications. Antibiotics may sometimes be prescribed in the case of a superimposed bacterial infection. Good hygiene practices and prompt medical attention are crucial for prevention and effective management. While Kerion is not contagious, the underlying fungal infection can be transmitted, making early treatment essential to prevent transfer to contacts and minimise complications. Children between 2 and 9 years old are more commonly affected by Kerion. If left untreated, Kerion can lead to scarring, permanent hair loss, and systemic infections, emphasising the importance of seeking medical attention when symptoms arise.