Topical treatments for nail infections are rarely effective, except for the superficial white type, in which infection occurs on the nail surface only. Tinea capitis mainly affects children. It is contagious and may become epidemic. T. tonsurans infection of the scalp is often subtle in onset. Characteristic black dots on the scalp result from broken hairs.
Inflammatory infections can occur.
Trichophyton sp may persist in adults. M. audouinii lesions are small, scaly, semi-bald grayish patches with broken, lusterless hairs. M. canis and M. gypseum usually cause an inflammatory reaction, with shedding of the infected hairs. Microsporum is also an ectothrix, producing spores to form a sheath around the hair. The sheath can be seen on microscopy.