Favus is a fungal infection which affects the scalp. It is usually caused by Trichophyton schoenleinii and is a chronic condition which may result in hair loss and scarring. The majority of cases of favus are found in developing countries where poverty results in poor living conditions and malnutrition. It is treated with antifungal drugs, which may need to be taken for an extended period of time.
The disease, which usually affects only the scalp, is also known as Tinea Favus. It may be a severe form of Tinea Capitis, which is commonly known as ringworm of the scalp. It may rarely also affect skin on other parts of the body or nails. People suffering from favus tend to give off a distinctive mousey smell, due to the infection.
Initially, favus, which is commonly seen in childhood, causes erythema or redness of the skin on the scalp, especially around the follicles of hair. In the second stage, scutula appear. These scutula are crusty plaques around the base of the hair made up of fungi and skin debris and the hair may begin to break off. In the third, most severe, stage, extensive hair loss occurs, with scarring and formation of further crusts. Bacterial infection of the area may occur, which can require treatment.
While the development of favus is slow and this process may occur over years, it can be physically disfiguring and distressing for the patient throughout. The hair loss and scarring may be permanent, especially if treatment is only administered at a later stage in the disease. Favus does not seem to be as contagious as other fungal infections such as ringworm, although often family members or household contacts may also be infected.
Treatment of favus requires systemic antifungals such as griseofulvin, terbinafine or fluconazole. The course of treatment is generally quite long due to the fact that the scalp is infected. When treatment is given, all contacts with the infection should be treated simultaneously to prevent reinfection. Topical treatment, such as shampoo or lotion may be used in combination with the oral medication. General good hygiene should be encouraged to prevent any secondary infection.
The choice of which treatment is used will be decided by the prescribing doctor. They will take into account numerous factors, including age, previous clinical history, current medical conditions and allergies. The duration of treatment will depend on the patient’s response and may extend after the infection has cleared up. The treatment course must be finished completely.