“Treatment takes long and is expensive."
(Credit: Umar Nsubuga)
Six-year-old Sam Kasule is unsettled as he plays with his friends and siblings. He keeps scratching his scalp with scaly white patches.
His siblings, too, are going through the same. Their mother is reluctant to take them for treatment because she believes it is a minor condition that will clear with time.
But according to Dr. Aisha Namirimu in Wakiso, the condition is a fungal infection of the scalp. "It is a skin condition caused by a fungus, and it is contagious."
Namirimu says at least one out of every six children at the Buwambo Skin Clinic presents with the infection. She attributes it to children's play behaviour of holding and rubbing onto each other's bodies.
Different communities have misconceptions about the infection. Some believe it is a family disease that is passed on from parents to their children as a result of eating too many mushrooms.
However, Dr. Namirimu says that when the infection occurs, communities tend to own it. For example, crowded communities, especially those with poor hygiene or the economically poor, are greatly affected.
"Treatment takes long and is expensive, and because people from the low class cannot afford it, they resort to using herbs."
Moses Lwanga, a dermatologist in Kampala, says the fungi and their spores remain alive on combs, unwashed clothes, furniture and bedding for a long period.
He adds that some people can be carriers. A child can get the infection through sharing combs, towels and hair-cutting machines. "For every 10 children who are taken to the salon to have their hair cut regularly, six end up with the fungal scalp infection."
Signs and symptoms
According to Dr. Namirimu, the commonest symptom is scaly patches on the scalp, and when scratched, they produce fluffy particles.
"Normally the infection does not destroy the skin unless there is secondary infection," she says.
"In this [latter] case, the skin swells or develops pimples which can lead to permanent hair loss because it destroys the skin and hair roots."
How it may be treated
Dr. Lwanga affirms that treatment is basically by application of creams or ointments around the affected area of the skin. However, once secondary bacterial infection (wounds or pimples with pus on the scalp) sets in, it is advisable to discontinue the creams and ointments.
"These are meant for external use only and not for the open skin. Besides, some creams and ointments contain steroids that only worsen the infection.
He recommends systemic anti-fungal treatment which involves giving the child oral medicine. "Antibiotics work best for secondary bacterial infection."
However, he warns against self-prescription because this can result in overdose "When administered in high doses, the drugs destroy children's cell membranes," cautions Dr. Lwanga.
Proper hygiene is important; you can bathe the child at least twice a day and you have to wash the clothes using soap and water, he goes on to advise.
Use sterilised machines in the salon and an electric steriliser to clean the machines.
Also make sure you have enough towels for the customers. The towels should be washed in a bleach because fungi can survive in harsh conditions.