Do hair care practices affect the acquisition of tinea capitis? A case-control study

Objective: To determine the influences of hair-grooming practices and environmental factors as risk factors for the acquisition of tinea capitis (TC) in children. Design: Case-control study comparing children with culture-proved TC with age-, sex-, and race-matched control subjects without scalp disease. Setting: A multicenter study involving 3 urban referral centers in the United States. Participants: A convenience sample of 66 patients aged 12 years and younger presenting to pediatric dermatology clinics with clinical evidence of TC were enrolled as cases. Matched control subjects (n=68), without known scalp disease, were enrolled from the outpatient pediatric clinics at the same institutions. Results: Significant associations with TC in the conditional logistic regression model were a prior history of TC (odds ratio, 3.11; 95% confidence interval, 1.02-9.43; P=.04) and exposure to TC (odds ratio, 16.32; 95% confidence interval, 3.55-75.16; P=.001). The use of a hair conditioner was statistically significant in the univariable model but not in the multivariable model (odds ratio, 0.46; 95% confidence interval, 0.20-1.08; P=.07). Hairstyling, frequency of washing, use of oils or grease, and other hair care practices were not shown to be associated with the presence of TC. Conclusion: Hair-grooming practices do not appear to plap a major role in the acquisition of TC. Hair conditioners may be protective in children at risk for TC, but further studies are needed to confirm this finding.