Which medications are effective for treatment of tinea capitis (scalp ringworm)?

Updated: Feb 21, 2020
  • Author: Marc Zachary Handler, MD; Chief Editor: Dirk M Elston, MD  more...
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Answer

Topical treatment alone usually is ineffective and is not recommended for the management of tinea capitis.

Newer antifungal medications, such as itraconazole, terbinafine, and fluconazole, have been reported as effective alternative therapeutic agents for tinea capitis. [28, 29]  Of these agents, itraconazole and terbinafine are used most commonly. There may be some advantage to giving itraconazole with whole milk to increase absorption. [32]  Data suggest that itraconazole and terbinafine have the highest mycological cure rates in children (79% and 81%, respectively), while griseofulvin and terbinafine have the highest complete cure rate (72% and 92%, respectively). Griseofulvin is more effective against Microsporum infections, while terbinafine and itraconazole are more effective in Trichophyton infections. [33] It should be noted that responses may vary geographically. [34]

Selenium sulfide shampoo may reduce the risk of spreading the infection early in the course of therapy by reducing the number of viable spores that are shed.


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