What is the treatment of choice for 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

Griseofulvin has been the traditional treatment of choice in all ringworm infections of the scalp. A 2008 meta-analysis found that griseofulvin remains an effective therapy for tinea capitis. [39] Most specialists recommend a griseofulvin dosage of 20-25 mg/kg/d for 4-6 weeks. Griseofulvin accumulates in keratin of the horny layer, hair, and nails, rendering them resistant to invasion by the fungus. Treatment must continue long enough for infected keratin to be replaced by resistant keratin, usually 4-6 weeks. In inflammatory lesions, compresses often are required to remove pus and infected scale. Therapeutic progress is monitored by regular clinical examination with the aid of a Wood lamp for fluorescent species such as M audouinii and M canis. Adverse effects include nausea and rashes in 8-15%. The drug is contraindicated in pregnancy, and the manufacturers caution against men fathering a child for 6 months following treatment. [40]


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