• Rationale and Comments

    Tinea capitis, a dermatophyte infection of the hair shafts of the scalp, is treated with antifungal agents. Topical treatments cannot penetrate the hair shaft itself, which is where the infection lies; thus, monotherapy with topical medications is insufficient to effectively treat the infection. This insufficient treatment can lead to increased health care costs resulting from multiple visits and the prescribing of ineffective medications. For this reason, when tinea capitis is suspected or is diagnosed, systemic treatment is warranted, most commonly with off-label griseofulvin or terbinafine. Terbinafine is effective for most types of tinea capitis and is less expensive than griseofulvin with improved compliance because of a shorter required course of treatment. Topical treatments such as ketoconazole shampoo and selenium sulfide shampoo may be used adjunctively to decrease carriage of viable spores, thus possibly decreasing the time to cure and decreasing shedding of the organism, which decreases risk of transmission of infection to other individuals.

    Sponsoring Organizations

    • American Academy of Pediatrics – Section on Dermatology


    • Expert consensus


    • Dermatologic


    • Kakourou T, et al.; European Society for Pediatric Dermatology. Guidelines for the management of tinea capitis in children. Pediatr Dermatol. 2010;27(3):226-228.
    • Chan YC, et al. New treatments for tinea capitis. Curr Opin Infect Dis. 2004;17(2):97-103.
    • Coulibaly O, et al. A double-blind randomized placebo-controlled clinical trial of squalamine ointment for tinea capitis treatment. Mycopathologia. 2015;179(3-4):187-193.