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.