Template:Tinea capitis treatment

Antifungals

• Coverage for Trichophyton and Microsporum and should use both topical and systemic therapy simultaneously
• Baseline liver function required prior to systemic antifungals

Topical

• Selenium sulfide 2.25% shampoo daily x 2 weeks
• Ketoconazole 2% shampoo daily x 2 weeks

Systemic

• Griseofulvin (first line)
  • No labs needed before griseofulvin treatment. However if repeat courses or if therapy continued beyond 8 weeks then obtain CBC and LFTs.
  • Microsize formulation: 20 mg/kg per day for six to eight weeks.
  • Ultramicrosize formulation: 10 mg/kg per day for six to eight weeks.
  • Give with fatty food (like peanut butter, ice cream) for better absorption. Therapy can fail due to lack of absorption.
• Terbinafine is alternative first line however need LFTs prior to therapy.
• Second line:
  • Fluconazole 150mg (6mg/kg) PO once a week x 8 weeks
  • Itraconazole 200mg (5mg/kg) PO daily x 4 weeks