TINEA CAPITIS

Scalp ringworm is common in children. The fungus has grown into the
hair follicle and will not be removed by topical treatment only. Severe
pustular forms exist with follicular pustules and nodules and often massive
purulent secretion. Lymph nodes in the neck swell and the patient
may have a fever and headache. There may be bacterial superinfection.
Systemic treatment is necessary to prevent scarring leading to permanent
bald patches.
Management of tinea capitis
- Griseofulvin 500 mg once daily for 8-12 weeks in adults.
- Griseofulvin 10-15 mg/kg once daily for 8-12 weeks in children.
- Add Whitfield’s ointment or miconazole twice daily topically for 4 weeks.
- Continue treatment after 12 weeks if the infection has not cleared completely.
- Alternative: Ketaconazole 200 mg twice daily or terbinafine 250 mg once daily or
itraconazole 200 mg (2 tabs) once daily for 4-8 weeks in adults.
- Ask for signs of infection in siblings or friends of affected children or in pets or
farm animals (bald patches, rash) and have these treated.
- In case of bacterial superinfection: antiseptics and / or antibiotics.