View source for Template:Tinea capitis treatment

*Treatment involves oral antifungal with topical antifungals not effective due to inadequate penetrating of hair follicles and may miss sites of subclinical infection
*[[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: 20-25 mg/kg per day (max daily dose 1000mg per day) for 6-12 weeks
***Typical initial dose 20mg/kg per day for 6-8 weeks, if partial response increase to 25mg/kg per day for 12 weeks
**Ultramicrosize formulation: 10-15 mg/kg (max daily dose 750mg per day) per day for 6-12 weeks
***Typical initial dose 10mg/kg per day for 6-8 weeks, if partial response increase to 15mg.kg per day for 12 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 (can be taken without regard to meals)
** 10 to 20 kg: 62.5 mg daily for four to six weeks
** 20 to 40 kg: 125 mg daily for four to six weeks
** Above 40 kg: 250 mg daily for four to six weeks
*Second line (both below with limited efficacy data):
**[[Fluconazole]] 6mg/kg PO (max daily dose 400mg)per day x 3-6 weeks
**[[Itraconazole]] 3-5mg/kg PO (max daily dose 400mg) per day x 4-6 weeks
*Adjunctive interventions
** Selenium sulfide 1 or 2.5%, ciclopirox 1%, or ketoconazole 2% shampoo at least twice weekly to decrease shedding of fungal spores
** Use of antifungal shampoo by other household members may also decrease the risk for reinfection
**Combs and hair trimming equipment be cleaned mechanically and disinfected (eg, with household bleach)