How is tinea capitis treated?

After the presence of a fungal infection is demonstrated by either culture or a positive KOH smear, treatment with an oral antifungal agent should be instituted. Most patients are placed on griseofulvin. Microsized griseofulvin at a dose of 20 to 25 mg/kg/day should be taken with meals to improve absorption. The medication is continued for 4 to 6 weeks, after which the site is recultured. Using antifungal shampoo may reduce shedding of the organism. Members of the patient’s family also should be evaluated for infection or a carrier state, and treated if needed. Patients who fail to respond to griseofulvin or are intolerant should be treated with an alternative treatment regimen:
• Fluconazole: 6 mg/kg/day for 6 weeks
• Itraconazole: 3–5 mg/kg/day for 6 weeks
• Terbinafine: 62.5 mg/day (<20 kg), 125 mg/day (20–40 kg), 250 mg/day (>40 kg) for 2 to 6 weeks (infections by
   M. canis may require double the dose)

Sobera JO, Elewski BE: Fungal infections. In Bolognia JL, Jorizzo JL, Rapini RP, et al, editors: Dermatology, New York, 2008, Mosby, pp 1135–1163.