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Fungal skin infection - scalp - Management
Which oral antifungal should I prescribe?
- If oral antifungal treatment is being considered in children, seeking specialist advice is usually advisable.
- Consider prescribing only if confident of the diagnosis and experienced in treating scalp ringworm in children.
- Prescribe either griseofulvin (licensed) or oral terbinafine (off licence) empirically until culture results are known.
- If the person lives in an urban area, start treatment with terbinafine and review once the results of mycology are available.
- If the person lives in a rural area, start treatment with griseofulvin and review once the results of mycology are available.
- Once culture results are known:
- If the infection is Trichophyton tonsurans, continue terbinafine if already taking it, or switch to treatment with terbinafine if currently taking griseofulvin.
- If the infection is a Microsporum species, continue griseofulvin if already taking it, or switch to treatment with griseofulvin if currently taking terbinafine.
- For more information on doses and duration of treatment, see Prescribing oral antifungals.
- Itraconazole, fluconazole, and ketoconazole are not recommended.
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