Tinea capitis is a dermatophyte infection of the scalp and hair shafts. Due to the involvement of hair follicles and the hair shaft itself, topical antifungal agents are generally ineffective in eradicating the infection. Systemic antifungal therapy is mandatory for tinea capitis. Oral griseofulvin is considered the first-line treatment for tinea capitis, especially in children, given its efficacy, safety profile, and activity against common causative organisms like Microsporum and Trichophyton species. Oral terbinafine is an alternative, particularly for Trichophyton infections, but griseofulvin remains a primary choice. Oral fluconazole can be used but is not typically first-line. Topical agents alone are insufficient.
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