From the Guidelines
The best treatment for ringworm in kids is oral antifungal therapy, with griseofulvin and terbinafine being the most widely used first-line treatments, and the choice of therapy should be directed by the causative dermatophyte and/or local epidemiology. When considering treatment options, it's essential to note that topical therapy alone is not recommended for the treatment of tinea capitis, and oral therapy is generally indicated to achieve both clinical and mycological cure 1. Some key points to consider when treating ringworm in kids include:
- Griseofulvin is more effective against Microsporum species, while terbinafine is more efficacious against Trichophyton species 1
- The dosage of griseofulvin and terbinafine varies by body weight, with griseofulvin dosed at 15-20 mg/kg/day for 6-8 weeks for children under 50 kg, and terbinafine dosed at 125-250 mg/day for 2-4 weeks depending on the child's weight 1
- Treatment failure should be addressed by considering lack of compliance, suboptimal absorption of the drug, relative insensitivity of the organism, and reinfection, and second-line therapy with itraconazole may be necessary 1
- Children receiving appropriate therapy should be allowed to attend school or nursery, and index cases due to T. tonsurans warrant screening of all family members and close contacts and treatment for those positive cases 1
From the FDA Drug Label
DOSAGE AND ADMINISTRATION Accurate diagnosis of the infecting organism is essential... Representative treatment periods are ... tinea corporis, 2 to 4 weeks; ... Pediatric patients (older than 2 years): A dosage of 10 mg/kg daily is usually adequate Directions ... for jock itch and ringworm: apply once a day (morning or night) for 1 week or as directed by a doctor.
The best treatment for ringworm in kids is griseofulvin (PO) for kids older than 2 years, with a dosage of 10 mg/kg daily, or terbinafine (TOP) for kids 12 years and older, applied once a day for 1 week. For kids under 12, terbinafine (TOP) should be used under doctor's direction 2 3.
- Griseofulvin (PO) is given orally, with a treatment period of 2 to 4 weeks for tinea corporis.
- Terbinafine (TOP) is a topical treatment, applied once a day for 1 week for ringworm.
From the Research
Treatment Options for Ringworm in Kids
- The most effective treatment for ringworm in kids is a topic of ongoing research, with various studies comparing the efficacy of different antifungal medications 4, 5, 6.
- A study published in 2001 found that griseofulvin, terbinafine, itraconazole, and fluconazole were all effective in treating tinea capitis caused by Trichophyton species, with cure rates ranging from 84% to 94% 4.
- Another study published in 2020 found that itraconazole was the most effective treatment for chronic and chronic relapsing tinea corporis, tinea cruris, and tinea faciei, with a cure rate of 66% at 8 weeks 5.
- A 2012 study compared the efficacy of griseofulvin, terbinafine, and fluconazole in treating tinea capitis, and found that griseofulvin had the highest cure rate at 96%, followed by terbinafine at 88%, and fluconazole at 84% 6.
Comparison of Antifungal Medications
- Griseofulvin is often considered the drug of choice for treating ringworm in kids, due to its high cure rates and long history of use 4, 6.
- Terbinafine is a viable alternative, offering a shorter course of therapy and high cure rates 4, 6.
- Itraconazole has been shown to be effective in treating certain types of ringworm, particularly in cases where other medications have failed 5.
- Fluconazole has been found to have lower cure rates compared to other medications, but may still be effective in certain cases 4, 6.
Considerations for Treatment
- The choice of antifungal medication should be based on the specific type of ringworm, the severity of the infection, and the patient's individual needs and medical history 4, 5, 6.
- Treatment should be guided by a healthcare professional, and patients should be monitored for adverse effects and treatment efficacy 4, 5, 6.