What is the first line treatment for tinea capitis?

The first-line treatment for tinea capitis is griseofulvin. Tinea capitis, a fungal infection of the scalp, typically requires systemic treatment rather than topical due to the nature and location of the infection. Griseofulvin is an oral antifungal that has been extensively studied and proven effective for this condition. It works by inhibiting fungal cell division and is absorbed by keratinized tissues, including the hair follicles, making it particularly useful for tinea capitis.

While topical antifungals are often used for superficial fungal infections, they are generally insufficient for tinea capitis due to the deeper invasion of the fungus into the hair follicles and scalp. Other systemic antifungals, like terbinafine or oral azole antifungals, may also be effective, but they are not considered first-line treatment based on established guidelines and clinical practice. Griseofulvin remains the preferred initial choice due to its longstanding success in treating this specific infection.