TINEA CAPITIS HANDOUT

My child can't swallow pills

You can crush the terbinafine tablets and add them to 2 tablespoons of chocolate syrup or corn syrup. The result is sweet, easy to prepare and consume, widely available, and affordable. The tablet can be crushed using a pill crusher ($5-$10 at pharmacies or on Amazon) or by placing it on a piece of paper and crushing it with the back of a metal spoon. For children, the recommended dosing of terbinafine with a 250-mg tablet is based on weight: one-quarter of a tablet for a child weighing 22-44 lbs; one-half of a tablet for a child weighing 44 to 88 lbs; and a full tablet for a child weighing more than 88 lbs. Because terbinafine tablets are not scored, a combined pill splitter-crusher can be used.

Should my child use a special shampoo?

Many doctors have the patient use an antifungal shampoo 2-3 times a week in addition to taking the pills. This helps the pills to be even more effective. Examples include 2.5% selenium sulfide shampoo OTC (e.g., Selsun Blue 2.5% Extra Strength) or Ketoconazole 2% shampoo by prescription. It is also often recommended for all family members to use the shampoo to prevent spread within the family.

When can my child return to the classroom?

Once your child starts the treatment, he/she may return to school immediately.

Should my child wear a hat, or should I shave my child's head?

There is no need for either.

How can I effectively disinfect items such as combs/brushes?

You can use bleach.

How can I clean bedding, towels, and linen?

You can wash those in hot with an all-purpose detergent. Laundering on cold is not sufficient.

How can I take care of myself and my family at home?

Everyone in the household should be screened for the infection, even if they lack symptoms. Avoid sharing personal items such as hats, hair brushes, combs and so on. Disinfect previously shared items and clothing/towels. In some cases, your doctor may recommend all family members use an antifungal shampoo 2-3 times a week (see above).

What to do if I suspect infection of my pet?

A veterinarian should examine your pets, even if they are asymptomatic and determine treatment if necessary. Wash hands thoroughly after any contact with pets.

References

  1. An update on tinea capitis in children Aditya K. Gupta MD, PhD et al. Pediatric Dermatology November/December 2024
  2. A “Solution” for Patients Unable to Swallow a Pill: Crushed Terbinafine Mixed With Syrup Rhiannon C. Miller, BA et al. Cutis. 2023;111:137, 149