Don’t worry about children’s tinea capitis, these five-word guidelines will help you!

Author: Li Ruoyu, Chief Physician, Peking University First Hospital

Reviewer: Yang Rongya, Chief Physician, Seventh Medical Center, PLA General Hospital

Tinea capitis mainly occurs in children. If it is not detected and treated early, and the best treatment stage is missed, it may cause permanent hair loss.

Because tinea capitis is not just a superficial infection of the scalp and hair, the pathogens may enter the hair roots and destroy the hair follicles. Once the hair follicles are completely destroyed, it is difficult to return to normal and new hair can no longer grow. Therefore, tinea capitis must be treated actively.

The treatment of tinea capitis is a very professional issue. Dermatologists are very familiar with this knowledge. As early as the 1950s and 1960s, they summarized the five-word principle for the treatment of tinea capitis, namely "apply, apply, shave, wash, and eliminate". In fact, this five-word principle is still applicable today.

Clothes:

To take means to take medicine.

There are four drugs recommended in the "Guidelines" now, and the most experienced one is griseofulvin, which has been used since the 1950s and 1960s. Many years of clinical application have proved that griseofulvin is suitable for various types of tinea capitis, such as white ringworm, yellow ringworm, black ringworm, etc., especially for white ringworm in children caused by animals, and its safety is relatively good.

The other three drugs are itraconazole, fluconazole, and terbinafine.

Figure 1 Original copyright image, no permission to reprint

Among the azole drugs, itraconazole and fluconazole are more suitable for infections with Trichophyton and Microsporum. Especially itraconazole, it is a broad-spectrum antifungal drug, so it can be used to treat white ringworm and black spot ringworm.

Terbinafine is also very effective in treating dermatophytes and some other fungal infections, and it has a fungal killing effect. However, its antibacterial effect on Microsporum, the main pathogen of white ringworm, is relatively weak, so terbinafine is often used as a second-line treatment for white ringworm. However, it is still very effective for black spot ringworm and yellow ringworm.

In addition, these three drugs are new-generation antifungal drugs with better safety. For example, adverse reactions such as liver and kidney damage are significantly reduced compared with previous antifungal drugs. They are relatively safe drugs, so there is no need to worry too much about safety issues when using them to treat tinea capitis.

However, the use of any drug should be weighed against its pros and cons, so be sure to ask a specialist in the hospital to decide whether your child is suitable for oral medication. The doctor will make a comprehensive judgment based on the child's clinical type, past medical history, drug allergy history, liver and kidney function, and physical condition to choose the most appropriate drug.

paint on:

To apply is to apply external medication.

There are many types of topical antifungal drugs, such as azole creams and solutions such as ketoconazole, miconazole, luliconazole, terbinafine cream, and some disinfectants such as iodine.

All these creams and solutions that can be used to treat tinea can be used to treat tinea capitis, but topical drugs are not the main measure for treating tinea capitis. The most important measure is to rely on oral medication. Because oral medication can reach deep into the hair shaft and even the root of the hair follicle to work, internal medication is the drug that can help completely cure tinea capitis, while topical medication can assist in solving some problems on the scalp surface.

shave:

Shaving means shaving off the diseased hair, and it is best to shave off all the hair.

Because some hairs are invisible to the naked eye and carry bacteria, the hair and scalp around tinea capitis may also be contaminated by bacteria. If only the visible hairs are shaved, new lesions may appear in other bacteria-carrying parts and new infections may occur. Therefore, it is recommended to shave the entire head of tinea capitis patients. In addition, after the hair is shaved short, it is easier to apply the medicine and observe the effect.

Figure 2 Original copyright image, no permission to reprint

wash:

Washing means washing your hair frequently.

Under current sanitary conditions, washing your hair every day can help wash away some pathogens.

remove:

Disinfection means disinfection and isolation.

The purpose of disinfection and isolation is to achieve a more thorough cure, and also to prevent the further spread of tinea capitis and prevent recurrence.

In addition to using iodine tincture to disinfect the affected area, hair cutting tools must also be disinfected. Disinfection methods such as alcohol soaking, steaming, and boiling can all be used.

Therefore, the five-word guideline summarizes the treatment process of tinea capitis very well, and also includes the prevention link, which is still very applicable to patients with tinea capitis.