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Consensus-based Guideline on tinea capitis.

Peter Mayser1, Dietrich Abeck2, Philipp P Bosshard3

  • 1Biebertal, Germany.

Journal Der Deutschen Dermatologischen Gesellschaft = Journal of the German Society of Dermatology : JDDG
|July 14, 2026
PubMed
Summary

This guideline offers a framework for managing tinea capitis (scalp fungal infection). It details updated treatment strategies for children and adults, emphasizing combined systemic and topical antifungals.

Keywords:
Antifungal therapyMycological diagnosticsTinea capitis

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Area of Science:

  • Dermatology
  • Infectious Diseases
  • Public Health

Background:

  • Tinea capitis is a common worldwide scalp fungal infection, primarily affecting children.
  • Recent epidemiological shifts in Europe show increased prevalence of anthropophilic dermatophytes like Trichophyton species.
  • Migration, tourism, and socioeconomic factors influence these epidemiological changes.

Purpose of the Study:

  • To provide physicians with a structured framework for clinical decision-making in tinea capitis management.
  • To enhance diagnostic accuracy, treatment adherence, and prevention strategies for scalp fungal infections.
  • To address the evolving epidemiology of causative dermatophytes in Europe.

Main Methods:

  • Development of a consensus-based guideline by the German Dermatological Society (DDG).
  • Review of current epidemiological data on dermatophyte species causing tinea capitis.
  • Synthesis of evidence for systemic and topical antifungal treatment efficacy.

Main Results:

  • Combined systemic and topical antifungal treatment is recommended; topical monotherapy is insufficient.
  • Pediatric treatment choice depends on the pathogen: terbinafine for Trichophyton, itraconazole or griseofulvin for Microsporum/Nannizzia.
  • Terbinafine is the recommended first-line systemic therapy for adult tinea capitis, regardless of species.

Conclusions:

  • The guideline provides a structured approach to tinea capitis diagnosis and management.
  • Updated therapeutic recommendations consider pathogen-specific treatments and epidemiological shifts.
  • Interruption of infection chains through carrier treatment, hygiene, and outbreak management is crucial.