Objectives Tinea capitis is a common paediatric infection for which Griseofulvin is the only licensed medication. However azole antifungals are readily available and may be efficacious in this cohort of patients.

Methods We conducted a retrospective study which investigated the efficacy and safety of oral Itraconazole in the management of tinea capitis; 86 children of varying ethnicity who attended our department over a 2 year period were included. All patients had a clinical diagnosis of tinea capitis and were treated with oral Itraconazole at doses ranging from 3 to 5 mgs/kg/day. Fungal scrapings were obtained from 54 patients, of whom 34 had positive cultures. Trichophyton tonsurans was the most common organism.

Results 17 patients failed to attend after the initial visit; of the remaining 69 patients, clinical cures were documented in 43 (62.3%) after 6 weeks or less of Itraconazole, a further 14 (20.3%) resolved after 6–12 weeks of treatment, while 4 (5.8%) did not respond and required introduction of another agent.

Of the 31 patients with confirmed Trichophyton species, clinical cures were recorded in 56% after less than 6 weeks of treatment and a further 20% were cured after 6–12 weeks. Of the 3 patients with confirmed M. canis, 1 patient had a partial response after 6 weeks of oral Itraconazole while 2 patients were unresponsive. Itraconazole was well tolerated in all cases with no recorded side effects.

Conclusions In summary, Itraconazole is a safe and effective option for childhood tinea capitis. Trichophyton species are particularly responsive but Microsporum infections appear much more resistant.