Griseofulvin to Treat Ringworm in Kids

In an earlier article I wrote a brief summary about ringworm treatments, so you may want to read How to Treat Ringworm  first.

I wanted to do a write up about griseofulvin because it is the most used to treat ringworm in kids that need an oral treatment.

Griseofulvin (Grifulvin) is the current prescription drug of choice.  Griseofulvin was first isolated  in 1938 and yet, over 70 years later, it continues to be first line of treatment.  Griseofulvin is available in microsize suspension and tablets (Grifulvin V) and ultramicrosize tablets (Gris-Peg).  It has been approved in children older than 2 years old.

Griseofulvin works by inhibiting fungal growth and helps protect new skin from being infected. This means it stops the fungal infection from progressing, allowing the infection to clear as the infected skin dies and sheds.  Because it does not kill the fungi, griseofulvin has a long length of therapy.  General ringworm of the body is usually treated for two to four weeks, whereas infections involving the head or feet can be treated for as long as four to 12 weeks.  Yes, that’s right, 2 to 3 months of  treatment.

Griseofulvin is typically given to children in the suspension form because it allows specific weight based dosing.  Both suspension and tablets are best absorbed when taken with a fatty meal.  Peanut butter or ice cream are recommended, which makes administering the medication a bit easier for parents J.  The ultramicrosize tablets may be crushed and mixed with 1 tablespoon of applesauce and taken right away without chewing.

Griseofulvin has a low incidence of serious side effects.  The most common adverse reaction is headache.  Also included are belly upset, oral thrush, sensitivity to sunlight and dizziness.  Rare but serious side effects include liver toxicity and decrease in white blood cells; these often disappear even with continuation of therapy.  Perhaps most interesting and pertinent is the estrogen-like effects that griseofulvin can cause in children.  Estrogen-like effects in children can include bloating, depression, headaches, thyroid interference and impaired blood sugar control- once again serious but rare.

Other antifungal medications used to treat ringworm are terbinafine (Lamisil), itraconzaole (Sporanox) and fluconazole (Diflucan).  These drugs appear to have similar efficacy as griseofulvin but with a shorter therapy cycle, typically four weeks.

It is imperative to treat ringworm in children.  If left untreated, bacterial infections and permanent hair loss can occur.  Griseofulvin remains the drug of choice for treatment of ringworm, however this is mostly based on old information.  Back in the day, griseofulvin was the only treatment option available in generic formulation and was therefore bumped to first in line due to price.  Nowadays, all of the medications have some dosage forms available in generic.  When discussing your child’s treatment plan with her physician, be sure to consider the length of treatment, dosage forms and price of the medications.

What do you think?  Love to hear from you -please leave a comment!

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25 comments

  1. My child and dog have both been on this medication for 2 weeks and have seen results. my child does complain of a headache.

  2. tonight was the first dose of this medication for my 7 year old boy. this better work????!!!!! the ringworm is on the back of his head and I’m mortified at the fact that this may lead to permanent hair loss. please please let it work, I know it’s going to take a while, but I really have my fingers crossed here!

  3. We have just been given the prescription for griseofulvin after trying to fight off this ringworm for 3 months on my 3yr old daughter. However we were told today this may be a ringworm or may be excema. We are going to be starting treatment tonight and I will keep you all posted on the progress.

  4. My son is 2yrs old and he has been taken this treatment for a month now. He has a nice size bald spot and im hoping his hair goes back. I feel bad this happened to him. Yes I he is still using the treatment.

  5. have used this drug to a 2 year old child and has realy worked,her head is now smomth and looks much healthy.

  6. My 10 yr old has been on this for a month now, serious kerion developed and also got a staph infection as well, we saw significant improvement in the first week, and I was interested in the sun exposure precautions on the label. What kind of reactions does this med have with sun exposure?

  7. Hi Mr. Youngs,

    Griseofulvin can be a rough medication!! I am glad that your 10 year old is improving. The sun exposure precaution, meaning if he/she is exposed to sun while using this medication, he/she has a higher risk of getting a sun burn. He/she should avoid sun exposure and wear sunblock/hat/clothes to protect his skin if he is going to be outside for a bit.

    I hope this helps!! Take care,
    Nova

    Nova Simpson, Pharm.D.

  8. Hi my son is 4 years old and apparently there was a ringworm outbreak at his school and he has multiple areas of ringworm on his head, he went to the doc this am and has been started on this medication, are there any serious things that i have to look out for.

  9. I will start this medication on Monday. I have being diagnosed with Lupus will this effective me in any way and also how long after I take it can I see results cause I am itching everywhere and breaking out each day with a new ringworm. Thanks i advance!

  10. Is it possible to see new ringworm spots while on the medication? I gave my daughter her first dosage last night and my mom told me she has two new spots on her feet.

    Thanks!
    Julissa

  11. Hi Julissa,

    Yes -after just a few doses, it is possible to see new spots. Most likely, those spots were erupting through as the drug was started. Once she has been on the medication for 5-7 days, there should not be any new spots…although it is possible with extreme cases.

    Thanks,
    Nova

  12. My opinion is to put ivory soap on the ringworm and to give the child the medication for the timely length the doctor ordered. My son has a ringworm which is formed on the inside but left his skin looking irritated and itches on the outside.she gave me medication and shampoo for the itch. I used the ivory and it makes the ringworm vanish on the outside. Continue to give the child the medication too.

  13. Good morning, my one year old grandson was diagnosed as having eczema, then acne, when in fact it was a ringworm. The ringworm got infected. . . . .a bacterial infection. He started griseofulvin; he has been on it for about a week now. He has three spots in his head, one of the three spots is HUGE. We have noticed some improvement. It appears as though the inflammation has improved. There is also less fluid (puss or white blood cells as the ER doc called it) leaking. He still picks at it, I believe because he knows something is wrong and there is probably some irritation. My question is. . in reading your article, the medicine is normally prescribed for children the age of two and up. . . is my grandson more susceptible to the side effects because he is one years old and do you think his hair loss will be permanent since it did turn into a bacterial infection?

    Thank you,
    SUPER CONCERNED ANXIOUS UPSET GRANDMOTHER

  14. Hi Ms. Adams,

    I am sorry to hear about your little grandson! The dose of griseofulvin
    is weight based. Typically, it is not given to children that weigh less
    then 30 lbs. However, it has been given to kids <30 lbs. Most likely the
    physician is giving him a lower dose based on his weight. If the dose is
    based on his weight than most likely the risk of side effects will be the
    same. Just keep an eye out for them so the medicine will be changed if
    needed.

    Another option you can discuss with the physician includes Diflucan
    (fluconazole). Diflucan has been studied in kids >6 months to treat
    ringworm on the head (tinea capitis). The dose was 8mg/kg once weekly.

    Most of the hair loss from ringworm is temporary. It can be permanent but
    that is typically when not treated for an extended period of time (months
    to years). Plus babies are super resilient! 🙂

    Kids pick up ringworm in different ways. Sometimes, it is from a family
    pet. If you have a dog or cat that the baby is living with, you may want
    to have it checked out for ringworm and treated if needed (sometimes dogs
    and cats will not show symptoms).

    I hope this helps and I hope he feels better very soon!! Let us know if
    you have any follow up questions or comments.

    Take care,
    Nova

    Nova Simpson,Pharm.D.

  15. My 1 year old has ringworm of the scalp that turned into kerion. She has been on griseofulvin for a week now. My question is how long before I Starr to see improvement and what will that look like and also what can I put on her head to make the inflammation and redness go down after washing her hair and removing the crust and scabs

  16. Hi Megha,

    Griseofulvin starts working with the first dose. However, it may take days up to weeks to see a major improvement. To help with her pain, itching and inflammation you can apply some cool compresses. Some other options that should first be approved by her pediatrician because she is only 1 year old — topical antifungal OTC creams and topical selenium sulfide.

    I hope this helps and she feels better soon!

    Take care,
    Nova

    Nova Simpson,Pharm.D.

  17. I’m 16 years old and I started taking Griseofulvin exactly 3 weeks ago, I’m not sure what it was at the beginning because I felt pain and itch I just knew it was a type of tinea capitis but I still had a bit of hair. A week later, the pain began to go away and the bump seemed to get smaller but I think my scalp dried up and caused my hair to fall easily. Last week, my doctor told me to take 2 pills a day when I usually just took one, he told me to use nizoral too but that was too strong that my skin didn’t react very well to it. Now I just take the pills twice a day and apply baking soda paste to my scalp of it ever itches. Am I doing anything wrong? Is there still a chance my hair can grow back?

  18. Hi Emanuel,

    It sounds like you are doing exactly what you need to! It can take a long time to treat tinea capitis. Griseofulvin dose ranges, so most likely you were taking the 250mg or 500mg pills and your doctor wanted to increase to double the dose to help treat the infection better. Most times, hair will grow back once the infection is fully treated.

    Nizoral has an antifungal (ketoconazole) that can help treat the fungal infection topically. However, if it hurts too much you can talk to your mom/dad about using a selenium sulfide shampoo -like Selsun Blue. It may be more gentle but still help topically. And keep using the baking soda paste to help with any itching!

    I hope this helps!
    Nova

    Nova Simpson,Pharm.D.

  19. Hi Danshella,

    Griseofulvin can cause a headache -it is actually one of the main side effects. Most of the time, it will go away after a few days to weeks. It is good to tell your doctor and keep an eye on it, especially if it continues longer than a week. Drinking extra water can help with the headache.

    Hope you feel better very soon!
    Nova

    Nova Simpson,Pharm.D.

  20. Hi my 6 year old son has had this ring worm in his scalp for about 3 months. Ive tried home remedies and creams, no luck at all. All the doctors say they can’t give him oral medication, because of a liver test. I really need help. I live in Lancaster Ca and the doctors out here are no help. What can I do to get rid of it. Please help

  21. Hi all,

    I’m looking for GRISEOFULVIN – ORAL SUSPENSION (Syrup) medication, but cannot find it in the market anywhere. Please help to find out selling outlets.

    Currently I’m in Dubai-UAE.

    Thanks

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