COMPARISON OF 1-PERCENT AND 2.5-PERCENT SELENIUM SULFIDE IN THE TREATMENT OF TINEA-CAPITIS

Objective: To determine whether an over-the-counter shampoo containing 1% selenium sulfide would have sporicidal activity equal to that of a 2.5% selenium sulfide prescription lotion in the adjunctive treatment of tinea capitis infection. Design: Prospective randomized nonblinded clinical trial. Setting: Outpatient clinics and emergency department of a children's hospital.Patients: Fifty-four patients between the age s of 1 and 15 years with culture-proved tinea capitis infection caused by Trichophyton tonsurans enrolled during a 14-month period. Methods: Patients were randomized to receive 2.5% selenium sulfide lotion, 1% selenium sulfide shampoo, or a bland, nonmedicated shampoo with which they were instructed to shampoo twice weekly. All received 15 mg/kg pe r day of griseofulvin. Dermatophyte cultures of the affected area of e ach patient's scalp were obtained on enrollment and every 2 weeks unti l a negative culture was obtained from a previously infected area. Res ults: Survival data analysis demonstrated that both the 2.5% selenium sulfide and 1% selenium sulfide preparations were superior to the nonm edicated control shampoo in terms of the time required to eliminate sh edding of viable spores. When compared with each other, there was no d ifference between the 2.5% selenium sulfide and 1% selenium sulfide pr eparations in rime required to produce a negative culture. Conclusion: Commercially available 1% selenium sulfide shampoo is an equally effe ctive yet less expensive alternative sporicidal therapy in the adjunct ive treatment of tinea capitis infection.