Favus Treatment & Management

Updated: May 11, 2020
  • Author: Robert A Schwartz, MD, MPH; Chief Editor: William D James, MD  more...
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Treatment

Medical Care

Although favus is not highly contagious, several family members may be affected, and all should be treated simultaneously. Treatment outcome depends on the stage at which the disease is arrested. Severe long-lasting disease can cause irreversible scarring alopecia. A Chinese traditional plant-derived medicine for favus may be of value and merit development as a modern drug. [25]

In most patients, favus involves hair; therefore, the disease requires systemic treatment. Additional topical agents, such as shampoo (2% ketoconazole, 2.5% selenium sulfide), lotion, and cream may be helpful. X-ray epilation no longer is used. General hygiene of the scalp must be improved, and debris and crusts must be removed.

Favus usually is controlled by griseofulvin, the standard treatment of tinea capitis; however, a longer treatment course than usual for tinea capitis may be advisable. Currently, favus is uncommon; therefore, no clinical trials with newer antifungals are available. In vitro studies indicate that T schoenleinii is sensitive to newer antifungal drugs, similar to other dermatophytes. Terbinafine, itraconazole, and fluconazole in a similar dosage schedule to tinea capitis may eradicate the fungus and cure the disease. [26] In young children, the terbinafine tablet may be split and hidden in food. [27] A 2017 study favored the use of terbinafine and ketoconazole. [28]

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Prevention

Breaking the lifestyle chain associated with malnutrition, neglect, and poverty can prevent this infection and possibly deter recurrence.

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Long-Term Monitoring

Monitor patients and their families for favus in regions where lifestyles are associated with malnutrition, neglect, and poverty.

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