Tinea capitis is a dermatophytosis affecting the hair-bearing scalp, with the fungus colonising the hair shaft itself. Clinically you see scaling, patchy hair loss, black dots from broken hairs, and at times a tender boggy kerion.
Because the dermatophyte resides within the follicle and hair shaft, drugs applied only to the skin surface cannot achieve fungicidal concentration at the site of infection. Effective cure therefore requires a drug that reaches the hair via systemic circulation.
Oral antifungals are the cornerstone - griseofulvin is the classic agent, and oral terbinafine, itraconazole or fluconazole are also used. Medicated antifungal shampoos serve only to limit contagious spore shedding.
Antibiotics target bacteria and are irrelevant unless there is bacterial superinfection; methotrexate is an immunosuppressant that would aggravate the infection; topical corticosteroids blunt local immunity and may mask or worsen the lesion (tinea incognito).
\[\boxed{\textbf{Oral antifungals}}\]