Prescription topical antifungals for athlete's foot

Examples

Topical allylamines

Generic Name	Brand Name
terbinafine hydrochloride	Lamisil

Topical azoles

Generic Name	Brand Name
econazole nitrate	Ecostatin Cream
ketoconazole	Nizoral Cream

Other topical antifungals

Generic Name	Brand Name
ciclopirox	Loprox
clotrimazole-betamethasone	Lotriderm

Topical medicines are put directly on the skin. These medicines are available in cream, solution, gel, and lotion forms. One medicine may be available in many forms. Your health professional will help you decide which form is best for you.

Lotriderm combines a topical antifungal (clotrimazole) with a topical corticosteroid (betamethasone).

Allylamines and azoles are classes of antifungal medicine. This is important because there may be differences in how effective the classes are.

How It Works

All of these medicines kill fungi. See the medicine label for specific instructions. In general:

• Terbinafine is used for 1 to 2 weeks.
• Other topical medicines are used for 4 weeks, except for topical ketoconazole, which is used for 6 weeks.

If you stop taking the medicines early, even after symptoms are gone, an athlete's foot infection will likely return. It is very important to use the medicine for the entire time directed.

Why It Is Used

Prescription antifungals usually are used to treat athlete's foot when treatment with non-prescription antifungals has not been successful or the athlete's foot is severe.

The topical forms are used for mild to moderate cases of athlete's foot.

Ciclopirox also fights bacterial infections.

Ketoconazole penetrates thick skin well and is a good treatment option for moccasin-type infections.

Clotrimazole-betamethasone may be used when the athlete's foot rash is itchy and burning.

For severe cases or when topical medicines do not work, oral antifungal medicines (pills) are used.

How Well It Works

Both topical and oral forms of prescription antifungals are effective for most people in curing athlete's foot.

Topical allylamines require a shorter course of treatment (1 week) than do topical azoles (4 to 8 weeks). Both types of medicine produce similar cure rates.¹ Although allylamines are more expensive than azoles, you use less of these medicines to successfully treat a fungal infection.

Side Effects

Topical antifungals rarely cause side effects. Stop using the medicine if it results in severe blistering, itching, redness, dryness, or irritation.

See Drug Reference for a full list of side effects. (Drug Reference is not available in all systems.)

What To Think About

Among topical medicines, creams may be best used on mild to moderate non-oozing infections, lotions on oozing infections, powders and sprays to prevent reinfection, and gels and ointments for long-term moccasin-type infections.²

It is not known whether these medicines harm a fetus or whether topical medicines pass into breast milk. If you are pregnant, could become pregnant, or are breast-feeding, consult your health professional.

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Author:	Douglas Dana Amy Fackler, MA Debby Golonka, MPH	Last Updated: September 7, 2006
Medical Review:	Patrice Burgess, MD - Family Medicine Tom Bailey, MD - Family Medicine Randall D. Burr, MD - Dermatology
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