Prescription topical antifungals for athlete's foot

Examples

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Topical allylamines

Brand Name	Generic Name
Naftin	naftifine hydrochloride

Topical azoles

Brand Name	Generic Name
Lotrimin	clotrimazole

Brand Name	Generic Name
Spectazole	econazole nitrate

Brand Name	Generic Name
Nizoral	ketoconazole

Brand Name	Generic Name
Monistat Derm	miconazole nitrate

Brand Name	Generic Name
Oxistat	oxiconazole nitrate

Brand Name	Generic Name
Ertaczo	sertaconazole nitrate

Brand Name	Generic Name
Exelderm	sulconazole nitrate

Other topical antifungals

Brand Name	Generic Name
Mentax	butenafine hydrochloride

Brand Name	Generic Name
Loprox	ciclopirox

Brand Name	Generic Name
Lotrisone	clotrimazole-betamethasone

Brand Name	Generic Name
Halotex	haloprogin

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 doctor will help you decide which form is best for you.

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

Allylamines and azoles are different classes of antifungal medicine. This is important because medicine from one class may work better than medicine from the other.

How It Works

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

• Butenafine 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

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Prescription antifungals usually are used to treat athlete's foot when treatment with nonprescription 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.

Miconazole, ciclopirox, and sulconazole also can treat bacterial infections that might occur along with a fungal infection.

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

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

Topical allylamines require a shorter course of treatment (1 week) than do topical azoles (4 to 8 weeks). But studies show that allylamine medicines work slightly better than azole medicines.^{1 2} Although allylamines are more expensive than azoles, you use less of these medicines to successfully treat a fungal infection.

Side Effects

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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

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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 .³

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, talk to your doctor before using these medicines.

Complete the new medication information form (PDF) (What is a PDF document?) to help you understand this medication.

References

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Citations

1. Crawford F (2006). Athlete's foot, search date April 2006. Online version of BMJ Clinical Evidence. Also available online: www.clinicalevidence.com.

2. Crawford F, et al. (2007). Topical treatments for fungal infections of the skin and nails of the foot. Cochrane Database of Systematic Reviews (3).

3. Weinstein A, Berman B (2003). Topical treatment of common superficial tinea infections. American Family Physician, 65(10): 2095–2102.

Credits

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Author	Maria G. Essig, MS, ELS
Editor	Susan Van Houten, RN, BSN, MBA
Associate Editor	Pat Truman, MATC
Primary Medical Reviewer	Kathleen Romito, MD - Family Medicine
Specialist Medical Reviewer	Anne C. Poinier, MD - Internal Medicine
Last Updated	July 2, 2008