From the FDA Drug Label
DOSAGE & ADMINISTRATION SECTION Cutaneous candidiasis, tinea corporis, tinea cruris, tinea pedis and tinea (pityriasis) versicolor: It is recommended that Ketoconazole Cream 2% be applied once daily to cover the affected and immediate surrounding area Clinical improvement may be seen fairly soon after treatment is begun; however, candidal infections and tinea cruris and corporis should be treated for two weeks in order to reduce the possibility of recurrence. Patients with tinea versicolor usually require two weeks of treatment. INDICATIONS & USAGE SECTION Ketoconazole Cream 2% is indicated for the topical treatment of tinea corporis, tinea cruris and tinea pedis caused by Trichophyton rubrum, T. mentagrophytes and Epidermophyton floccosum; in the treatment of tinea (pityriasis) versicolor caused by Malassezia furfur (Pityrosporum orbiculare); Tinea Versicolor Treatment:
- The recommended treatment duration for tinea versicolor with ketoconazole cream 2% is two weeks 1.
- Ketoconazole cream 2% is indicated for the topical treatment of tinea versicolor caused by Malassezia furfur (Pityrosporum orbiculare) 1.
From the Research
Tinea versicolor should be treated with topical antifungal medications as the first line of treatment, with oral antifungal therapy reserved for patients with extensive disease, frequent recurrences, or disease that is refractory to topical therapy, as recommended by the most recent study 2.
Treatment Options
- Topical antifungal medications such as selenium sulfide 2.5% shampoo, ketoconazole 2% shampoo, or clotrimazole or miconazole cream are effective for treating tinea versicolor 3, 2.
- Oral antifungal medications like fluconazole or itraconazole may be prescribed for widespread cases, with dosing regimens of 300 mg/wk for 2 weeks of fluconazole or 200 mg/d for 5 or 7 days of itraconazole 4.
Diagnosis and Prevention
- Diagnosis is usually based on characteristic clinical features, with a potassium hydroxide preparation test used to reveal numerous short, stubby hyphae intermixed with clusters of spores if necessary 2.
- Maintenance therapy with topical treatments once or twice monthly is recommended to prevent recurrence, especially during warm, humid months 3, 2.
Important Considerations
- The selection of antifungal agents depends on several factors, including efficacy, safety, local availability, ease of administration, likelihood of compliance, and potential drug interactions of the antifungal agent 2.
- Long-term intermittent prophylactic therapy should be considered for patients with frequent recurrence of the disease 2.