From the Guidelines
The best treatment for tinea corporis is oral itraconazole, 100 mg, given orally once a day for 15 days, which has shown a superior mycological cure rate of 87% compared to other treatments. This recommendation is based on a study published in the journal Pediatrics in 2017 1. The study found that itraconazole was more effective than griseofulvin in treating tinea corporis, with a higher cure rate at the end of 2 weeks after completion of therapy.
Some key points to consider when treating tinea corporis include:
- Avoiding skin-to-skin contact with people known to have lesions, not sharing towels and other fomites, and limiting exposure to swimming pools that have recently been associated with known outbreaks 1
- Keeping the affected area clean and dry to prevent the spread of the infection
- Using oral antifungal medications, such as itraconazole or terbinafine, for extensive, severe, or resistant cases
- Considering the use of terbinafine, which appears to be superior for treating T tonsurans infections 1
It's worth noting that topical antifungal medications, such as azoles or allylamines, may also be effective in treating tinea corporis, but the study cited above found oral itraconazole to be a more effective treatment option 1. Additionally, the treatment should be continued for at least one week after the rash resolves to prevent recurrence.
From the FDA Drug Label
DOSAGE AND ADMINISTRATION Accurate diagnosis of the infecting organism is essential. Identification should be made either by direct microscopic examination of a mounting of infected tissue in a solution of potassium hydroxide or by culture on an appropriate medium Medication must be continued until the infecting organism is completely eradicated as indicated by appropriate clinical or laboratory examination. Representative treatment periods are tinea capitis, 4 to 6 weeks; tinea corporis, 2 to 4 weeks; INDICATIONS AND USAGE Griseofulvin oral suspension, USP is indicated for the treatment of dermatophyte infections of the skin not adequately treated by topical therapy, hair and nails, namely: Tinea corporis
The best treatment for tinea corporis is griseofulvin (PO), with a treatment period of 2 to 4 weeks 2. The dosage for adults is 0.5 g daily, and for pediatric patients, it is 10 mg/kg daily. It is essential to continue medication until the infecting organism is completely eradicated, as indicated by clinical or laboratory examination 2. Concomitant use of appropriate topical agents is usually required.
From the Research
Treatment Options for Tinea Corporis
- Topical antifungal agents are generally successful in treating tinea corporis, unless the infection covers an extensive area or is resistant to initial therapy 3
- Treatment should continue for at least one week after clinical clearing of infection 3
- Newer medications require fewer applications and a shorter duration of use 3
Effective Topical Antifungal Treatments
- Terbinafine has been shown to be effective in achieving clinical cure, with a risk ratio of 4.51 compared to placebo 4
- Naftifine 1% has also been shown to be effective in achieving mycological and clinical cure, with a risk ratio of 2.38 and 2.42 compared to placebo, respectively 4
- Clotrimazole 1% has been shown to be effective in achieving mycological cure, with a risk ratio of 2.87 compared to placebo 4
Oral Antifungal Treatments
- Itraconazole has been shown to be the most effective oral antifungal drug in treating chronic and chronic relapsing dermatophytosis in India, with a cure rate of 66% at 8 weeks 5
- Fluconazole, griseofulvin, and terbinafine have also been shown to be effective, but to a lesser extent than itraconazole 5
Diagnosis and Management
- Diagnosis of tinea infections can be unreliable due to many mimics, and confirmation with a potassium hydroxide preparation or culture is recommended 6
- Tinea corporis, tinea cruris, and tinea pedis generally respond to topical agents such as terbinafine cream or butenafine cream, but oral antifungal agents may be indicated for extensive disease or failed topical treatment 6