From the Guidelines
The most effective antifungal treatment for tinea cruris is terbinafine 1% cream applied daily for 1 week, with a mycological cure rate of approximately 94%. This treatment option is supported by a study published in Pediatrics in 2017 1. The study found that terbinafine 1% cream is effective in treating tinea cruris, with a high cure rate, and is approved for children 12 years and older.
Some other treatment options for tinea cruris include:
- Butenafine applied twice daily for 2 weeks, although it is only approved for adults
- Clotrimazole applied twice weekly for 4 weeks
- Oral itraconazole, which has been shown to be effective in adults for treating tinea cruris, with a dosage of 100 mg daily for 2 weeks or 200 mg daily for 1 week, and is superior to oral griseofulvin 1
It is essential to note that treatment should continue for at least one week after symptoms resolve to prevent recurrence. Additionally, keeping the affected area clean and dry, wearing loose-fitting cotton underwear, and avoiding sharing towels or clothing can help prevent the spread of the infection. Applying the topical medication beyond the visible rash border by about 1-2 cm can also ensure complete coverage and effective treatment.
From the FDA Drug Label
Uses • cures most athlete's foot (tinea pedis) • cures most jock itch (tinea cruris) and ringworm (tinea corporis) • relieves itching, burning, cracking and scaling which accompany these conditions The most effective antifungal treatment for tinea cruris is Terbinafine (TOP), as it cures most jock itch (tinea cruris) 2.
- The treatment should be applied once a day (morning or night) for 1 week or as directed by a doctor 2.
- It is essential to wash the affected skin with soap and water and dry completely before applying the treatment 2.
- Wash hands after each use to prevent the spread of the infection 2.
From the Research
Effective Antifungal Treatments for Tinea Cruris
- The most effective antifungal treatments for tinea cruris include fluconazole 3, terbinafine 4, 5, 6, itraconazole 4, naftifine 5, 6, and clotrimazole 5.
- Fluconazole has been shown to be an efficacious and safe regimen in the treatment of tinea corporis and cruris, with a significant reduction in clinical symptoms 3.
- Terbinafine has been found to have a higher clinical cure rate compared to placebo, with a risk ratio of 4.51 5, 6.
- Itraconazole has been shown to be effective in the treatment of tinea cruris and corporis, with a mycological cure rate of 91.8% after 4 weeks of treatment 4.
- Naftifine has been found to have a higher mycological cure rate compared to placebo, with a risk ratio of 2.38 5, 6.
- Clotrimazole has been shown to be effective in achieving mycological cure, with a risk ratio of 2.87 compared to placebo 5.
Comparison of Antifungal Treatments
- There is no significant difference in mycological cure rates between azoles and benzylamines 5.
- Azoles were found to be slightly less effective in achieving clinical cure compared to azole and steroid combination creams immediately at the end of treatment 5.
- Combinations of azoles with corticosteroids were found to be slightly more effective than azoles for clinical cure, but there was no statistically significant difference with regard to mycological cure 6.
Limitations of Current Evidence
- Many of the studies included in the reviews were found to be of unclear or high risk of bias, and were poorly designed and inadequately reported 5, 6.
- There is a need for further, high-quality, adequately powered randomized controlled trials to evaluate the effects of antifungal treatments for tinea cruris and corporis 5, 6.