From the Guidelines
Ringworm treatment should always involve oral antifungal therapy, as topical therapy alone is not recommended, with the choice of systemic therapy directed by the causative dermatophyte and/or local epidemiology 1. The most effective treatment for ringworm depends on the severity and location of the infection.
- For mild cases, over-the-counter antifungal creams like clotrimazole, miconazole, or terbinafine may be sufficient.
- For more severe or persistent infections, oral antifungal medications like griseofulvin or terbinafine are recommended, with dosing regimens as follows:
- Griseofulvin: 15-20 mg/kg per day for 6-8 weeks for children under 50 kg, and 1 g per day for 6-8 weeks for children over 50 kg 1.
- Terbinafine: 625 mg per day for 2-4 weeks for children under 20 kg, 125 mg per day for 2-4 weeks for children between 20-40 kg, and 250 mg per day for 2-4 weeks for children over 40 kg 1. It's essential to note that treatment should continue for at least 2 weeks after symptoms disappear to ensure complete eradication of the fungus. In addition to medication, keeping the affected area clean and dry, avoiding sharing personal items, and washing bedding and clothing regularly in hot water can help prevent the spread of ringworm. If the infection doesn't improve after 2 weeks of self-treatment or if it's widespread, it's crucial to see a healthcare provider for stronger medication options, as ringworm is highly contagious and can spread to others or to other parts of the body 1.
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; tinea pedis, 4 to 8 weeks; tinea unguium-depending on rate of growth-fingernails, at least 4 months; toenails, at least 6 months 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 Tinea pedis Tinea cruris Tinea barbae Tinea capitis Tinea unguium when caused by one or more of the following species of fungi:
The treatment for Ringworm (also known as Tinea) is Griseofulvin (PO). The dosage is as follows:
- Adults: 0.5 g daily
- Pediatric patients (older than 2 years): 10 mg/kg daily The treatment period varies depending on the type of infection:
- Tinea capitis: 4 to 6 weeks
- Tinea corporis: 2 to 4 weeks
- Tinea pedis: 4 to 8 weeks
- Tinea unguium: at least 4 months for fingernails, at least 6 months for toenails 2 2
From the Research
Ringworm Treatment Options
- The treatment of ringworm, also known as tinea capitis, typically requires systemic anti-fungal medication rather than topical treatment 3.
- Two FDA-approved medications for treating tinea capitis are griseofulvin (Grifulvin) and terbinafine (Lamisil Granules), with treatment durations of 6 to 8 weeks and 6 weeks, respectively 3.
- Other medications, such as itraconazole and fluconazole, have been used off-label to treat tinea capitis, with varying degrees of success 4, 5.
Effectiveness of Antifungal Agents
- Studies have shown that itraconazole and terbinafine are effective in treating tinea imbricata, with significant remission achieved in patients treated with these medications 4.
- In contrast, fluconazole has been shown to have limited effectiveness in treating tinea imbricata, with no significant remission achieved in patients treated with this medication 4.
- The effectiveness of antifungal agents can vary depending on the specific type of ringworm infection being treated, as well as the patient's individual circumstances 6, 5.
Treatment Considerations
- The decision to treat ringworm and the choice of medication depend on various factors, including the extent of involvement, social situation, and availability of resources such as laboratory testing and follow-up 4.
- Topical antifungal treatment is often the standard treatment for tinea corporis, but systemic antifungal treatment may be indicated in certain cases, such as multiple, extensive, or recurrent lesions 7.
- Physicians should be familiar with the clinical presentation and treatment options for ringworm to ensure accurate diagnosis and effective treatment 7.