What is the treatment for Tinea (Ringworm) infection?

From the Guidelines

Ringworm can be effectively treated with antifungal medications, and the treatment approach should be based on the severity and location of the infection. When considering treatment options, it's essential to understand the cause of ringworm, which is a fungal infection, typically caused by dermatophyte fungi, such as species in the genera Microsporum and Trichophyton, as noted in the British Association of Dermatologists' guidelines for the management of tinea capitis 1. For mild to moderate cases, over-the-counter topical antifungals like clotrimazole, miconazole, or terbinafine can be applied twice daily for 2-4 weeks. Some key points to consider when treating ringworm include:

• Keeping the affected area clean and dry to prevent the spread of the infection
• Avoiding sharing personal items like towels or clothing
• Washing bedding and clothes in hot water to prevent spreading the infection
• Continuing treatment for at least one week after the rash disappears to prevent recurrence
• Considering oral antifungal medications for more severe or widespread infections, such as fluconazole, itraconazole, or terbinafine, which may be prescribed by a doctor and taken for 1-4 weeks depending on the severity. It's crucial to prioritize proper hygiene and keeping the area dry, as ringworm thrives in warm, moist environments. Most cases clear up completely with consistent treatment, though the infection may take several weeks to resolve fully.

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) with griseofulvin (PO) typically involves:

• Accurate diagnosis of the infecting organism
• Medication continued until the infecting organism is completely eradicated
• Treatment periods varying by 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
• Dosage:
  • Adults: 0.5 g daily
  • Pediatric patients: 10 mg/kg daily Griseofulvin is indicated for the treatment of dermatophyte infections of the skin, hair, and nails, including Tinea corporis, Tinea pedis, Tinea capitis, and Tinea unguium 2 2.

From the Research

Ringworm Treatment Options

• The treatment of ringworm, also known as tinea capitis, typically involves the use of oral antifungal medications 3, 4, 5, 6.
• Commonly used medications include griseofulvin, terbinafine, itraconazole, and fluconazole 3, 4, 5, 6.
• Topical treatments, such as 2% ketoconazole and 1% selenium sulfide shampoos, may also be used as adjuvant therapy 4.

Efficacy of Treatment Options

• Studies have shown that terbinafine, itraconazole, and fluconazole are effective in treating tinea capitis, with similar efficacy to griseofulvin 3, 4, 5.
• A study found that terbinafine for four weeks and griseofulvin for eight weeks had similar efficacy in treating Trichophyton species infections 5.
• Another study found that itraconazole was the most effective treatment option, followed by fluconazole, terbinafine, and then griseofulvin, in chronic and chronic relapsing dermatophytosis in India 6.

Treatment Duration and Adverse Effects

• The duration of treatment varies depending on the medication and the severity of the infection 3, 4, 5.
• Terbinafine, itraconazole, and fluconazole are often given for 2-3 weeks, while griseofulvin is typically given for 6-8 weeks 3, 4, 5.
• Adverse effects are generally mild and reversible, with the most common being gastrointestinal effects 3, 5.