From the Guidelines
To treat tinea pedis, apply ciclopirox olamine 0.77% cream or gel twice daily to the affected areas for 4 weeks, as it has been shown to be effective in eradicating the infection and achieving both clinical and mycological cure 1. This treatment is recommended due to its broad-spectrum antifungal properties and proven efficacy against common causative fungi such as T rubrum, T mentagrophytes, and Epidermophyton floccosum. Some key points to consider when treating tinea pedis include:
- Keeping feet clean and dry by washing daily with soap and water and thoroughly drying between toes
- Wearing breathable footwear and changing socks daily
- Using antifungal powder in shoes to prevent reinfection
- Avoiding walking barefoot in public areas like pools and showers It is also important to note that obesity and diabetes are additional risk factors for tinea pedis 1, and individuals with these conditions should take extra precautions to prevent infection. If the infection does not improve after two weeks of treatment, or if signs of bacterial superinfection (increased pain, swelling, warmth) are present, consultation with a healthcare provider is necessary for further evaluation and 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
Representative treatment periods are ... tinea pedis, 4 to 8 weeks;
- Terbinafine (TOP) can be used to treat Tinea pedis, as it cures most athlete's foot (tinea pedis) and relieves accompanying symptoms 2.
- Griseofulvin (PO) can also be used to treat Tinea pedis, with a treatment period of 4 to 8 weeks, and may require concomitant use of topical agents 3.
- The dosage of Griseofulvin for adults is 0.5 g daily, and for pediatric patients (older than 2 years) is 10 mg/kg daily 3.
From the Research
Treatment Options for Tinea Pedis
- Topical antifungal therapy is the mainstay of treatment for superficial or localized tinea pedis, with examples of topical antifungal agents including allylamines (e.g. terbinafine), azoles (e.g. ketoconazole), benzylamine, ciclopirox, tolnaftate, and amorolfine 4
- Oral antifungal therapy should be reserved for severe disease, failed topical antifungal therapy, concomitant presence of onychomycosis, or in immunocompromised patients 4
- Combined therapy with topical and oral antifungals may increase the cure rate 4
Efficacy of Terbinafine and Clotrimazole
- Terbinafine 1% solution used for 1 week to treat tinea pedis is well tolerated and at least as effective as clotrimazole 1% solution used for 4 weeks 5
- A one week course of terbinafine 1% cream is more effective in the treatment of tinea pedis than a four week course of clotrimazole 1% cream, both in terms of mycological cure and effective treatment 6
- Oral terbinafine in a single daily dose of 250 mg for 1 week is as effective and as well tolerated as 1% clotrimazole cream applied twice daily for 4 weeks in the treatment of interdigital tinea pedis 7
Treatment Duration and Response
- Topical terbinafine has been shown to give equally good results when applied once or twice daily for 1-2 weeks 8
- A faster response rate was observed in the terbinafine group with respect to signs and symptoms at week 1 7
- Mycological cure rates were similar at each assessment visit in the two groups, with terbinafine solution and clotrimazole solution 5