From the Guidelines
The best medication for athlete's foot (tinea pedis) is terbinafine 1% cream applied daily for 1 week, which has a mycological cure rate of approximately 94%. This treatment is effective for mild to moderate cases and is approved for children 12 years and older 1. For severe or persistent infections, oral itraconazole (100 mg daily for 2 weeks or 200 mg daily for 1 week) has been shown to be effective in adults, but this should be considered only when topical treatments are not sufficient 1. Some key points to consider when treating athlete's foot include:
- Applying the medication to clean, dry feet, covering the affected area and extending slightly beyond visible infection
- Continuing treatment for the full recommended duration, even if symptoms improve sooner, to prevent recurrence
- Keeping feet dry, wearing breathable footwear, changing socks daily, and avoiding walking barefoot in public areas to prevent reinfection or spreading the fungus to others It's also important to note that certain factors, such as trauma, previous tinea pedis infection, increased sweating, and increased exposure to infectious dermatophytes, can contribute to a higher prevalence of onychomycosis and tinea pedis in athletes 1.
From the FDA Drug Label
Uses • cures most athlete's foot (tinea pedis) PRINCIPAL DISPLAY PANEL - 30 g Carton Cures Most Athlete's Foot Terbinafine Hydrochloride Cream 1% Antifungal Cream Full Prescription Strength NET WT 1 oz (30 g) The best medication for athlete's foot (tinea pedis) is terbinafine (TOP), as it cures most athlete's foot 2 and is available in full prescription strength 2.
- It is recommended to apply twice a day for 1 week between the toes or 2 weeks on the bottom or sides of the foot, or as directed by a doctor 2.
- It is also important to practice good hygiene, such as wearing well-fitting, ventilated shoes and changing shoes and socks at least once daily 2.
From the Research
Treatment Options for Athlete's Foot
The treatment for athlete's foot (tinea pedis) typically involves the use of antifungal medications, which can be topical or oral.
- Topical antifungal therapy is usually the first line 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 3.
- Oral antifungal therapy is usually reserved for severe disease, failed topical antifungal therapy, concomitant presence of onychomycosis, or in immunocompromised patients, with examples of oral antifungal agents including terbinafine, itraconazole, and fluconazole 3.
Comparison of Antifungal Medications
Several studies have compared the efficacy of different antifungal medications in treating tinea pedis.
- A study comparing terbinafine and clotrimazole found that terbinafine was more effective in achieving mycological cure and effective treatment 4, 5.
- Another study found that terbinafine achieved mycological cure more rapidly than clotrimazole, which may result in improved compliance and better control over transmission of infection 6.
- A review of oral treatments for fungal infections of the skin of the foot found that terbinafine was more effective than griseofulvin, and terbinafine and itraconazole were more effective than no treatment 7.
Effective Treatment Duration
The duration of treatment for tinea pedis can vary depending on the severity of the infection and the type of medication used.