What is the treatment for Tinea pedis?

From the Guidelines

Tinea pedis is best treated with a combination of topical antifungal medications and preventive measures, including keeping feet clean and dry, wearing breathable footwear, and changing socks daily. The treatment approach should prioritize reducing morbidity, mortality, and improving quality of life. According to a study published in Pediatrics 1, preventive measures such as using foot powder after bathing and thorough drying between the toes after showers can be helpful in reducing the rates of Tinea pedis.

Some key points to consider in the treatment of Tinea pedis include:

• Using over-the-counter topical antifungals like clotrimazole, miconazole, or terbinafine for mild to moderate cases
• Applying topical antifungals twice daily for 1-4 weeks, continuing for at least one week after symptoms resolve
• Considering prescription-strength topical medications or oral antifungals for more severe or resistant infections
• Implementing preventive measures such as daily changes of socks, periodic cleaning of athletic footwear, and avoiding walking barefoot in public areas to prevent reinfection and spread to others.

It is essential to note that the use of foot powder after bathing has been associated with a decline in the rates of Tinea pedis, as reported in the study 1. Therefore, incorporating such preventive measures into the treatment plan can be beneficial in managing Tinea pedis and improving patient outcomes.

From the FDA Drug Label

• cures most athlete's foot (tinea pedis) Directions • adults and children 12 years and older o use the tip of the cap to break the seal and open the tube o wash the affected skin with soap and water and dry completely before applying o for athlete's foot wear well-fitting, ventilated shoes. Change shoes and socks at least once daily. ▪ between the toes only: apply twice a day (morning and night) for 1 week or as directed by a doctor. ▪ on the bottom or sides of the foot: apply twice a day (morning and night) for 2 weeks or as directed by a doctor.

The treatment for Tinea pedis (athlete's foot) is applying terbinafine (TOP) twice a day for:

• 1 week for infection between the toes
• 2 weeks for infection on the bottom or sides of the foot 2 2.

From the Research

Treatment Options for Tinea Pedis

• Topical antifungal therapy is the mainstay of treatment for superficial or localized tinea pedis, with treatment duration ranging from 1-6 weeks 3, 4, 5, 6.
• Examples of topical antifungal agents include:
  • Allylamines (e.g. terbinafine) 4, 7, 5, 6.
  • Azoles (e.g. ketoconazole) 3, 6.
  • Benzylamine, ciclopirox, tolnaftate, and amorolfine 6.
• Oral antifungal therapy should be reserved for severe disease, failed topical antifungal therapy, concomitant presence of onychomycosis, or in immunocompromised patients 6.
• Oral antifungal agents used for the treatment of tinea pedis include terbinafine, itraconazole, and fluconazole 6.
• Combined therapy with topical and oral antifungals may increase the cure rate 6.

Duration of Treatment

• Tinea pedis is usually treated for four weeks with an azole or for one to two weeks with allylamine medication 3.
• Terbinafine 1% cream can be applied once a day for one week 4.
• A single application of 1% terbinafine cream has been shown to achieve a cure rate of 78% in patients with tinea pedis 5.

Factors Affecting Treatment

• The presence of inflammation may necessitate the use of an agent with inherent anti-inflammatory properties or the use of a combination antifungal/steroid agent 3.
• Treatment should continue for at least one week after clinical clearing of infection 3.