What is the treatment for tinea pedis?

From the Guidelines

Tinea pedis is treated with antifungal medications applied directly to the affected skin, with terbinafine 1% cream being a highly effective option, as demonstrated by a mycological cure rate of approximately 94% when applied daily for 1 week 1. The treatment approach for tinea pedis involves the use of over-the-counter topical antifungals such as clotrimazole, miconazole, or terbinafine, which should be applied twice daily for 1-2 weeks, and continued for at least one week after symptoms resolve to prevent recurrence. Some key points to consider in the treatment of tinea pedis include:

• Keeping feet clean and dry
• Wearing breathable footwear
• Changing socks daily
• Avoiding walking barefoot in public areas These measures are important because tinea pedis is caused by dermatophyte fungi that thrive in warm, moist environments and can easily spread in communal areas. For more severe or resistant infections, prescription-strength topical medications like ciclopirox or oral antifungals such as terbinafine (250mg daily for 2 weeks) or itraconazole (200mg daily for 1 week) may be necessary, as supported by studies demonstrating their efficacy in treating fungal infections 1. It is essential to note that the fungi infect the outer layer of skin, causing the characteristic scaling, itching, and sometimes painful cracks between toes or on the soles of feet, and proper treatment eliminates the fungal infection while preventive measures reduce the risk of reinfection.

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

The treatment for tinea pedis, a common fungal infection of the foot, can be managed through various methods, including:

• Topical antifungal therapy, which is the mainstay of treatment for superficial or localized tinea pedis 3
• Oral antifungal therapy, reserved for severe disease, failed topical antifungal therapy, concomitant presence of onychomycosis, or in immunocompromised patients 3, 4
• Combined therapy with topical and oral antifungals, which may increase the cure rate 4

Topical Antifungal Therapy

Topical antifungal agents, such as:

• Allylamines (e.g., terbinafine) 5, 6, 7
• Azoles (e.g., ketoconazole) 3
• Benzylamine, ciclopirox, tolnaftate, and amorolfine 3 can be applied once to twice daily for 1-6 weeks to treat superficial or localized tinea pedis 3

Oral Antifungal Therapy

Oral antifungal agents, such as:

• Terbinafine 6, 7, 3, 4
• Itraconazole 3, 4
• Fluconazole 3, 4 can be used to treat severe disease or when topical antifungal therapy has failed 3, 4

Treatment Duration and Efficacy

Studies have shown that:

• A one-week course of terbinafine 1% cream can be more effective than a four-week course of clotrimazole 1% cream in treating tinea pedis 6, 7
• Terbinafine has a high efficacy in treating tinea pedis, with cure rates ranging from 78% to 97.2% 5, 6, 7