From the Guidelines
Topical antifungal medications are the treatment of choice for tinea corporis (ringworm). First-line options include azole antifungals such as clotrimazole 1%, miconazole 2%, or econazole 1% cream applied twice daily for 2-4 weeks. Alternatively, allylamine antifungals like terbinafine 1% cream or butenafine 1% cream can be used once or twice daily for 1-2 weeks. These topical treatments are highly effective because they directly target the dermatophyte fungi by disrupting their cell membranes or inhibiting ergosterol synthesis, which is essential for fungal cell wall integrity. Treatment should continue for at least one week after clinical resolution of the rash to prevent recurrence. For extensive, severe, or resistant cases, oral antifungal therapy may be necessary, with terbinafine 250mg daily or itraconazole 200mg daily for 1-2 weeks being common choices, as supported by 1. Patients should also be advised to keep the affected area clean and dry, avoid sharing personal items like towels or clothing, and treat any concurrent tinea infections to prevent reinfection. It's worth noting that the provided evidence from 1 primarily focuses on tinea capitis, which, although related, does not directly address tinea corporis treatment, making 1 a more relevant source for this specific condition. Key considerations in managing tinea corporis include preventing reinfection and promoting a clean environment, as highlighted in 1. In terms of morbidity, mortality, and quality of life, the goal is to achieve mycological cure and prevent recurrence, which can be effectively managed with the recommended topical and, when necessary, oral antifungal treatments.
From the FDA Drug Label
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 Representative treatment periods are ... tinea corporis, 2 to 4 weeks;
The medication of choice for tinea corporis is griseofulvin (PO), with a treatment period of 2 to 4 weeks 2 2.
- The dosage for adults is 0.5 g daily.
- The dosage for pediatric patients (older than 2 years) is 10 mg/kg daily.
- The dosage should be individualized.
From the Research
Medication Options for Tinea Corporis
The following medications have been studied for the treatment of tinea corporis:
- Fluconazole: effective in treating tinea corporis, with a dosage of 50-100 mg daily or 150 mg once weekly for 2-3 weeks 3, 4
- Itraconazole: effective in treating tinea corporis, with a dosage of 100 mg daily for 2 weeks or 200 mg daily for 7 days 4, 5
- Terbinafine: effective in treating tinea corporis, with a dosage of 250 mg daily for 1-2 weeks 4, 5
- Griseofulvin: effective in treating tinea corporis, but with a higher dosage and longer treatment duration compared to other options 6, 7, 5
Efficacy Comparison
A study comparing the efficacy of fluconazole, griseofulvin, itraconazole, and terbinafine in treating tinea corporis found that:
- Itraconazole was the most effective treatment, with a cure rate of 66% at 8 weeks 5
- Fluconazole had a cure rate of 42% at 8 weeks 5
- Terbinafine had a cure rate of 28% at 8 weeks 5
- Griseofulvin had a cure rate of 14% at 8 weeks 5
Treatment Considerations
When choosing a medication for tinea corporis, consider the following factors: