What is the treatment for Tinea pedis (Athlete's foot)?

From the Guidelines

Tinea pedis (athlete's foot) can be effectively treated with ciclopirox olamine 0.77% cream or gel applied twice daily to the affected areas for 4 weeks, as it has been shown to be superior to other treatments in achieving both clinical and mycological cure. This treatment has been evaluated in randomized controlled trials in adults and has been found to be effective in eradicating T pedis, with a mycological cure rate of approximately 60% at the end of treatment and 85% two weeks after treatment 1.

Some key points to consider when treating Tinea pedis include:

• Applying the cream or gel to the affected areas twice daily for 4 weeks
• Continuing treatment for at least one week after symptoms resolve to prevent recurrence
• Keeping feet clean and dry, changing socks daily, wearing breathable footwear, and using shower shoes in public facilities to prevent reinfection
• Maintaining good foot hygiene, as the warm, moist environment between toes creates ideal conditions for dermatophyte fungi to thrive

It's also important to note that other treatments, such as clotrimazole 1% cream or terbinafine 1% cream, may be effective, but ciclopirox olamine 0.77% cream or gel has been shown to be superior in achieving both clinical and mycological cure 1. If symptoms persist beyond 2-4 weeks of treatment or if there's significant pain, swelling, or signs of bacterial infection, it's essential to consult a healthcare provider for further evaluation.

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

Concomitant use of appropriate topical agents is usually required, particularly in treatment of tinea pedis.

The treatment for Tinea pedis (Athlete's foot) includes:

• Terbinafine (TOP), which cures most athlete's foot and relieves accompanying symptoms such as itching, burning, cracking, and scaling 2.
• Griseofulvin (PO), with a treatment period of 4 to 8 weeks, and concomitant use of appropriate topical agents is usually required 3.
• General measures in regard to hygiene should be observed to control sources of infection or reinfection 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
• Terbinafine 1% cream applied twice daily for one week has been shown to be 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 5
• A one week course of terbinafine 1% cream can achieve a mycological cure rate of 93.5% and an effective treatment rate of 89.7% 5
• Topical terbinafine has also been compared to clotrimazole for the treatment of tinea pedis, with terbinafine 1% cream applied twice daily for 1 week being significantly superior to a 4-week course of clotrimazole 1% cream 6
• Oral antifungal therapy should be 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 4

Duration of Treatment

• Topical antifungal therapy is usually applied once to twice daily for 1-6 weeks 4
• Tinea pedis can be effectively treated topically with azole cream preparations applied twice daily for four weeks, or with 1% terbinafine cream applied once a day for one week 7
• Treatment should continue for at least one week after clinical clearing of infection 8

Treatment Efficacy

• Terbinafine has been shown to give equally good results when applied once or twice daily for 1-2 weeks, with a cure rate of 78% achieved in patients with tinea pedis after a single application of 1% terbinafine cream 6
• The high efficacy of topical terbinafine in treating tinea pedis is undoubtedly due to its fungicidal mode of action 6
• Combined therapy with topical and oral antifungals may increase the cure rate 4