What is the treatment for ringworm?

From the Guidelines

Ringworm treatment typically involves oral antifungal medications, with griseofulvin and terbinafine being the most widely used first-line treatments, as recommended by the British Association of Dermatologists' guidelines for the management of tinea capitis 2014 1. The choice of systemic therapy should be directed by the causative dermatophyte and/or local epidemiology.

• For patients with Trichophyton species, terbinafine is more efficacious, while griseofulvin is more effective against Microsporum species.
• The dosage of griseofulvin is 15-20 mg/kg per day for 6-8 weeks for patients weighing less than 50 kg, and 1 g per day for 6-8 weeks for patients weighing more than 50 kg.
• The dosage of terbinafine is 625 mg per day for 2-4 weeks for patients weighing less than 20 kg, 125 mg per day for 2-4 weeks for patients weighing 20-40 kg, and 250 mg per day for 2-4 weeks for patients weighing more than 40 kg. It is essential to note that topical therapy alone is not recommended for the treatment of tinea capitis, and oral therapy is generally indicated to achieve both clinical and mycological cure 1. During treatment, it is crucial to keep the affected area clean and dry, avoid sharing personal items like towels or clothing, and wash bedding and clothes in hot water to prevent spreading the infection. Ringworm is caused by a fungus, not a worm, and is highly contagious, so treatment should begin promptly to prevent spreading to others or to other parts of the body. Most infections clear up completely with proper treatment, though the skin may remain discolored for weeks after the infection resolves.

From the FDA Drug Label

DOSAGE AND ADMINISTRATION Accurate diagnosis of the infecting organism is essential. Identification should be made either by direct microscopic examination of a mounting of infected tissue in a solution of potassium hydroxide or by culture on an appropriate medium Medication must be continued until the infecting organism is completely eradicated as indicated by appropriate clinical or laboratory examination. Representative treatment periods are tinea capitis, 4 to 6 weeks; tinea corporis, 2 to 4 weeks; tinea pedis, 4 to 8 weeks; tinea unguium-depending on rate of growth-fingernails, at least 4 months; toenails, at least 6 months INDICATIONS AND USAGE 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 Tinea pedis Tinea cruris Tinea barbae Tinea capitis Tinea unguium when caused by one or more of the following species of fungi:

The treatment for ringworm, also known as tinea, is griseofulvin (PO). The dosage is as follows:

• Adults: 0.5 g daily
• Pediatric patients (older than 2 years): 10 mg/kg daily The treatment period varies depending on the type of infection:
• Tinea capitis: 4 to 6 weeks
• Tinea corporis: 2 to 4 weeks
• Tinea pedis: 4 to 8 weeks
• Tinea unguium: at least 4 months for fingernails, at least 6 months for toenails 2 2

From the Research

Treatment Options for Ringworm

• The treatment for ringworm, also known as tinea corporis, typically involves the use of antifungal medications 3.
• Topical antifungal treatments, such as terbinafine, naftifine, and clotrimazole, have been shown to be effective in treating ringworm 3.
• Systemic antifungal therapy, such as griseofulvin, itraconazole, and fluconazole, may be necessary for more severe cases or for infections that cover a large area of the body 4, 5, 6.
• The choice of treatment depends on the severity of the infection, the size of the affected area, and the presence of any underlying medical conditions 7.

Topical Treatments

• Terbinafine has been shown to be effective in treating ringworm, with clinical cure rates significantly higher than placebo 3.
• Naftifine and clotrimazole have also been shown to be effective in treating ringworm, with mycological cure rates favoring these treatments over placebo 3.
• Topical treatments are generally well-tolerated, with minimal adverse effects reported 3, 7.

Systemic Treatments

• Griseofulvin has been the mainstay of treatment for ringworm, but newer antifungal agents such as itraconazole, fluconazole, and terbinafine may be preferred due to their shorter treatment durations and improved safety profiles 4, 5, 6.
• Systemic treatments may be necessary for more severe cases of ringworm or for infections that cover a large area of the body 4, 5, 6.
• The choice of systemic treatment depends on the severity of the infection, the size of the affected area, and the presence of any underlying medical conditions 7.