What is the treatment for ringworm?

From the Guidelines

Ringworm treatment should involve oral antifungal medications, with terbinafine and griseofulvin being the most widely used first-line treatments, as they have good evidence of efficacy 1. The choice of systemic therapy should be directed by the causative dermatophyte and/or local epidemiology, with terbinafine being more efficacious against Trichophyton species and griseofulvin more effective against Microsporum species 1. Some key points to consider when treating ringworm include:

• 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
• The dose of terbinafine and griseofulvin varies by body weight, with specific dosing regimens outlined in the guidelines 1
• Treatment failure should be initially considered due to lack of compliance, suboptimal absorption of drug, relative insensitivity of the organism, and reinfection, and second-line therapy with itraconazole may be necessary 1
• Children receiving appropriate therapy should be allowed to attend school or nursery, and index cases due to T. tonsurans warrant screening of all family members and close contacts and treatment for those positive cases 1

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, a common fungal infection, can vary depending on the severity and location of the infection. Here are some treatment options:

• Topical Antifungal Treatments: Topical antifungal agents such as terbinafine, naftifine, and clotrimazole are effective in treating ringworm, especially for mild cases 3.
• Systemic Antifungal Therapy: For more severe cases or cases that do not respond to topical treatment, systemic antifungal therapy such as griseofulvin, terbinafine, itraconazole, and fluconazole may be necessary 4, 5.
• Treatment Duration: The duration of treatment can vary from 2-6 weeks for topical treatments and 2-12 weeks for systemic treatments 4, 5, 3.
• Combination Therapy: Combination therapy, such as using a topical antifungal agent with a steroid, may be effective in reducing inflammation and promoting healing 3, 6.

Factors to Consider

When choosing a treatment option, consider the following factors:

• Severity of Infection: More severe cases may require systemic antifungal therapy.
• Location of Infection: Infections on the scalp or nails may require longer treatment durations.
• Patient Factors: Patient age, health status, and medication interactions should be considered when choosing a treatment option.
• Potential Side Effects: Topical antifungal agents are generally well-tolerated, but systemic antifungal therapy can have more significant side effects 4, 5.

Evidence-Based Recommendations

Based on the available evidence, the following recommendations can be made:

• Terbinafine and naftifine are effective topical antifungal agents for treating ringworm 3.
• Griseofulvin, terbinafine, itraconazole, and fluconazole are effective systemic antifungal agents for treating ringworm 4, 5.
• Combination therapy may be effective in reducing inflammation and promoting healing 3, 6.