What is the treatment for tinea pedis (athlete's foot)?

From the Guidelines

Tinea pedis (athlete's foot) is treated with antifungal medications applied directly to the affected skin, with over-the-counter topical antifungals like clotrimazole, miconazole, or terbinafine being effective for mild to moderate cases. For these cases, applying the medication twice daily for 1-2 weeks, and continuing for at least one week after symptoms resolve, is a common treatment approach 1. It's also important to keep feet clean and dry, wear breathable footwear, change socks daily, and avoid walking barefoot in public areas to prevent reinfection.

Some key considerations for treatment include:

• The use of prescription-strength topical medications such as ciclopirox for more severe or resistant infections
• The potential need for oral antifungals like terbinafine (250 mg daily for 2 weeks) or itraconazole (200 mg daily for 1 week) for severe cases
• The importance of proper foot hygiene and environmental modifications to prevent reinfection
• The mechanism of action of antifungal medications, which disrupt the fungal cell membrane or inhibit ergosterol synthesis, essential for fungal cell survival 1

In terms of specific treatment options, terbinafine 1% cream applied daily for 1 week has been shown to be effective in treating similar fungal infections, with a mycological cure rate of approximately 94% 1. However, for tinea pedis, the most effective treatment approach is often a combination of topical antifungal medications and preventive measures to reduce the risk of reinfection. Overall, the goal of treatment is to eradicate the infection, prevent reinfection, and improve quality of life for individuals with tinea pedis.

From the FDA Drug Label

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. Uses • cures most athlete's foot (tinea pedis) The treatment for athlete's foot (tinea pedis) is to apply terbinafine (TOP) cream:

• Between the toes only: apply twice a day for 1 week or as directed by a doctor.
• On the bottom or sides of the foot: apply twice a day for 2 weeks or as directed by a doctor. Additionally, it is recommended to:
• Wear well-fitting, ventilated shoes.
• Change shoes and socks at least once daily.
• Wash the affected skin with soap and water and dry completely before applying the cream.
• Wash hands after each use 2.

From the Research

Treatment Options for Athlete's Foot

The treatment for athlete's foot, also known as tinea pedis, typically involves a combination of topical antifungal agents, oral medications, and preventive measures. Some key treatment options include:

• Topical antifungal agents, such as terbinafine 1% cream, which has been shown to be highly effective in treating tinea pedis 3, 4
• Oral griseofulvin, which may be prescribed for more resistant cases 5
• Topical antibiotics, which can help suppress bacterial overgrowth 6
• Aluminum chloride, which combines broad-spectrum antimicrobial activity with chemical drying 6

Preventive Measures

In addition to treatment, preventive measures can help reduce the risk of athlete's foot. These include:

• Keeping the feet dry, especially between the toes 5, 6
• Wearing nonocclusive leather shoes or sandals and absorbent cotton socks 5
• Applying talcum or antifungal powder at least twice daily 5
• Exposing the feet to air, such as by wearing sandals, to enhance evaporation of water and prevent the accumulation of excess moisture 6

Comparison of Treatment Options

Studies have compared the efficacy of different treatment options for athlete's foot. For example, one study found that terbinafine 1% cream was more effective than clotrimazole 1% cream in treating tinea pedis 4. Another study found that topical terbinafine was significantly more effective than placebo in treating chronic tinea pedis 3.