From the FDA Drug Label
DOSAGE & ADMINISTRATION SECTION Cutaneous candidiasis, tinea corporis, tinea cruris, tinea pedis and tinea (pityriasis) versicolor: It is recommended that Ketoconazole Cream 2% be applied once daily to cover the affected and immediate surrounding area Patients with tinea versicolor usually require two weeks of treatment.
The treatment for a patient with tinea versicolor is to apply Ketoconazole Cream 2% once daily to the affected and surrounding area for two weeks 1.
- Treatment duration: 2 weeks
- Application frequency: once daily
- Affected area: cover the affected and immediate surrounding area
From the Research
Tinea versicolor is best treated with a single dose of fluconazole 400mg or itraconazole 400mg, as these oral antifungals have shown high efficacy and safety in clinical trials. The choice of treatment depends on the severity of the condition, with topical antifungals such as selenium sulfide 2.5% shampoo or ketoconazole 2% shampoo being suitable for mild to moderate cases 2. For extensive or recurrent cases, oral antifungals are recommended, with fluconazole 400mg as a single dose or 300mg weekly for 2-4 weeks being a common option 3. Itraconazole 200mg daily for 5-7 days is another effective option, as shown in a randomized clinical trial comparing the efficacy of single dose 400mg versus 7 day 200mg daily dose of itraconazole 4.
Some key points to consider when treating tinea versicolor include:
- Topical antifungals can be effective for mild to moderate cases, but may be difficult to apply to large body surface areas
- Oral antifungals such as fluconazole and itraconazole have shown high efficacy and safety in clinical trials
- Maintenance therapy with selenium sulfide or ketoconazole shampoo once or twice monthly may be recommended to prevent recurrence, especially during warm, humid months 5
- Patients should be advised that skin discoloration may persist for weeks or months after successful treatment
In terms of specific treatment regimens, the following options may be considered:
- Selenium sulfide 2.5% shampoo applied to affected areas for 10 minutes daily for 7 days
- Ketoconazole 2% shampoo applied for 5 minutes daily for 3 days
- Fluconazole 400mg as a single dose or 300mg weekly for 2-4 weeks
- Itraconazole 200mg daily for 5-7 days
- Topical azoles such as clotrimazole, miconazole, or ketoconazole cream applied twice daily for 2-4 weeks 6.