From the Guidelines
Tinea pedis should be treated with ciclopirox olamine cream or gel (0.77%) applied twice daily to the affected areas for 4 weeks, as it has been shown to be effective in eradicating the infection and superior to other treatments. This recommendation is based on a randomized controlled trial in adults, which demonstrated the efficacy of ciclopirox olamine in achieving both clinical and mycological cure 1. The treatment of tinea pedis involves the use of antifungal medications, and ciclopirox olamine has been proven to be a broad-spectrum hydroxypyridone antifungal with efficacy against T rubrum, T mentagrophytes, and Epidermophyton floccosum.
Some key points to consider when treating tinea pedis include:
- Keeping feet clean and dry is essential during treatment, as the fungus thrives in warm, moist environments
- Patients should wash feet daily, dry thoroughly between toes, wear breathable footwear, change socks when damp, and avoid walking barefoot in public areas like pools and showers
- Ciclopirox olamine cream or gel (0.77%) has been shown to be effective in eradicating tinea pedis, with a clinical and mycological cure rate of approximately 60% at the end of treatment and 85% two weeks after treatment 1
- Other treatments, such as 1% clotrimazole cream, have been shown to be less effective compared to ciclopirox olamine 1
It is also important to note that obesity and diabetes are additional risk factors for tinea pedis 1, and patients with these conditions may require closer monitoring and more aggressive treatment. Overall, the use of ciclopirox olamine cream or gel (0.77%) for 4 weeks is a effective treatment option for tinea pedis, and patients should be advised to practice good foot hygiene to prevent recurrence.
From the FDA Drug Label
Clotrimazole is also available as a nonprescription item which is indicated for the topical treatment of the following dermal infections: tinea pedis, tinea cruris, and tinea corporis due to Trichophyton rubrum, Trichophyton mentagrophytes, Epidermophyton floccosum, and Microsporum canis. The treatment for tinea pedis is topical treatment with clotrimazole [ 2 ].
- The drug name is clotrimazole
- The form is a topical cream
- The pathogens that can be treated include Trichophyton rubrum, Trichophyton mentagrophytes, Epidermophyton floccosum, and Microsporum canis.
From the Research
Treatment Options for Tinea Pedis
- Topical antifungal therapy is the mainstay of treatment for superficial or localized tinea pedis, with a cure rate of > or = 80% when applied twice or 3 times a day for 3-4 weeks 3
- Terbinafine, a new antifungal, has been shown to give equally good results when applied once or twice daily for 1-2 weeks, with a cure rate of 78% in patients with tinea pedis after a single application of 1% terbinafine cream 3
- Oral antifungal therapy should be reserved for severe disease, failed topical antifungal therapy, concomitant presence of onychomycosis or in immunocompromised patients 4
- Combined therapy with topical and oral antifungals may increase the cure rate 5, 4
Topical Antifungal Agents
- Examples of topical antifungal agents include allylamines (e.g. terbinafine), azoles (e.g. ketoconazole), benzylamine, ciclopirox, tolnaftate and amorolfine 4
- Terbinafine 1% cream applied twice daily for 1 week was significantly superior to a 4-week course of clotrimazole 1% cream for treating tinea pedis 3
- A novel, single-dose, topical treatment of tinea pedis using terbinafine has been shown to be effective, with effective treatment rates at week 6 with terbinafine 1%, 5% and 10% FFS being 66%, 70%, 61% compared with 18% with placebo 6
Oral Antifungal Agents
- Oral antifungal agents used for the treatment of tinea pedis include terbinafine, itraconazole and fluconazole 4
- Oral antifungal drugs are useful for treating tinea pedis, especially in cases of hyperkeratotic tinea pedis that is unresponsive to topical monotherapy, or in cases of tinea facialis adjacent to the eyes, ears, or mouth, or widespread tinea corporis, or tinea cruris involving the complex skin folds of the external genitalia 5