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 achieving both clinical and mycological cure. This treatment option is supported by a randomized controlled trial in adults, which demonstrated the superiority of ciclopirox olamine over 1% clotrimazole cream or its vehicle in achieving a clinical and mycological cure 1. The study found that approximately 60% of patients treated with ciclopirox olamine cream achieved a cure at the end of treatment, compared to 6% for the vehicle only, and 85% versus 16% two weeks after treatment.
Treatment Options
- Ciclopirox olamine cream or gel (0.77%) applied twice daily for 4 weeks
- Alternative options may include over-the-counter topical antifungals like clotrimazole 1%, miconazole 2%, or terbinafine 1%, although these may not be as effective as ciclopirox olamine
- Prescription-strength medications like terbinafine, butenafine, or ciclopirox may be needed for more severe or resistant infections
- Oral antifungals like terbinafine or itraconazole may be prescribed for extensive infections or those that don't respond to topical treatment
Prevention of Recurrence
- Keep feet dry by wearing breathable shoes and cotton socks
- Change socks when damp
- Dry between toes after bathing
- Use foot powder to reduce moisture
- Avoid walking barefoot in public areas like pools and showers
The treatment of tinea pedis with ciclopirox olamine cream or gel (0.77%) applied twice daily for 4 weeks is a effective option, with a high cure rate and minimal side effects, as demonstrated in the study by 1. This treatment option should be considered as the first line of treatment for tinea pedis, due to its high efficacy and safety profile.
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 examples of topical antifungal agents including allylamines (e.g. terbinafine), azoles (e.g. ketoconazole), benzylamine, ciclopirox, tolnaftate, and amorolfine 3
- Oral antifungal therapy should be reserved for severe disease, failed topical antifungal therapy, concomitant presence of onychomycosis, or in immunocompromised patients 3
- Combined therapy with topical and oral antifungals may increase the cure rate 3, 4
Topical Treatment Duration and Frequency
- Topical antifungal therapy is usually applied once or twice daily for 1-6 weeks 3
- 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 5
- A single application of 1% terbinafine cream achieved a cure rate of 78% in patients with tinea pedis 5
- Terbinafine 1% FFS is an effective, safe dose for the treatment of tinea pedis, with effective treatment rates at week 6 of 66% 6