From the FDA Drug Label
Treats fungal infections of the skin, such as folliculitis, athlete's foot, jock itch, ringworm, and seborrheic dermatitis. Effective for relieving symptoms of itching, scaling, redness, and discomfort caused by fungal infections. Helps reduce and control fungal skin infections, including tinea corporis (body fungus), tinea cruris (groin fungus), tinea pedis (foot fungus), and tinea versicolor. Clean the affected area thoroughly with soap and water and dry completely before applying the cream Apply a small amount of ointment to the affected area and gently rub in. Use daily for up to 4 weeks, or as directed by a healthcare provider.
The treatment for severe tinea versicolor is applying ketoconazole (TOP) cream to the affected area, after cleaning and drying the area thoroughly. The cream should be applied daily for up to 4 weeks, or as directed by a healthcare provider 1 1.
- Key points:
- Clean and dry the affected area before application
- Apply a small amount of cream to the affected area
- Use daily for up to 4 weeks
- Follow the healthcare provider's directions for use.
From the Research
Severe tinea versicolor is typically treated with oral antifungal medications, with fluconazole being a commonly prescribed option, but the most recent and highest quality study suggests that itraconazole can be effective in the treatment of tinea versicolor with extensive involvement. The treatment of severe tinea versicolor involves the use of oral antifungal medications due to the extensive nature of the infection, which cannot be adequately addressed by topical treatments alone.
- The standard regimen for fluconazole is 400 mg as a single dose, or 300 mg once weekly for two to four weeks.
- Alternatively, itraconazole 200 mg daily for seven days can be effective, as shown in a study comparing the efficacy of single dose (400 mg) versus 7 day (200 mg) daily dose itraconazole in the treatment of tinea versicolor 2.
- Ketoconazole 200 mg daily for ten days is another option, although its use has been limited due to safety concerns.
- Topical antifungals like ketoconazole shampoo used as a body wash once or twice monthly may be beneficial for maintenance therapy to prevent recurrence, especially in hot, humid climates or for those who sweat heavily.
- Oral medications work by inhibiting ergosterol synthesis, which is essential for fungal cell membrane integrity, effectively killing the Malassezia yeast that causes the condition.
- A review of antifungal treatment for pityriasis versicolor suggests that oral itraconazole and fluconazole may be more appropriate for severe or recalcitrant cases, with maintenance therapy potentially useful in preventing recurrent infection 3.