From the Guidelines
Terbinafine 1% cream applied daily for 1 week is the most effective treatment for tinea pedis (athlete's foot), with a mycological cure rate of approximately 94%. When treating tinea pedis, it is essential to consider the treatment options that prioritize morbidity, mortality, and quality of life as the outcome. The treatment of tinea pedis involves the use of antifungal medications, and the choice of medication depends on the severity of the infection and the patient's age. Some key points to consider when treating tinea pedis include:
- Keeping feet clean and dry, washing daily with soap and water, then thoroughly drying, especially between toes
- Wearing breathable footwear and moisture-wicking socks, changing them when damp
- Avoiding walking barefoot in public areas like pools and showers
- Applying antifungal cream or spray to the affected area twice daily for at least two weeks, continuing for one week after symptoms disappear to ensure the fungus is completely eliminated According to a study published in Pediatrics in 2017 1, terbinafine 1% cream is an effective treatment option for tinea pedis, with a high mycological cure rate. Other treatment options, such as butenafine and clotrimazole, are also available, but terbinafine 1% cream is a preferred choice due to its high efficacy and safety profile. It is crucial to note that if symptoms persist beyond two weeks of treatment or if the infection appears to be spreading, consultation with a healthcare provider is necessary for further evaluation. In severe cases, prescription-strength medications like oral terbinafine may be necessary, but this should be determined by a healthcare provider. Overall, the treatment of tinea pedis requires a comprehensive approach that includes the use of antifungal medications, proper foot care, and prevention of further infection.
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 tinea pedis (athlete's foot) is applying terbinafine (TOP):
- Between the toes only: twice a day for 1 week
- On the bottom or sides of the foot: twice a day for 2 weeks As directed by a doctor, and in conjunction with wearing well-fitting, ventilated shoes and changing shoes and socks at least once daily 2.
From the Research
Treatment Options for Tinea Pedis
- Topical antifungal agents are the primary treatment for superficial or localized tinea pedis, with examples including allylamines (e.g. terbinafine), azoles (e.g. ketoconazole), benzylamine, ciclopirox, tolnaftate, and amorolfine 3
- Oral antifungal therapy, such as terbinafine, itraconazole, and fluconazole, is typically reserved for severe disease, failed topical antifungal therapy, concomitant presence of onychomycosis, or in immunocompromised patients 4, 3
- Combined therapy with topical and oral antifungals may increase the cure rate 3
Effectiveness of Specific Treatments
- Terbinafine has been shown to be more effective than griseofulvin in treating tinea pedis, with a pooled risk ratio of 2.26 in favor of terbinafine 4
- Terbinafine and itraconazole have been found to be effective compared to placebo, with risk ratios of 24.54 and 6.67, respectively 4
- Topical terbinafine 1% cream has been shown to be significantly more effective than placebo in treating chronic tinea pedis, with 78% of patients achieving combined mycologic and clinical cure at the end of therapy and 89% at the 2-week follow-up 5
Preventive Measures
- Keeping the feet dry, wearing nonocclusive leather shoes or sandals, and applying talcum or antifungal powder at least twice daily can help prevent tinea pedis 6