From the FDA Drug Label
Ketoconazole Cream 2%, for topical administration only, contains the broad-spectrum synthetic antifungal agent, ketoconazole 2%
- Antifungal creams are topical treatments that contain broad-spectrum synthetic antifungal agents, such as ketoconazole, used to treat various fungal infections 1
- These creams are formulated to be applied directly to the affected area, providing a localized treatment for fungal infections such as tinea corporis, tinea cruris, and tinea pedis 1
- The active ingredient in these creams, such as ketoconazole, works to treat the fungal infection by targeting the causative fungus, including Trichophyton rubrum, T. mentagrophytes, and Epidermophyton floccosum 1
From the Research
Antifungal creams are topical medications used to treat fungal infections of the skin, and for most common fungal infections, I recommend using over-the-counter options such as terbinafine 1% (Lamisil) cream, as it has been shown to be highly effective against a wide variety of dermatophytes, moulds, and certain dimorphic fungi, with mycological cure rates of > 80% 2.
Key Characteristics of Antifungal Creams
- They work by disrupting the fungal cell membrane or inhibiting ergosterol synthesis, which is essential for fungal cell survival
- Examples of antifungal creams include clotrimazole 1% (Lotrimin), miconazole 2% (Micatin), and terbinafine 1% (Lamisil) cream
- They are available over-the-counter or by prescription, depending on the severity of the infection
Treatment Recommendations
- Apply a thin layer to the affected area and about 1 inch beyond it, twice daily for 2-4 weeks, even if symptoms improve sooner
- Keep the affected area clean and dry before application, as fungi thrive in warm, moist environments
- For more severe infections, prescription-strength options include ketoconazole 2% (Nizoral), econazole 1% (Spectazole), or ciclopirox 0.77% (Loprox)
Important Considerations
- If the infection doesn't improve after two weeks of treatment, shows signs of bacterial infection (increased redness, warmth, pus), or affects large areas of the body, consult a healthcare provider as oral antifungals may be necessary
- The choice of antifungal cream may depend on the type of fungal infection, with allylamines such as terbinafine being preferred for dermatophytic fungal infections, and azole drugs such as miconazole being preferred for yeast infections 3
- Topical antifungal therapy is not effective for nail infections, as the infections usually occur under the nail instead of on top of it, and products penetrate poorly through the nail plate 3