Treatment of Athlete's Foot with Canesten (Clotrimazole) 1% Cream
For athlete's foot (tinea pedis), Canesten (clotrimazole) 1% cream should be applied twice daily to the affected areas for 4 weeks. 1
Application Instructions
- Clean and thoroughly dry the affected area before each application
- Apply a thin layer of Canesten 1% cream to the affected area and surrounding skin
- Gently rub in until absorbed
- Apply twice daily (morning and evening)
- Continue treatment for the full 4 weeks, even if symptoms improve earlier
- Extend application approximately 1-2 cm beyond the affected area
Efficacy and Evidence
Clotrimazole 1% cream is an effective treatment for tinea pedis, though it has been shown to be less effective than some newer antifungal agents. In comparative studies, terbinafine 1% cream applied twice daily for just 1 week demonstrated superior efficacy to clotrimazole 1% cream applied for 4 weeks, with mycological cure rates of 93.5% versus 73.1% respectively 2.
The British Journal of Dermatology recommends considering the following if treatment failure occurs 1:
- Compliance issues
- Suboptimal absorption
- Organism insensitivity
- Reinfection
Treatment Monitoring
- If clinical improvement is observed but mycology remains positive, continue the current therapy for an additional 2-4 weeks 1
- If no clinical improvement is observed after 4 weeks, consider switching to a second-line therapy 1
Preventive Measures
To prevent recurrence and enhance treatment success:
- Keep feet dry, especially between toes
- Wear well-fitting, breathable shoes or sandals
- Use absorbent cotton socks and change them daily
- Apply talcum or antifungal powder at least twice daily 1, 3
- Treat all infected family members simultaneously to prevent reinfection 1
- Clean footwear periodically 1
Special Considerations
For patients with diabetes:
- More aggressive treatment and careful monitoring is required due to higher risk of complications and secondary bacterial infections 1
- Regular foot examinations are essential to detect early signs of infection
For athletes:
- Consider preventive measures including regular application of antifungal powders to shoes and feet 1
- Avoid walking barefoot in communal showers and locker rooms 3
Alternative Treatment Options
If clotrimazole is ineffective or not tolerated, consider:
- Topical terbinafine 1% cream (first-line alternative): Applied twice daily for 1-2 weeks 1
- Ciclopirox olamine 0.77% cream/gel: Applied for 4 weeks, with ~60% clinical and mycological cure at end of treatment 1
- For severe or resistant cases: Oral terbinafine 250mg daily or oral itraconazole 100mg daily may be considered 1