Treatment of Tinea Cruris (Jock Itch)

Topical terbinafine 1% cream applied once daily for 1 week is the most effective first-line treatment for jock itch (tinea cruris). 1, 2

First-Line Treatment Options

Terbinafine 1% cream applied once daily for 1 week has demonstrated a 94% mycological cure rate and is recommended as the first-line treatment for uncomplicated tinea cruris 1, 2
Ciclopirox olamine (0.77%) cream or gel applied twice daily for 4 weeks has shown superior efficacy compared to clotrimazole in achieving both clinical and mycological cure 1
Other effective topical antifungal options include:
- Butenafine applied twice daily for 2 weeks 1
- Clotrimazole applied twice daily for 4 weeks 1, 3
- Naftifine 1% cream has demonstrated significant efficacy compared to placebo (RR 2.38,95% CI 1.80 to 3.14) 3

Wash the affected skin with soap and water and dry completely before applying any topical antifungal 2
For jock itch, apply terbinafine once daily (morning or night) for 1 week 2
Wash hands after each application 2
Continue treatment for the full recommended duration even if symptoms improve before completion 3

Oral antifungal therapy is generally not required for uncomplicated tinea cruris but may be considered in cases that are:
- Extensive
- Resistant to topical therapy
- Recurrent
- Associated with immunosuppression 4, 5
When oral therapy is needed, effective options include:
- Terbinafine 250 mg daily for 1 week (highly effective with complete mycological cure) 6
- Fluconazole 150 mg once weekly for 2-3 weeks 4
- Itraconazole 100 mg daily for 2 weeks or 200 mg daily for 7 days 4

Completely dry the groin area after bathing or showering 1, 7
Use separate clean towels for drying the groin and other body parts 1
Wear loose-fitting, cotton underwear that absorbs moisture 7
Change underwear and workout clothes promptly after sweating 7
Treat concurrent tinea pedis (athlete's foot) if present, as it can be a source of reinfection 1
Cover active foot lesions with socks before wearing underwear to prevent spread 1

Failure to identify and treat concurrent fungal infections (especially tinea pedis) can lead to recurrence 1, 5
Misdiagnosis is common - other conditions like candidiasis, erythrasma, or contact dermatitis can mimic tinea cruris 5
Combination products containing corticosteroids should be avoided for initial treatment as they may mask symptoms while allowing the infection to persist 3
Adverse effects of topical antifungals are generally mild and infrequent, mainly consisting of local irritation and burning 3
Treatment should be continued for the full recommended duration to ensure complete eradication of the infection 3, 6