What are the causes and treatments of dermatophytosis (fungal skin infection)?

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From the Guidelines

Dermatophytosis, a fungal skin infection, can be effectively treated with antifungal medications, and the most recent guidelines recommend using itraconazole or terbinafine for treatment, as they have shown high efficacy against dermatophytes and nondermatophyte moulds 1. The causes of dermatophytosis include various fungal species, such as dermatophytes, nondermatophyte moulds, and yeasts.

  • Dermatophytes, such as Trichophyton rubrum, are the most common cause of dermatophytosis.
  • Nondermatophyte moulds, such as Aspergillus and Scopulariopsis, can also cause dermatophytosis, particularly in immunocompromised individuals.
  • Yeasts, such as Candida, can cause dermatophytosis, especially in warm and moist environments.

For common infections like athlete's foot, ringworm, or jock itch, treatment options include:

  • Topical antifungal creams containing clotrimazole, miconazole, or terbinafine, applied to the affected area twice daily for 1-2 weeks, continuing for at least one week after symptoms resolve to prevent recurrence.
  • Prescription-strength medications, such as oral fluconazole (150mg once weekly for 2-4 weeks) or itraconazole (200mg daily for 1-2 weeks), for more severe or persistent infections. It is essential to keep the affected area clean and dry, as fungi thrive in warm, moist environments, and to practice good hygiene, such as wearing loose-fitting clothing and changing socks and underwear daily, to prevent the spread of infection 1. If symptoms worsen or don't improve after two weeks of treatment, it is crucial to consult a healthcare provider, as the patient may have a different type of infection or need stronger medication. Prevention strategies, such as applying antifungal powders containing miconazole, clotrimazole, or tolnaftate in shoes and on the feet, and wearing cotton, absorbent socks, can help reduce the risk of recurrence and reinfection 1.

From the Research

Causes of Dermatophytosis

  • Dermatophytosis is caused by fungi, specifically dermatophytes, which infect the skin, nails, and hair [(2,3,4,5,6)]
  • The most common organisms causing superficial cutaneous fungal infections are dermatophytes, especially Trichophyton spp. 4

Treatments of Dermatophytosis

  • Topical antifungal therapy is effective for most cases of superficial cutaneous fungal infections [(3,4,6)]
  • Topical antifungal agents include azoles (e.g. miconazole, clotrimazole, ketoconazole), allylamines (e.g. terbinafine, naftifine), and benzylamines (e.g. butenafine) [(3,4)]
  • Allylamines are superior to azoles in activity against dermatophytes, but azoles are more effective against yeasts 4
  • Systemic antifungal therapy, such as itraconazole, terbinafine, and griseofulvin, may be required for extensive or resistant infections [(2,5)]
  • Treatment duration varies depending on the infection, with tinea corporis and cruris typically treated for 2 weeks, and tinea pedis treated for 4 weeks 6

Specific Treatment Options

  • Itraconazole is a systemic antifungal drug effective against dermatophytes, yeasts, and some molds 2
  • Naftifine is a topical allylamine with fungicidal activity against dermatophytes 4
  • Terbinafine is a systemic and topical antifungal agent effective against dermatophytes [(2,3,5)]

References

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Research

The significance of itraconazole for treatment of fungal infections of skin, nails and mucous membranes.

Journal der Deutschen Dermatologischen Gesellschaft = Journal of the German Society of Dermatology : JDDG, 2009

Research

Topical therapy for fungal infections.

American journal of clinical dermatology, 2004

Research

Therapy of common superficial fungal infections.

Dermatologic therapy, 2004

Research

Topical treatment of common superficial tinea infections.

American family physician, 2002

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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