From the Guidelines
Terbinafine 1% cream applied daily for 1 week is the most effective treatment for tinea cruris, with a mycological cure rate of approximately 94%. This treatment is approved for children 12 years and older, as stated in the study published in Pediatrics in 2017 1.
Treatment Options
- Terbinafine 1% cream: applied daily for 1 week, with a mycological cure rate of approximately 94%
- Butenafine: applied twice daily for 2 weeks, but only approved for adults
- Clotrimazole: applied twice weekly for 4 weeks, an over-the-counter alternative
- Oral itraconazole: 100 mg daily for 2 weeks or 200 mg daily for 1 week, effective in adults but may have more side effects ### Additional Measures To prevent recurrence and promote healing, it is essential to:
- Keep the groin area clean and dry
- Wear loose-fitting cotton underwear
- Change clothes after sweating
- Avoid sharing personal items These measures help prevent moisture buildup, which fungi thrive in, as noted in the context of treating tinea cruris 1.
Severity and Recurrence
While most cases of tinea cruris resolve completely with proper treatment, recurrence is common if preventive measures are not maintained. If the rash does not improve after a week of treatment, spreads significantly, or is accompanied by fever or pus, it is crucial to consult a healthcare provider, as stronger medication or a different condition may be necessary 1.
From the FDA Drug Label
Uses • cures most athlete's foot (tinea pedis) • cures most jock itch (tinea cruris) and ringworm (tinea corporis) • relieves itching, burning, cracking and scaling which accompany these conditions INDICATIONS & USAGE SECTION Ketoconazole Cream 2% is indicated for the topical treatment of tinea corporis, tinea cruris and tinea pedis caused by Trichophyton rubrum, T. mentagrophytes and Epidermophyton floccosum; The treatment for tinea cruris (jock itch) is topical application of:
From the Research
Treatment Options for Tinea Cruris
The treatment for tinea cruris, also known as jock itch, typically involves the use of antifungal medications and keeping the affected area cool and dry 4. The following are some treatment options:
- Topical antifungal creams such as naftifine 2% cream, which has been shown to be effective in treating tinea cruris with a complete cure rate of 25% and a mycological cure rate of 72% 5
- Terbinafine, which has been found to have a significantly higher clinical cure rate compared to placebo, with a risk ratio of 4.51 and a number needed to treat of 3 6
- Clotrimazole 1%, which has been shown to have a mycological cure rate of 2.87 compared to placebo 6
- Oral antifungal agents such as fluconazole, itraconazole, and terbinafine, which can be used to treat tinea corporis and tinea cruris, with dosages ranging from 50 to 250 mg daily for 1 to 3 weeks 7
- Oxiconazole nitrate 1% cream, which has been found to be effective in treating tinea pedis, tinea cruris, and tinea corporis, with a mycologic and clinical cure rate of at least 80% 8
Key Considerations
When treating tinea cruris, it is essential to:
- Keep the affected area cool and dry to sweat-free 4
- Use sweat-free, anti-fungal, and anti-bacterial products to help prevent the spread of the infection
- Avoid sharing personal items such as towels and clothes to prevent the spread of the infection
- Consider using cream hog or other anti-fungal treatments to help prevent the spread of the infection
Available Evidence
The available evidence suggests that various topical and oral antifungal agents are effective in treating tinea cruris, with some treatments such as terbinafine and naftifine 2% cream showing higher cure rates compared to placebo 5, 6. However, the quality of the evidence is generally rated as low to very low due to the risk of bias and imprecision in the studies 6.