From the Guidelines
To treat athlete's foot, start with over-the-counter antifungal medications like clotrimazole (Lotrimin), miconazole (Micatin), or terbinafine (Lamisil), as these have been shown to be effective in managing the condition 1. When treating athlete's foot, it is essential to apply the cream or spray to the affected area twice daily for at least two weeks, continuing for one week after symptoms disappear to ensure the fungus is completely eliminated. Some key points to consider when treating athlete's foot include:
- Keeping your feet clean and dry, washing them daily with soap and water and drying thoroughly, especially between the toes
- Changing socks daily, wearing breathable footwear, and avoiding walking barefoot in public areas like pools and showers
- Applying antifungal powders containing miconazole, clotrimazole, or tolnaftate in shoes and on the feet to prevent reinfection 1
- Discarding old and moldy footwear or treating them with naphthalene mothballs or a terbinafine solution to eliminate fungal elements 1 For severe cases that don't respond to OTC treatments within two weeks, it is recommended to see a doctor who may prescribe stronger antifungal medications like oral terbinafine or itraconazole 1. These treatments work by killing the dermatophyte fungi that cause athlete's foot by disrupting their cell membranes or inhibiting essential enzyme production. Maintaining good foot hygiene is crucial because the warm, moist environment between toes creates ideal conditions for fungal growth. It is also important to note that athlete's foot can be contagious, so all infected family members should be treated at the same time to prevent reinfection 1.
From the FDA Drug Label
Directions • adults and children 12 years and older o use the tip of the cap to break the seal and open the tube o wash the affected skin with soap and water and dry completely before applying o for athlete's foot wear well-fitting, ventilated shoes. Change shoes and socks at least once daily. ▪ between the toes only: apply twice a day (morning and night) for 1 week or as directed by a doctor. ▪ on the bottom or sides of the foot: apply twice a day (morning and night) for 2 weeks or as directed by a doctor.
The treatment for Tinea pedis (Athlete's foot) is to apply terbinafine (TOP):
- Between the toes only: twice a day for 1 week
- On the bottom or sides of the foot: twice a day for 2 weeks It is also recommended to wear well-fitting, ventilated shoes and change shoes and socks at least once daily 2
From the Research
Treatment Options for Tinea Pedis
- Topical antifungal agents, such as allylamines (e.g. terbinafine) and azoles (e.g. ketoconazole), are commonly used to treat tinea pedis 3, 4, 5, 6, 7
- Oral antifungal agents, such as terbinafine, itraconazole, and fluconazole, may be used for severe cases or when topical treatment fails 3, 6
- Combined therapy with topical and oral antifungals may increase the cure rate 6
Specific Treatment Regimens
- Terbinafine 1% cream applied twice daily for 1-6 weeks has been shown to be effective in treating tinea pedis 5, 7
- Clotrimazole 1% cream applied twice daily for 4 weeks is also effective, but may have lower cure rates compared to terbinafine 7
- Allylamines and azoles have been shown to have high cure rates in placebo-controlled trials, with allylamines being slightly more effective than azoles 4