From the Guidelines
Tinea pedis treated with topical terbinafine and aluminum chloride typically resolves within 1-4 weeks, though complete cure may take longer. Apply terbinafine cream once or twice daily as prescribed, usually for 1-2 weeks, and aluminum chloride (which helps control moisture) as directed, typically once daily. Improvement should begin within the first week, with redness, itching, and scaling gradually diminishing. Continue treatment for the full prescribed duration even if symptoms improve early to prevent recurrence. Complete eradication of the fungus may take longer than symptom resolution. Terbinafine works by inhibiting ergosterol synthesis, disrupting fungal cell membranes, while aluminum chloride reduces excessive sweating that creates the moist environment fungi thrive in. For faster healing, keep feet clean and dry, wear breathable footwear, change socks daily, and avoid walking barefoot in public areas. If symptoms persist beyond 2-4 weeks or worsen during treatment, the patient should follow up for possible oral antifungal therapy, such as oral terbinafine, 250 mg, given once daily for 1 week, which has similar efficacy to 4 weeks of clotrimazole 1% cream applied twice a day but with faster clinical resolution 1. Key factors to promote healing include:
- Keeping the feet dry and clean
- Using breathable footwear
- Changing socks daily
- Avoiding walking barefoot in public areas It's essential to note that while topical treatment is often effective, oral antifungal therapy may be necessary for more severe cases or if symptoms persist, as oral terbinafine has been shown to have a slightly lower rate of relapse compared to other treatments 1.
From the FDA Drug Label
▪ 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 healing time for tinea pedis with topical terbinafecc (TOP) is 1 week for infections between the toes and 2 weeks for infections on the bottom or sides of the foot, as directed by a doctor 2.
From the Research
Treatment Duration for Tinea Pedis
The treatment duration for tinea pedis using topical terbinafine can vary depending on the formulation and concentration of the medication.
- According to a meta-analysis published in 2007 3, terbinafine has been shown to have clinical efficacy after just 1 week of treatment when applied once daily.
- A study published in 2002 4 found that a 7-day course of oral terbinafine treatment was effective in treating tinea pedis, with a cure rate of 98.5% for plantar type and 93.5% for interdigital type.
- A dose-finding clinical trial published in 2008 5 found that a single dose of topical terbinafine (1%, 5%, or 10% film-forming solution) was effective in treating tinea pedis, with effective treatment rates ranging from 61% to 70% at week 6.
- Another study published in 2008 6 noted that topical terbinafine can reduce the duration of therapy for tinea pedis, with a 1% terbinafine cream applied once a day for one week being effective for uncomplicated tinea pedis interdigitalis.
- A dose-ranging clinical trial published in 2007 7 found that a 5-day treatment course with terbinafine emulsion gel (1% or 3%) was effective in treating tinea pedis, with efficacy rates of 86% and 68%, respectively.
Factors Affecting Treatment Duration
Several factors can affect the treatment duration for tinea pedis, including:
- The type and severity of the infection
- The formulation and concentration of the terbinafine medication
- The frequency and duration of treatment
- Patient compliance with the treatment regimen
Expected Healing Time
Based on the available evidence, the expected healing time for tinea pedis using topical terbinafine can range from 1 week to several weeks, depending on the specific treatment regimen and individual patient factors.
- A meta-analysis published in 2007 3 found that terbinafine has been shown to have clinical efficacy after just 1 week of treatment when applied once daily.
- A study published in 2008 5 found that a single dose of topical terbinafine was effective in treating tinea pedis, with effective treatment rates ranging from 61% to 70% at week 6.