From the Guidelines
Topical antifungal medications, such as terbinafine 1% cream, are the first-line treatment for tinea corporis, and should be applied to the affected area and approximately 2 cm beyond the border of the lesion for 2-4 weeks, as recommended by the most recent guidelines 1. The treatment of tinea corporis typically involves the use of topical antifungal medications, which work by disrupting fungal cell membrane formation or inhibiting ergosterol synthesis, essential for fungal cell wall integrity.
- The most commonly used topical antifungal medications for tinea corporis include:
- Terbinafine 1% cream, applied once or twice daily
- Clotrimazole 1% cream, applied twice daily
- Miconazole 2% cream, applied twice daily
- Ketoconazole 2% cream, applied once or twice daily
- These medications should be applied to the affected area and approximately 2 cm beyond the border of the lesion for 2-4 weeks, and continued for at least one week after the rash resolves to prevent recurrence.
- For more extensive infections or those that don't respond to topical therapy, oral antifungals like terbinafine 250 mg daily or itraconazole 200 mg daily for 2 weeks may be necessary, as supported by studies such as 1. It is also important to note that prevention of reinfection is crucial, and can be achieved by:
- Washing clothing, bedding, and towels in hot water
- Avoiding sharing personal items
- Keeping skin clean and dry
- Wearing loose-fitting clothing in hot, humid weather If the infection worsens, spreads, or doesn't improve after 2 weeks of treatment, it is essential to consult a healthcare provider for reevaluation, as recommended by guidelines such as 1.
From the FDA Drug Label
Directions ... o for jock itch and ringworm: apply once a day (morning or night) for 1 week or as directed by a doctor.
Directions ... for athlete's foot & ringworm, use daily for 4 weeks; for jock itch, use daily for 2 weeks
- Tinea corporis is also known as ringworm.
- The topical regimens for tinea corporis (ringworm) are:
From the Research
Tinea Corporis Topical Regimens
- The efficacy of terbinafine 1% cream in the treatment of tinea corporis has been demonstrated in several studies 4, 5, 6.
- A study published in 2001 found that once daily treatment with terbinafine 1% cream for one week was effective in the treatment of tinea corporis and cruris, achieving mycological cure in 84.2% of patients 5.
- Another study published in 2000 compared the efficacy of terbinafine 1% emulsion-gel with ketoconazole 2% cream in the treatment of tinea corporis and cruris, and found that terbinafine was significantly more effective, achieving mycological cure in 94% of patients 6.
- Terbinafine 1% formulations have been shown to be at least as effective as other topical antifungal agents, such as miconazole 2% cream and naftifine 1% gel, in the treatment of tinea pedis and tinea corporis/cruris 4.
- The use of oral terbinafine in the treatment of tinea corporis and cruris has also been studied, with one study finding that 250 mg daily was effective in achieving clinical improvement and mycological cure 7.
- However, another study found that increasing the dose of oral terbinafine to 500 mg daily did not provide any additional benefit in the treatment of tinea corporis and cruris 8.
Comparison of Topical Regimens
- Terbinafine 1% cream has been compared with other topical antifungal agents, such as ketoconazole 2% cream, and found to be more effective in achieving mycological cure and clinical response 6.
- The efficacy of terbinafine 1% emulsion-gel has been compared with ketoconazole 2% cream, and found to be significantly more effective in achieving mycological cure and clinical response 6.
Oral Therapy
- Oral terbinafine has been shown to be effective in the treatment of tinea corporis and cruris, with a dose of 250 mg daily achieving clinical improvement and mycological cure 7.
- However, increasing the dose of oral terbinafine to 500 mg daily did not provide any additional benefit in the treatment of tinea corporis and cruris 8.