What is the treatment for tinea corporis (ringworm of the body)?

From the Guidelines

Tinea corporis should be treated with oral itraconazole, 100 mg, given orally once a day for 15 days, as it has shown a superior mycological cure rate of 87% compared to other treatments. This recommendation is based on a study published in Pediatrics in 2017 1, which found that itraconazole was more effective than griseofulvin in treating tinea corporis.

Key Considerations

• The treatment of tinea corporis depends on the severity and extent of the infection, as well as the causative fungus.
• Oral antifungal therapy, such as itraconazole, is often necessary for more extensive or resistant infections.
• Topical antifungal medications, such as azoles or allylamines, may be used for mild to moderate cases, but are not as effective as oral therapy for more severe infections.
• It is essential to continue treatment for the full prescribed duration, even if symptoms improve earlier, to prevent recurrence.

Prevention Measures

• Avoiding skin-to-skin contact with people known to have lesions, covering lesions, not sharing towels and other fomites, and limiting exposure to swimming pools that have recently been associated with known outbreaks can help prevent the spread of tinea corporis 1.
• Keeping the affected areas clean and dry can also help prevent the spread of the infection.

Causative Fungi

• The most common cause of tinea corporis is Trichophyton tonsurans, but it may also be caused by Trichophyton rubrum and Trichophyton mentagrophytes 1.
• Terbinafine appears to be superior for treating T tonsurans infections 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

Representative treatment periods are tinea capitis, 4 to 6 weeks; tinea corporis, 2 to 4 weeks;

The treatment for tinea corporis includes:

• Terbinafine (TOP), which cures most ringworm (tinea corporis) and relieves accompanying symptoms 2
• Griseofulvin (PO), with a recommended treatment period of 2 to 4 weeks 3

From the Research

Treatment Options for Tinea Corporis

• Tinea corporis is a superficial fungal infection that can be treated with various antifungal agents, including terbinafine, itraconazole, fluconazole, and griseofulvin 4, 5, 6.
• Topical treatment is generally successful for tinea corporis, unless the infection covers an extensive area or is resistant to initial therapy, in which case systemic therapy may be required 7.
• Terbinafine has been shown to be effective in the treatment of tinea corporis, with mycological cure rates of over 80% 4.
• Itraconazole has also been found to be effective in the treatment of tinea corporis, with cure rates of 66% at 8 weeks 6.
• Fluconazole and griseofulvin have also been used to treat tinea corporis, but with lower cure rates compared to itraconazole 6.
• Topical amorolfine and clotrimazole have also been found to be effective and safe in the treatment of tinea corporis, with no significant difference in mycological cure rate and clinical improvement between the two groups 8.

Dosage and Duration of Treatment

• The dosage and duration of treatment for tinea corporis vary depending on the antifungal agent used and the severity of the infection.
• Terbinafine is typically given orally at a dose of 250 mg/day for 2-4 weeks 4.
• Itraconazole is typically given orally at a dose of 5 mg/kg/day for 2-4 weeks 6.
• Fluconazole is typically given orally at a dose of 5 mg/kg/day for 2-4 weeks 6.
• Griseofulvin is typically given orally at a dose of 10 mg/kg/day for 6-8 weeks 6.
• Topical amorolfine and clotrimazole are typically applied for 4 weeks, with evaluation of efficacy at 4 and 8 weeks 8.

Safety and Efficacy

• The safety and efficacy of antifungal agents in the treatment of tinea corporis have been evaluated in several studies.
• Terbinafine has been found to be well tolerated and effective in the treatment of tinea corporis, with a low potential for drug interactions 4.
• Itraconazole has been found to be effective in the treatment of tinea corporis, but with a higher potential for drug interactions compared to terbinafine 6.
• Fluconazole and griseofulvin have also been found to be effective in the treatment of tinea corporis, but with lower cure rates and a higher potential for adverse effects compared to itraconazole 6.
• Topical amorolfine and clotrimazole have been found to be safe and effective in the treatment of tinea corporis, with no significant difference in adverse effects between the two groups 8.