From the Guidelines
Topical treatment of ringworm should involve antifungal creams applied directly to the affected area, with over-the-counter options like clotrimazole, miconazole, or terbinafine being effective for most cases. For most cases, these creams should be applied twice daily for 2-4 weeks 1. It is essential to continue treatment for at least one week after symptoms disappear to ensure complete eradication of the fungus. Some key points to consider when using topical treatments for ringworm include:
- Cleaning and drying the affected area before applying the cream
- Applying a thin layer of cream extending slightly beyond the visible rash
- Avoiding sharing towels, clothing, or personal items to prevent spreading the infection
- Considering oral antifungal medications prescribed by a healthcare provider if the ringworm affects the scalp or beard area, or if it doesn't improve after two weeks of topical treatment. However, the provided evidence does not directly support the use of specific topical treatments for ringworm, as the studies focus on guidelines for managing tinea capitis and sexually transmitted diseases 1. Nevertheless, based on general medical knowledge and the principle of prioritizing morbidity, mortality, and quality of life, the use of antifungal creams like clotrimazole, miconazole, or terbinafine remains the most appropriate recommendation for topical treatment of ringworm.
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 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. o for jock itch and ringworm: apply once a day (morning or night) for 1 week or as directed by a doctor. o wash hands after each use
Topical treatment of ringworm can be achieved with terbinafine (TOP) 2. The recommended application is once a day (morning or night) for 1 week or as directed by a doctor 2.
- Key points:
- Apply terbinafine (TOP) to the affected area
- Wash the affected skin with soap and water and dry completely before applying
- Wash hands after each use
- Follow the recommended application duration of 1 week or as directed by a doctor 2
From the Research
Topical Treatment of Ringworm
- The topical treatment of ringworm, also known as tinea corporis, has been studied in several clinical trials 3, 4, 5.
- Terbinafine 1% cream has been shown to be effective in treating tinea corporis, with mycological cure rates of > 80% when applied once or twice daily for up to 2 weeks 3, 4.
- A study comparing terbinafine 1% cream to clotrimazole 1% cream found that terbinafine was significantly more effective in treating tinea pedis, with a cure rate of 78% after a single application 4.
- Another study found that a 7-day course of terbinafine 1% cream applied once daily was effective in treating tinea corporis and cruris, with a mycological cure rate of 84.2% 5.
- The effectiveness of oral antifungal agents, including terbinafine, has also been studied in the treatment of tinea corporis and other superficial fungal infections 6, 7.
- However, a recent study found that the effectiveness of oral antifungal agents, including terbinafine, was limited in the treatment of chronic and chronic relapsing tinea corporis, tinea cruris, and tinea faciei in India 7.
Treatment Options
- Topical terbinafine 1% cream is a treatment option for ringworm, with a high mycological cure rate when applied once or twice daily for up to 2 weeks 3, 4, 5.
- Oral antifungal agents, including terbinafine, may also be effective in treating ringworm, but their effectiveness may be limited in certain cases 6, 7.
- The choice of treatment should be based on the severity and location of the infection, as well as the patient's medical history and other factors 3, 6.