From the Guidelines
Moccasin foot treatment should prioritize the use of terbinafine 1% cream applied daily for 1 week, as it has been shown to have a high mycological cure rate of approximately 94% 1. When treating moccasin foot, it is essential to consider the severity of the infection and the patient's age. For mild to moderate cases, over-the-counter antifungal creams such as terbinafine, clotrimazole, or butenafine can be effective. However, for severe cases or in patients who do not respond to topical treatment, oral antifungal medications like itraconazole may be necessary. Some key points to consider when treating moccasin foot include:
- Applying antifungal cream to clean, dry feet twice daily for 2-4 weeks, even after symptoms improve
- Using oral antifungal medications like terbinafine or itraconazole for severe cases
- Keeping feet dry by wearing breathable shoes, changing socks daily, and using moisture-wicking socks
- Thoroughly drying between toes after bathing to prevent moisture buildup
- Using antifungal powders to help manage moisture and prevent recurrence It is crucial to note that moccasin foot can be challenging to treat due to the thick skin on the sole, and treatment may need to be extended to ensure complete eradication of the infection 1.
From the FDA Drug Label
Representative treatment periods are ... tinea pedis, 4 to 8 weeks; Concomitant use of appropriate topical agents is usually required, particularly in treatment of tinea pedis. In some forms of tinea pedis, yeasts and bacteria may be involved as well as dermatophytes. Griseofulvin will not eradicate these associated bacterial or yeast infections.
Moccasin foot is another term for tinea pedis, a fungal infection of the foot.
- The treatment period for tinea pedis with griseofulvin is 4 to 8 weeks.
- Concomitant use of topical agents is usually required.
- Griseofulvin will not eradicate associated bacterial or yeast infections 2.
- Griseofulvin is indicated for the treatment of tinea pedis when caused by certain species of fungi 2.
From the Research
Moccasin Foot Treatment Options
- Terbinafine has been shown to be effective in treating moccasin tinea pedis, with a mycological cure rate of 86% after 8 weeks of treatment 3.
- A double-blind, placebo-controlled trial found that terbinafine was well tolerated and highly effective in treating moccasin-type tinea pedis, with a mycologic cure rate of 59% after 6 weeks of treatment 4.
- A Cochrane review found that terbinafine was more effective than griseofulvin in treating tinea pedis, with a pooled risk difference of 52% in favor of terbinafine 5, 6.
- The use of 40% urea cream as an adjunct to topical antifungals has also been shown to be effective in treating moccasin tinea pedis, with a 100% cure rate achieved in 12 patients after 2 to 3 weeks of treatment 7.
Treatment Efficacy
- Terbinafine has been shown to be effective in treating moccasin tinea pedis, with a high mycological cure rate and minimal side effects 3, 4.
- Itraconazole has also been shown to be effective in treating tinea pedis, although the evidence is limited by small trial sizes 5, 6.
- The combination of 40% urea cream and topical antifungals has been shown to be effective in treating moccasin tinea pedis, although further studies are needed to confirm these findings 7.
Side Effects and Tolerability
- Terbinafine has been shown to be well tolerated, with minimal side effects reported in clinical trials 3, 4.
- Itraconazole has also been shown to be well tolerated, although gastrointestinal effects have been reported in some patients 5, 6.
- The use of 40% urea cream has been shown to be safe and effective, with no significant side effects reported in clinical trials 7.