What is the treatment for Tinea pedis (Athlete's foot)?

From the Guidelines

Athlete's foot can be effectively treated with terbinafine 1% cream applied daily for 1 week, which has a mycological cure rate of approximately 94%. This treatment option is supported by a study published in Pediatrics in 2017 1. The study discusses the management of Tinea cruris infection, but the treatment approach can be applied to athlete's foot (Tinea pedis) as well.

Key Treatment Options

• Terbinafine 1% cream applied daily for 1 week
• Butenafine applied twice daily for 2 weeks (only approved for adults)
• Clotrimazole applied twice weekly for 4 weeks
• Oral itraconazole (100 mg daily for 2 weeks or 200 mg daily for 1 week) for severe cases in adults It is essential to note that while these treatment options are effective, it is crucial to prioritize prevention measures to avoid recurrence, such as:
• Keeping feet clean and dry
• Changing socks daily
• Wearing breathable footwear
• Using shower shoes in public facilities Athlete's foot is caused by dermatophyte fungi that thrive in warm, moist environments and feed on keratin in the skin, leading to symptoms like itching, burning, cracking, and peeling skin between the toes or on the soles. Completing the full treatment course is vital, even if symptoms improve quickly, to ensure the fungus is completely eliminated and prevent the infection from spreading to other body parts.

From the FDA Drug Label

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. Uses • cures most athlete's foot (tinea pedis)

The terbinafine (TOP) cream is used to cure most athlete's foot (tinea pedis). For athlete's foot, the cream should be applied:

• Between the toes only: twice a day for 1 week
• On the bottom or sides of the foot: twice a day for 2 weeks as directed by a doctor 2. The cream relieves itching, burning, cracking and scaling which accompany these conditions 2.

From the Research

Prevalence of Athlete's Foot

• Around 15% to 25% of people are likely to have athlete's foot at any one time 3, 4, 5, 6, 7
• The infection can spread to other parts of the body and to other people 3, 5

Topical Treatments for Athlete's Foot

• Topical allylamines (naftifine and terbinafine) are effective in treating athlete's foot 3, 5
• Topical azoles (bifonazole, clotrimazole, econazole nitrate, miconazole nitrate, sulconazole nitrate, and tioconazole) are also effective in treating athlete's foot 3, 5
• Topical ciclopirox olamine is another effective treatment for athlete's foot 3, 5

Oral Treatments for Athlete's Foot

• Terbinafine is more effective than griseofulvin in treating athlete's foot 4, 6, 7
• Itraconazole is also effective in treating athlete's foot, especially in cases where topical treatment has failed 4, 6, 7
• Adverse effects, such as gastrointestinal effects, have been reported for all oral treatments 4, 6, 7

Effectiveness of Treatments

• Terbinafine and itraconazole have been shown to be effective in curing athlete's foot, with terbinafine being more effective than griseofulvin 4, 6, 7
• The evidence suggests that terbinafine and itraconazole are more effective than no treatment, but more research is needed to confirm this 4, 6, 7