From the Guidelines
To treat a small ringworm infection on your arm, apply an over-the-counter antifungal cream such as terbinafine (Lamisil) directly to the affected area and about one inch beyond its border, as it appears superior for T tonsurans 1. When treating ringworm, it's essential to keep the area clean and dry, as fungi thrive in warm, moist environments.
- Apply the medication twice daily for at least two weeks, even if the rash appears to improve sooner.
- Before application, wash the area with soap and water and dry it thoroughly.
- Avoid sharing towels, clothing, or personal items to prevent spreading the infection, and avoid skin-to-skin contact with people known to have lesions 1. If the ringworm doesn't improve after two weeks of treatment, spreads significantly, or becomes increasingly red and painful, consult a healthcare provider who may prescribe stronger antifungal medications, such as itraconazole, which has been shown to be effective in treating T corporis 1.
- Oral agents like itraconazole and terbinafine have proven efficacious in the treatment of most cases of T corporis, with itraconazole, 100 mg, given orally once a day, being superior to griseofulvin in some studies 1.
From the FDA Drug Label
DOSAGE AND ADMINISTRATION Accurate diagnosis of the infecting organism is essential. Identification should be made either by direct microscopic examination of a mounting of infected tissue in a solution of potassium hydroxide or by culture on an appropriate medium Medication must be continued until the infecting organism is completely eradicated as indicated by appropriate clinical or laboratory examination. Representative treatment periods are tinea capitis, 4 to 6 weeks; tinea corporis, 2 to 4 weeks; INDICATIONS AND USAGE Griseofulvin oral suspension, USP is indicated for the treatment of dermatophyte infections of the skin not adequately treated by topical therapy, hair and nails, namely: Tinea corporis
The treatment for a small ringworm on the arm is griseofulvin (PO), with a treatment period of 2 to 4 weeks for tinea corporis, as indicated by the drug label 2 and 2. The dosage for adults is 0.5 g daily, and for pediatric patients, it is 10 mg/kg daily. It is essential to continue medication until the infecting organism is completely eradicated, as indicated by clinical or laboratory examination. Concomitant use of appropriate topical agents is usually required.
From the Research
Treatment Options for Ringworm on the Arm
- The treatment for ringworm on the arm typically involves the use of oral antifungal medications, such as terbinafine, griseofulvin, itraconazole, and fluconazole 3, 4, 5, 6, 7.
- Topical antifungal creams or ointments may also be used in conjunction with oral medications to help clear up the infection 4, 7.
Efficacy of Different Treatments
- A study comparing the efficacy of terbinafine, griseofulvin, itraconazole, and fluconazole in the treatment of tinea capitis found that griseofulvin was the most effective treatment, followed by terbinafine, itraconazole, and fluconazole 3.
- Another study found that oral terbinafine 250 mg daily was not effective in treating tinea cruris and corporis after 4 weeks of treatment, and increasing the dose to 500 mg did not provide any additional benefit 4.
- A randomized pragmatic trial found that itraconazole was the most effective treatment for chronic and chronic relapsing dermatophytosis in India, followed by fluconazole, terbinafine, and griseofulvin 5.
- A comparative evaluation of griseofulvin, terbinafine, and fluconazole in the treatment of tinea capitis found that griseofulvin was the most effective treatment, followed by terbinafine and fluconazole 6.
- A randomized double-blind comparative study found that oral terbinafine was more effective than oral griseofulvin in the treatment of tinea corporis and tinea cruris 7.