What is the treatment for facial tinea (ringworm) with topical cream?

From the Guidelines

For face ringworm (tinea faciei), I strongly recommend using an over-the-counter antifungal cream containing clotrimazole 1%, miconazole 2%, or terbinafine 1% as the first line of treatment. According to the British Association of Dermatologists' guidelines for the management of tinea capitis 2014 1, topical therapy alone is not recommended for the treatment of tinea capitis, but for tinea faciei, over-the-counter antifungal creams are often sufficient.

Key Points to Consider

• Apply a thin layer to the affected area and about 1 inch beyond the border of the rash twice daily for 2-4 weeks, even if symptoms improve sooner.
• Wash your hands before and after application to prevent spreading the infection.
• If the infection is severe or doesn't improve after 2 weeks of treatment, prescription-strength medications like ketoconazole cream or oral antifungals may be necessary, as suggested by the guidelines for treatment failure 1.
• Keep the affected area clean and dry, avoid sharing towels or personal items, and refrain from scratching to prevent spreading the infection.
• These antifungal medications work by disrupting the fungal cell membrane or inhibiting essential enzymes, preventing the ringworm fungus from growing and reproducing, as seen in the mechanism of action of griseofulvin and terbinafine 1.
• If you experience increased redness, swelling, or the rash spreads despite treatment, consult a healthcare provider promptly, as this may indicate treatment failure or the need for second-line therapy 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 The terbinafine (TOP) cream can be used to cure ringworm (tinea corporis).

• The cream should be applied once a day for 1 week or as directed by a doctor 2, 2.

From the Research

Face Ringworm Cream

• The treatment of face ringworm, also known as tinea faciei, can be done using various topical antifungal creams 3.
• Terbinafine 1% cream has been shown to be effective in treating dermatophytosis of the skin, including tinea faciei, with high mycological cure rates 4, 5.
• Clotrimazole 1% cream is also used to treat tinea infections, but it may require a longer treatment duration compared to terbinafine 4, 5.
• Other topical antifungal agents, such as naftifine 1% and butenafine, have also been shown to be effective in treating tinea corporis and tinea cruris, and may be used to treat face ringworm as well 3, 6.
• The choice of treatment may depend on the severity of the infection, the patient's medical history, and the potential for side effects 3.
• It is essential to note that the effectiveness of these treatments may vary, and some studies have reported limited effectiveness of oral antifungal drugs in treating tinea faciei 7.