From the Guidelines
To treat a fungal infection on the feet, terbinafine 1% cream applied daily for 1 week is the most effective treatment, with a mycological cure rate of approximately 94%. This treatment is approved for children 12 years and older, as stated in the study published in Pediatrics in 2017 1.
Treatment Options
- Terbinafine 1% cream applied daily for 1 week is a highly effective treatment for T cruris, with a mycological cure rate of approximately 94% 1.
- Butenafine applied twice daily for 2 weeks and clotrimazole applied twice weekly for 4 weeks are also over-the-counter alternatives, but butenafine is only approved in adults 1.
- Oral itraconazole (100 mg daily for 2 weeks or 200 mg daily for 1 week) has been shown to be effective in adults for treating T cruris and superior to oral griseofulvin (500 mg daily for 2 weeks) 1.
Prevention and Management
- Keep your feet clean and dry, washing them daily with soap and water, then thoroughly drying, especially between the toes.
- Change socks daily, wear breathable footwear, and avoid walking barefoot in public areas like pools and showers.
- These treatments work by either killing the fungus directly or preventing its reproduction, and the fungus thrives in warm, moist environments, which is why keeping feet dry and using antifungal agents is effective.
When to Consult a Healthcare Provider
- If symptoms persist beyond four weeks of treatment or if you have diabetes or a weakened immune system, consult a healthcare provider promptly.
From the FDA Drug Label
DOSAGE AND ADMINISTRATION ... tinea pedis, 4 to 8 weeks; ... Concomitant use of appropriate topical agents is usually required, particularly in treatment of tinea pedis.
INDICATIONS AND USAGE ... Tinea pedis ... when caused by one or more of the following species of fungi: ...
Treatment for Feet Fungal Infection (Tinea Pedis):
- The recommended treatment period for tinea pedis with griseofulvin is 4 to 8 weeks 2.
- Concomitant use of topical agents is usually required for the treatment of tinea pedis 2.
- Griseofulvin is indicated for the treatment of tinea pedis caused by certain species of fungi, including Epidermophyton floccosum, Trichophyton mentagrophytes, and Trichophyton rubrum 2.
From the Research
Treatment Options for Feet Fungal Infections
- Topical treatments are available for fungal infections of the skin and nails of the foot, including allylamines, azoles, ciclopiroxolamine, tolnaftate, butenafine, and undecanoates 3
- Oral therapy is sometimes necessary for superficial fungal infections of the skin, and antifungal agents such as fluconazole, itraconazole, and terbinafine can be effective in treating tinea pedis 4
- The effectiveness of oral antifungal drugs, including fluconazole, griseofulvin, itraconazole, and terbinafine, has been tested in a randomized pragmatic trial, with itraconazole showing the highest cure rate 5
Recommended Treatment Duration
- Tinea pedis is typically treated for 4 weeks with an azole or for 1 to 2 weeks with allylamine medication 6
- Treatment should continue for at least one week after clinical clearing of infection 6
- Oral therapy is usually used for chronic conditions or when topical treatment has failed, and treatment duration can vary depending on the specific condition and medication used 7
Comparison of Antifungal Agents
- Allylamines have been shown to be slightly more effective than azoles in treating athlete's foot 3
- Itraconazole has been shown to be more effective than fluconazole, griseofulvin, and terbinafine in treating chronic and chronic relapsing dermatophytosis in India 5
- Terbinafine has been shown to be more effective than griseofulvin in treating tinea pedis 7