What is the treatment for ringworm (tinea corporis)?

From the Guidelines

Ringworm treatment should involve oral antifungal medications, such as itraconazole or terbinafine, for most cases, especially for T corporis and T capitis infections, as they have proven efficacious in achieving high mycological cure rates. When considering treatment options, the following factors should be taken into account:

• The causative agent of the infection, with Trichophyton tonsurans being the most common cause of T capitis gladiatorum, and Trichophyton rubrum and Trichophyton mentagrophytes also being potential causes 1
• The severity and location of the infection, with T corporis and T capitis infections requiring more aggressive treatment
• The patient's age and medical history, with adolescents and adults being treated with itraconazole or terbinafine Some key points to consider when treating ringworm include:
• Avoiding skin-to-skin contact with people known to have lesions, not sharing towels and other fomites, and limiting exposure to swimming pools that have recently been associated with known outbreaks 1
• Using oral agents, such as itraconazole, 100 mg, given orally once a day, which has been shown to be superior to griseofulvin in achieving mycological cure rates 1
• Terbinafine appearing superior for T tonsurans infections 1 It is essential to note that ringworm is a highly contagious infection, and thorough treatment and hygiene practices are crucial for complete resolution. In terms of specific treatment regimens, the following options may be considered:
• Itraconazole, 100 mg, given orally once a day, for 15 days, which has been shown to achieve an 87% mycological cure rate 1
• Terbinafine, which appears superior for T tonsurans infections, and may be given orally once a day, for 2-4 weeks 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

• Terbinafine (TOP) can be used to treat ringworm (tinea corporis) as it cures most cases of this condition 2.
• The treatment with terbinafine (TOP) also relieves symptoms such as itching, burning, cracking, and scaling associated with ringworm.
• Alternatively, griseofulvin (PO) can also be used to treat tinea corporis, with a recommended treatment period of 2 to 4 weeks 3.

From the Research

Treatment Options for Ringworm

• The treatment of ringworm, also known as tinea, typically involves the use of antifungal medications, such as griseofulvin, terbinafine, itraconazole, and fluconazole 4, 5, 6, 7.
• These medications can be administered orally or topically, depending on the severity and location of the infection 8.
• Studies have shown that terbinafine, itraconazole, and fluconazole are effective in treating tinea capitis, with cure rates ranging from 84% to 94% 4, 5.
• Griseofulvin has been the mainstay of treatment for tinea capitis, but newer antifungal agents like terbinafine and itraconazole have shown similar efficacy and safety profiles 4, 5, 6.
• The choice of treatment depends on the type of fungus causing the infection, as well as the patient's age, weight, and medical history 5, 6, 7.

Efficacy of Antifungal Medications

• Terbinafine has been shown to be effective in treating tinea pedis, with a cure rate of 78% after a single application of 1% terbinafine cream 8.
• Itraconazole has been found to be superior to fluconazole, griseofulvin, and terbinafine in treating chronic and chronic relapsing tinea corporis, tinea cruris, and tinea faciei, with a cure rate of 66% at 8 weeks 7.
• Griseofulvin remains the drug of choice for treating tinea capitis, with a cure rate of 96% in one study 6.
• Fluconazole has been found to have a lower cure rate compared to griseofulvin and terbinafine, but is easier to administer 6.

Safety and Adverse Effects

• Antifungal medications can cause adverse effects, such as gastrointestinal symptoms, nausea, and vomiting 4, 5, 7.
• Terbinafine, itraconazole, and fluconazole have been found to have similar safety profiles, with mild and reversible adverse effects 5, 7.
• Griseofulvin has been associated with a higher risk of adverse effects, including gastrointestinal symptoms and discontinuation of therapy due to adverse effects 4.