From the Guidelines
Tinea pedis can be effectively treated with ciclopirox olamine 0.77% cream or gel applied twice daily to the affected areas for 4 weeks, as it has been shown to be superior to 1% clotrimazole cream in achieving both clinical and mycological cure. This treatment option has been evaluated in randomized controlled trials in adults and has proven efficacy against T rubrum, T mentagrophytes, and Epidermophyton floccosum 1. The application of ciclopirox olamine cream or gel twice daily for 4 weeks has been shown to achieve a clinical and mycological cure in approximately 60% of patients, compared to 6% for the vehicle only at the end of treatment, and 85% versus 16% two weeks after treatment 1.
Some key points to consider when treating tinea pedis include:
- Keeping feet clean and dry
- Changing socks daily
- Wearing breathable footwear
- Using shower shoes in public facilities
- Treating shoes with antifungal powders to eliminate fungal reservoirs in cases of recurrent infections
It is also important to note that obesity and diabetes are additional risk factors for T pedis, and management of these underlying conditions may be necessary to prevent recurrence 1. Overall, the use of ciclopirox olamine 0.77% cream or gel is a effective treatment option for tinea pedis, and its application should be continued for at least one week after symptoms resolve to prevent recurrence.
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
Representative treatment periods are ... tinea pedis, 4 to 8 weeks;
- Terbinafine (TOP) can be used to treat tinea pedis, as it cures most athlete's foot.
- Griseofulvin (PO) can also be used to treat tinea pedis, with a treatment period of 4 to 8 weeks.
- The treatment of tinea pedis with griseofulvin (PO) may require concomitant use of appropriate topical agents, as yeasts and bacteria may be involved in some forms of the infection 2 3.
- Dosage of griseofulvin (PO) for tinea pedis should be individualized, with adults typically requiring 0.5 g daily and pediatric patients requiring 10 mg/kg daily 3.
From the Research
Tinea Pedis Treatment Overview
- Tinea pedis, also known as athlete's foot, is a common superficial fungal infection of the skin, with various clinical manifestations 4.
- The treatment of tinea pedis depends on the severity of the infection, with mild infections often resolved using topical agents, while more severe cases may require oral antifungal therapy or a combination of both 4, 5.
Topical Treatment
- Topical antifungal therapy is the mainstay of treatment for superficial or localized tinea pedis, with examples of topical antifungal agents including allylamines (e.g., terbinafine), azoles (e.g., ketoconazole), benzylamine, ciclopirox, tolnaftate, and amorolfine 4.
- A one-week course of terbinafine 1% cream has been shown to be more effective in the treatment of tinea pedis than a four-week course of clotrimazole 1% cream, both in terms of mycological cure and effective treatment 6.
- Topical therapy is generally successful unless the infection covers an extensive area or is resistant to initial therapy, in which case systemic therapy may be required 7.
Oral Treatment
- Oral antifungal agents, such as terbinafine, itraconazole, and fluconazole, are reserved for severe disease, failed topical antifungal therapy, concomitant presence of onychomycosis, or in immunocompromised patients 4.
- A single daily dose of 250 mg of oral terbinafine for 1 week has been shown to be as effective and as well tolerated as 1% clotrimazole cream applied twice daily for 4 weeks in the treatment of interdigital tinea pedis 8.