Fungal Skin Infection

Treatable fungal infections

Tinea corporis - Ring Worm

Tinea pedis - Athlete’s foot

Tinea cruris - Jock itch

Refer fungal infections

Tinea capitis - scalp

Tinea unguium - nails

Treat or refer? Failed (correct) treatment

Refer

Treat or Refer? Nails, scalp, face, genitalia, or mucous membrane involvement

Refer

Treat or refer? Sign of secondary infection (oozing purulent, material, fever, malaise)

Refer

Treat or Refer? Diabetes, immunodeficiency

Refer

Treatment Goals

To provide symptomatic relief

To eradicate existing infection

To prevent future infections

General Approach

OTC topical antifungals + nonpharmacologic measures

Nonpharmacologic Therapy

Clean and dry

Don’t share

Avoid others infected

Use rubber shoes in shared public areas

Ointments

Greasy, occlusive, Hydrating

Best for: Dry, scaly lesions

Creams/Solutions

Balanced moisture, excellent epidermal delivery

Best for: Dry and scaly tinea pedis

Powders

Absorbs moisture, reduces friction

Best for: Moist areas, adjunct or prevention

Gels/Aerosols

Cooling, quick-drying, minimal moisture

Best for: Macerated, erosive interdigital tinea pedis

Tolnaftate

• Prevention of tinea pedis

• 2 and over

• Does not treat sides and bottoms of feet

• Directions for between toes: twice daily for 4 weeks

• Directions for tinea cruris: twice daily for 2 weeks

• Directions for tinea corporis: twice daily for 4 weeks

Terbinafine

• Does not prevent tinea pedis

• 12 and over

• Directions for bottom and sides of feet: Cream only twice daily for 2 weeks

• Directions for between toes: Other dosage forms, twice daily for 1 week

  • Directions for tinea cruris and tinea corporis: Daily for 1 week

Follow up/Monitoring

Refer if symptoms remain longer than suggested treatment duration

Refer if signs of worsening