Nonpharmacologic measures

Patients should be encouraged to wear loose-fitting garments made of cotton or synthetic materials designed to wick moisture away from the surface. Socks should have similar properties.

Areas likely to become infected should be dried completely before being covered with clothes. Patients should also be advised to avoid walking barefoot and sharing garments.

Pharmacologic management with antifungals

Topical antifungal therapy in Tinea corporis, cruris, and pedis

Tinea corporis, tinea cruris, and tinea pedis are generally responsive to topical creams such as terbinafine and butenafine, but oral antifungal agents may be indicated for extensive disease, failed topical treatment, immunocompromised patients, or severe moccasin-type tinea pedis. Patients with chronic or recurrent tinea pedis may benefit from wide shoes, drying between the toes after bathing, and placing lamb's wool between the toes.

Pairwise comparison of topical antifungals for the outcome of fungal cure showed butenafine and terbinafine each to be superior to clotrimazole, oxiconazole, and sertaconazole; terbinafine to be superior to ciclopirox.

Topical antifungal treatments for tinea cruris and tinea corporis suggests that the individual treatments with terbinafine and naftifine are effective with few adverse effects.

Tinea pedis is usually treated with a topical antifungal cream for 4 weeks; interdigital tinea pedis may only require 1 week of therapy. Various topical antifungal effective against tinea pedis include azoles (clotrimazole), allylamines (terbinafine), butenafine, ciclopirox, tolnaftate, and amorolfine as evidenced by a meta-analysis finding strong evidence of superiority of topical antifungal agents over placebo.

Naftifine hydrochloride gel was also found to be effective both for interdigital and moccasin type of tinea pedis.

Oral antifungal therapy in Tinea corporis, cruris, and pedis

Systemic antifungals are indicated in case of extensive involvement and patients who fail topical therapy. Out of the various systemic antifungals, terbinafine, and itraconazole are commonly prescribed. Griseofulvin and fluconazole are also effective but require long-term treatment.

Comparative trial between itraconazole 100 mg/day with ultramicronized griseofulvin 500 mg/day for tinea corporis or tinea cruris showed significantly better clinical and mycological outcome in favor of itraconazole after 2 weeks of therapy.

Similar study comparing terbinafine with griseofulvin (both 500 mg daily for 6 weeks) for tinea corporis found mycological cure rate of about 87% in former group compared to 73% in latter.

Topical therapy is less effective than oral antifungals for the treatment of tinea pedis, and oral treatment is generally given for 4–8 weeks.

In a systematic review of efficacy of oral antifungals in, terbinafine was found to be more effective than griseofulvin, whereas the efficacy of terbinafine and itraconazole were similar.