Examples
Nonprescription topical
| Brand Name | Chemical Name |
| Lotrimin | clotrimazole |
| Micatin | miconazole nitrate |
| Lamisil cream or solution | terbinafine hydrochloride 1% |
| Loprox, Penlac | ciclopirox |
| Spectazole | econazole |
| Nizoral | ketoconazole |
| Oxistat | oxiconazole |
Prescription topical
| Brand Name | Chemical Name |
| Lotrimin | clotrimazole |
| Micatin | miconazole nitrate |
| Lamisil cream or solution | terbinafine hydrochloride 1% |
| Loprox, Penlac | ciclopirox |
| Spectazole | econazole |
| Nizoral | ketoconazole |
| Oxistat | oxiconazole |
Ciclopirox comes as a cream or lotion (Loprox) or lacquer (Penlac). The cream or lotion is applied to the skin or nail twice a day for 2 weeks. The lacquer (nail polish) is applied once daily to the nail for up to 6 months.
Terbinafine cream or solution is applied to the skin and nail. To kill a fungal skin infection, terbinafine is applied twice daily for at least 2 weeks, or once daily for 2 to 4 weeks. To control a fungal nail infection, longer-term use is necessary.
The other medications are available as creams, lotions, solutions, or sprays and are applied directly to the nail and surrounding skin once or twice a day for 3 to 12 months.
Why It Is Used
Topical antifungal medications are used to treat fungal nail infections. Which medication is used often depends on the type of infection you have.
- Terbinafine may be used to treat fungal nail infections caused by dermatophytes, such as distal subungual onychomycosis and white superficial onychomycosis.
- Ketoconazole, oxiconazole, and econazole are used to treat fungal nail infections caused by dermatophytes and yeasts, such as Candida.
- Clotrimazole is used to treat dermatophytes and molds.
- Ciclopirox is used to treat fungal infection on the nail surface (white superficial onychomycosis).
Topical medications are also used to prevent reinfection, to prevent athlete's foot from causing a fungal nail infection, and after removal of a nail.
How Well It Works
Topical medicines may be used to treat fungal nail infections. However, they are not as successful as oral medicines in curing fungal nail infections.
- One review of research reports that ciclopirox killed fungi in about 30% of people who used it.1
- Using a topical antifungal around the toes after an infection is cured may prevent reinfection.2
These medicines may be used when there are concerns about the risks of oral antifungal medication.
Side Effects
Topical antifungals rarely cause side effects. Stop using the medication if it results in severe blistering, itching, redness, dryness, or irritation.
See Drug Reference for a full list of side effects. (Drug Reference is not available in all systems.)
What To Think About
It is not known whether these medications harm a fetus or pass into breast milk. Ciclopirox is not expected to harm a fetus. If you are pregnant, could become pregnant, or are breast-feeding, consult your health professional before using any of these medications.
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References
Citations
Crawford F, Ferrari J (2005). Fungal nail infections, search date January 2006. Online version of Clinical Evidence (14): 1–9.
Habif TP (2004). Dermatophyte fungal infections section of Superficial fungal infections. In Clinical Dermatology: A Color Guide to Diagnosis and Therapy, 4th ed., pp. 409–439. Philadelphia: Mosby.
Credits
| Author | Sabra L. Katz-Wise |
| Editor | Susan Van Houten, RN, BSN, MBA |
| Associate Editor | Terrina Vail |
| Primary Medical Reviewer | Patrice Burgess, MD - Family Medicine |
| Specialist Medical Reviewer | Randall D. Burr, MD - Dermatology |
| Last Updated | August 23, 2006 |
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