Topical antifungal medicine for fungal nail infections

Examples

Nonprescription topical

Generic Name	Brand Name
clotrimazole	Lotrimin cream
miconazole nitrate	Micatin
terbinafine hydrochloride	Lamisil cream or gel

Prescription topical

Generic Name	Brand Name
ciclopirox	Loprox, Penlac,
econazole
ketoconazole	Nizoral
oxiconazole	Oxistat

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 to the nail once a day for up to 6 months.

Terbinafine cream or gel is applied to the skin and nail. To kill a fungal skin infection, terbinafine is applied twice a day for at least 2 weeks, or once a day for 2 to 4 weeks. To control a fungal nail infection, longer-term use is necessary.

The other medicines 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.

How It Works

Topical antifungal medicines prevent the growth of or kill fungi.

Why It Is Used

Topical antifungal medicines are used to treat fungal nail infections. Often, the medicine that is used 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 medicines 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. But 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 medicine.

Side Effects

Topical antifungals rarely cause side effects. Stop using the medicine 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 medicines 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, talk to your doctor before using any of these medicines.

Complete the new medication information form (PDF) (What is a PDF document?) to help you understand this medication.

Author:	Maria G. Essig, MS, ELS	Last Updated: July 24, 2008
Medical Review:	Kathleen Romito, MD - Family Medicine Alexander H. Murray, MD, FRCPC - Dermatology
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