- Nonprescription antifungals usually are used first. These include clotrimazole (Lotrimin), miconazole (Micatin), terbinafine (Lamisil), and tolnaftate (Tinactin). Nonprescription antifungals are applied to the skin (topical medicines).
- Prescription antifungals may be tried if nonprescription medicines are not successful or if you have a severe infection. Some of these medicines are topical antifungals, which are put directly on the skin. Examples include butenafine (Mentax), clotrimazole, and naftifine (Naftin). Prescription antifungals can also be taken as a pill, which are called oral antifungals. Examples of oral antifungals include fluconazole (Diflucan), itraconazole (Sporanox), and terbinafine (Lamisil).
For severe athlete's foot that doesn't improve, your doctor may prescribe oral antifungal medicine (pills). Oral antifungal pills are used only for severe cases, because they are expensive and require periodic testing for dangerous side effects. Athlete's foot can return even after antifungal pill treatment.
Even if your symptoms improve or stop shortly after you begin using antifungal medicine, it is important that you complete the full course of medicine. This increases the chance that athlete's foot will not return. Reinfection is common, and athlete's foot needs to be fully treated each time symptoms develop.
Toe web infections
Toe web (interdigital) infections occur between the toes, especially between the fourth and fifth toes. This is the most common type of athlete's foot infection.
- Treat mild to moderate toe web infections by keeping your feet clean and dry and using nonprescription antifungal creams or lotions.
- If a severe infection develops, your doctor may prescribe a combination of topical antifungal creams plus either oral or topical antibiotic medicines.
Moccasin-type athlete's foot causes scaly, thickened skin on the sole and heel of the foot. Often the toenails become infected (onychomycosis). A moccasin-type infection is difficult to treat, because the skin on the sole of the foot is very thick.
- Nonprescription medicines may not penetrate the thick skin of the sole well enough to cure moccasin-type athlete's foot. In this case, a prescription topical antifungal medicine that penetrates the sole, such as ketoconazole, may be used.
- Prescription oral antifungal medicines are sometimes needed to cure moccasin-type athlete's foot.