Most ringworm infections of the skin can be treated at home with nonprescription antifungal creams. The rash will usually improve within 2 weeks. But most antifungals need to be used for 2 to 4 weeks to eliminate the fungus.³

If the rash does not improve after you have used an antifungal cream and it is severe and widespread or returns frequently, you may need antifungal pills that your doctor prescribes. When treating ringworm, it is important to finish the full course of medicine prescribed, even if the symptoms have gone away, so that the infection does not return.

Medication Choices

The most common antifungals used to treat ringworm of the skin are:

• Allylamines, such as terbinafine (Lamisil). Allylamines come as creams, pills, and gels. Lamisil is available as a cream without a prescription.
• Azoles. Oral prescription forms include fluconazole (Diflucan) and itraconazole (Sporanox). Some of these medicines are available without a prescription. Brand names include Micatin, Monistat-Derm, and Lotrimin.
• Griseofulvin (Fulvicin U/F, Grifulvin V, Grisactin). Griseofulvin comes in pill form and requires a prescription.
• Other antifungals such as tolnaftate (Tinactin). Tinactin is available without a prescription and comes in lotion, cream, gel, and spray forms.

Clotrimazole/betamethasone (Lotrisone), a combination antifungal and corticosteroid, is sometimes used to treat ringworm that is burning, itchy, and inflamed. This prescription medicine should be used with caution and for no longer than 2 weeks, because complications can occur with long-term use of corticosteroids.

What To Think About

Griseofulvin is the oldest and least expensive of the oral medicines. The newer oral medicines-terbinafine, fluconazole, and itraconazole-require shorter treatment times, which may make it more likely that the person will complete the full course of treatment.

If you take antifungal pills, you will need frequent blood tests to check for liver problems.

If there is no improvement of the skin infection after 2 to 4 weeks of treatment, the rash may not be due to a fungal infection.