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Topical Antifungal Medicine for Fungal Nail Infections


Examples

Nonprescription topical

Generic NameBrand Name
clotrimazoleLotrimin, Micatin, Lamisil, Loprox, Penlac, Nizoral, Oxistat
miconazoleLotrimin, Micatin, Lamisil, Loprox, Penlac, Nizoral, Oxistat
terbinafineLotrimin, Micatin, Lamisil, Loprox, Penlac, Nizoral, Oxistat

Prescription topical

Generic NameBrand Name
ciclopiroxLoprox, Penlac, Nizoral, Oxistat
econazoleLoprox, Penlac, Nizoral, Oxistat
ketoconazoleLoprox, Penlac, Nizoral, Oxistat
oxiconazoleLoprox, Penlac, Nizoral, 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 needed.

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 do not work as well 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.2
  • Using a topical antifungal around the toes after an infection is cured may prevent reinfection.1

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)Click here to view a form.(What is a PDF document?) to help you understand this medication.

References

Citations

  1. Habif TP (2010). Fungal nail infections section of Nail diseases. In Clinical Dermatology: A Color Guide to Diagnosis and Therapy, 5th ed., pp. 956–961. Edinburgh: Mosby Elsevier.

  2. Ferrari J (2008). Fungal toenail infections, search date May 2008. Online version of BMJ Clinical Evidence: http://www.clinicalevidence.com.

Credits

ByHealthwise Staff
Primary Medical ReviewerKathleen Romito, MD - Family Medicine
Specialist Medical ReviewerAlexander H. Murray, MD, FRCPC - Dermatology
Last RevisedJuly 20, 2010

eMedicineHealth Medical Reference from Healthwise

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