What medications help treat ringworm of the skin?

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 get rid of the fungus.

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 you are 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. Terbinafine also comes as oral granules, which are little grains that can be sprinkled over food and easily swallowed. 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 and Mycelex.
• Griseofulvin (Grifulvin V). 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 - People who are taking antifungal pills should have a doctor monitor their blood counts and liver and kidney function during treatment to watch for any harmful side effects.