Pharmacists are likely to encounter patients seeking education on the wide variety of topical over the counter sprays and creams available to treat fungal skin conditions. These conditions vary, though the most common is tinea pedis–most commonly referred to as athlete’s foot.
Athlete’s foot is commonly seen in individuals that practice regularly in sporting activities or in gyms or locker rooms. This fungal infection can lead to itching, flaking, and scaliness of the feet and between the toes. There are a variety of treatments available to patients that are experiences tinea pedis, and each anti-fungal agent has its own benefits and specific treatment regime. Clotrimazole and miconazole nitrate are common active ingredients in the over the counter cream Lotramin AF and Desenex Anti-fungal, and is typically applied twice a day for up to 4 weeks. Though patients may see improvement after two weeks, pharmacists should advise patients to continue to use the cream for the full four-week dosage cycle to achieve maximum efficiency. Rarely, patients may experience an adverse reaction of burning and skin irritation unrelated to their fungal infection; in these cases, patients should be advised to discontinue use.
Terbinafine hydrochloride is the active ingredient in Lamasil AT gel and Lamasil AT cream or spray, and is used to treat both athlete’s foot and jock itch. These sprays and gels are especially beneficial to patients that have affected areas in hard to reach places, such as between toes. These medications are also to be applied twice daily for 2-4 weeks, and can cause skin irritation, burning, and additional dryness. Patients must observe the affected area for signs of side effects, and can ask their pharmacist how to treat a reaction to the active ingredients in Lamasil AT without further irritating their skin.
Pharmacists can also recommend that patients use tolnaftate to treat their fungal infection. Tolnaftate is the only non-prescription agent approved for both treatment and prevention of fungal infections. Applied twice daily to a clean area, tolnaftate takes 2-4 weeks to fully treat and cure an infected area. Occasionally, patients may require up to six weeks of treatment with tolnaftate containing sprays. These products include Tinactin cream, Tinactin powder spray, and Lamasil Defense Athlete’s Foot spray powder.
Butenafine hydrochloride is another active ingredient which may be helpful to patients who have not seen results from other treatment options. This over the counter cream is applied once daily for a two week period of time, which can be easier for patients that are pressed for time or do not wish to use a product with a longer treatment schedule. Butenafine hydrochloride is seen in the over the counter product Lotramin Ultra, and can be recommended to patients as an alternative to other anti-fungal medications.
Regardless of their choice, over the counter medications offer patients a variety of treatment options when visiting their local pharmacy. Pharmacists can do their part to serve their community by educating themselves on the products available, their dosage cycles, and overall treatment effectiveness.