When the athlete's foot is severe, the topical medications generally do not work. In such cases, oral anti-fungal drugs are required. All the oral anti fungal drugs are safe for use and need to be taken for at least 2-4 weeks or even longer before a response can be seen.
The most common oral medications to treat athlete's foot include:
- Itraconazole (Sporanox)
- Fluconazole (Diflucan)
- Terbinafine (Lamisil)
The older anti fungal agent like griseofulvin is no longer used because of its toxicity. It is a good drug but there are safer drugs available today.
The oral anti fungal drugs are also very useful in the treatment of Candida skin infections. Candida typically occurs in the body creases such as the armpit, groins and under the breast. Drugs like Diflucan are very effective in the treatment of Candida. Further, Diflucan can also cure Candida infections of the vagina and mouth.
Antibiotics: Often when the fungal infection is prolonged and there is skin breakdown, bacterial infections also occur at the same time. Thus, many physicians will also prescribe a short course of antibiotics to treat the bacterial infection.
There are reports that both oral itraconazole and oral terbinafine may be linked to rare cases of liver failure and death. In addition, there is also evidence that oral itraconazole may be detrimental to individuals who have poor heart function, such as those with heart failure.
Toe nail: Nail infections are very difficult to treat and require months of therapy. Topical medications for the toes almost never work. In many cases, the infection may slow down and come back once the medication is stopped. In such cases removal of the entire nail is probably the best therapy. The procedure can be done in a doctor's office under local anesthesia. The resulting nail will be free of the fungus infection.
To compliment the oral anti fungal therapy, one should also:
- prevent dampness in the house
- dry your feet after a shower
- routinely clean the bathroom and toilet with disinfectant to prevent the fungus from spreading to other members of the family
- regularly wash your clothes in hot water
- avoid sharing personal hygiene products
- wear shower sandals in locker rooms and gyms especially after showering
- keep the foot dry with medicated powder
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