Topical antifungal agents

Drug	Dose	How supplied^*
Azoles^¶
Clotrimazole^Δ	Twice per day	Cream 1% Lotion 1% Ointment 1% Solution 1%
Econazole	Once per day (twice per day for candidiasis)	Cream 1% Foam 1%
Efinaconazole^◊	Once per day	Solution 10%
Ketoconazole	Once per day (cream and foam are applied twice per day for seborrheic dermatitis)	Cream 2% Gel 2% Foam 2% Shampoo 2% (1% shampoo is available over the counter)
Luliconazole	Once per day	Cream 1%
Miconazole^Δ	Twice per day	Aerosol powder 2% Aerosol solution 2% Cream 2% Ointment 2% Powder 2% Solution 2%
Oxiconazole	Once or twice per day	Cream 1% Lotion 1%
Sertaconazole	Twice per day	Cream 2%
Sulconazole	Once or twice per day	Cream 1% Solution 1%
Allylamines^§
Naftifine	Once per day (cream and 2% gel), twice per day (1% gel)	Cream 1% Cream 2% Gel 1% Gel 2%
Terbinafine^Δ	Once or twice per day	Cream 1% Spray solution 1%^¥
Benzylamine^§
Butenafine^Δ	Once per day (twice per day for tinea pedis)	Cream 1%
Polyene: Treats Candida infections only
Nystatin	2 to 3 times per day	Cream 100,000 units/gram Ointment 100,000 units/gram Powder 100,000 units/gram
Other
Ciclopirox^‡	Twice per day (cream, gel, suspension), twice per week (shampoo), once per day (solution [nail lacquer])	Cream 0.77% Gel 0.77% Shampoo 1% Solution (nail lacquer) 8%^◊ Suspension 0.77%
Tavaborole^◊	Once per day	5% solution
Tolnaftate^Δ†	Twice per day	Aerosol powder 1% Aerosol solution 1% Cream 1% Gel 1% Powder 1% Solution 1%

For additional details on agent selection, use, and dosing, refer to related clinical content, the drug monographs included with UpToDate, and local prescribing information.

* Preparations available in the United States and some other countries.

¶ Azoles have activity against dermatophytes, tinea versicolor, and Candida. Sulconazole, oxiconazole, and luliconazole may be less effective for Candida infection than other azoles.

Δ Available in over-the-counter (nonprescription) preparations in the United States and some other countries.

◊ Indicated for onychomycosis.

§ Can treat Candida in addition to dermatophytes and tinea versicolor but may be less effective than azoles and ciclopirox for Candida infection.

¥ Not available in the United States but may be available elsewhere. Refer to local product information.

‡ Treats dermatophytes, tinea versicolor, and Candida.

† Does not treat Candida; less effective than other options for dermatophytes.

Prepared with data from: US Food & Drug Administration (FDA) approved product information. US National Library of Medicine. (Available online at: https://dailymed.nlm.nih.gov/dailymed/).

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Topical antifungal agents