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DermNet NZ


Facts about the skin from DermNet New Zealand Trust. Topic index: A B C D E F G H I J K L M N O P Q R S T U V W X Y Z


Topical antifungal medications

Topical antifungal medications can often cure fungal infections. Many suitable creams can be obtained over the counter without a doctor's prescription.

Many antifungal medications are suitable for both dermatophyte and yeast infections. The medications available in New Zealand are listed below, with their trade names in parentheses.

Those unsuitable for dermatophyte fungal infections are marked with an asterix (*).

Preparations for skin infections

Topical antifungal creams can be used to treat:

The creams are applied to the affected area twice daily for two to four weeks, including a margin of several centimetres of normal skin. Continue for one or two weeks after the last visible rash has cleared. Repeated treatment is often necessary.

In other countries, additional antifungal agents include the azoles, bifonazole, tioconzaole, sulconazole, efinaconazole and luliconazole; naftifine; and a benzoxaborole, tavaborole.

Scalp antifungal agents

Antifungal shampoos are mainly used to treat dandruff / seborrhoeic dermatitis but are used as an adjunct for tinea capitis and scalp psoriasis.

The most effective ingredients are ketoconazole (Daktagold® shampoo; Ketopine® shampoo, Nizoral® shampoo; Sebizole® shampoo), miconazole (HairScience® shampoo) and ciclopirox (Stieprox® liquid), but many other shampoos marketed for dandruff have antifungal properties.

Preparations for nail fold infections

There are many antiseptic and antifungal preparations to control nail fold infections (paronychia). They should be applied two or three times daily for several months.

Preparations for nail plate infections

Mild onychomycosis can be treated with antifungal lacquers applied once or twice weekly. The medication should be applied to the surface of the cleaned nail plate after it has been roughened using an emery board. Extra lacquer should be applied under the edge of the nail.

These can be expected to reduce and sometimes cure the infection provided:

Available preparations are:

Preparations for oral infections

Oral candidiasis can be treated with:

Note: miconazole oral gel should not be usd in patients who are taking warfarin because it has been reported to cause a dangerous interaction, which could result in serious bleeding.

Preparations for vaginal infections

Vulvovaginal candidiasis can be treated with:

* Unsuitable for dermatophyte fungal infections

Combination products

Topical antifungals may be sold with an oral antifungal, e.g. Canesten® combination pack (fluconazole capsule and clotrimazole cream duo).

Antifungal creams are sometimes combined with:

Oral antifungal medications may be required for a fungal infection if:

Related information

On DermNet NZ:

Other websites:

Books about fungal infections:

Note:

New Zealand approved datasheets are the official source of information for medicines, including approved uses and risk information. Check the individual New Zealand datasheet on the Medsafe website.

DermNet NZ does not provide an online consultation service.
If you have any concerns with your skin or its treatment, see a dermatologist for advice.