There are more than 40 different types of fungus that cause athlete’s foot, and some are more stubborn than others. These may require prescription drugs like Lamisil (terbinafine) or Diflucan (fluconazole).
This is especially true if the infection is severe or you have a weakened immune system.
This explains when you might need a topical or oral prescription athlete’s foot treatment. It also reviews the various options and possible side effects.
Who Needs a Prescription Athlete’s Foot Treatment?
People tend to regard athlete’s foot as a relatively minor and common skin infection, and that’s largely true. Studies suggest that anywhere from 15% to 25% of people will get athlete’s foot at some point in their life.
This doesn’t mean that an infection can’t turn serious, however.
Standard over-the-counter antifungal remedies are often enough to clear the fungus. When that’s not the case, prescription antifungals may be needed to clear the infection and prevent secondary infections (i.e., those that arise as a result of the primary infection).
Generally speaking, prescription medications are needed to treat athlete’s foot if:
The infection hasn’t cleared after four weeks of self-treatment. The infection goes away but comes back repeatedly. The infection has spread to other parts of the body (such as the nails, groin, or hands). You have developed a secondary infection, such as cellulitis.
Prescription Treatment Options
Depending on the severity and location of the infection, your healthcare provider may prescribe topical medications (which you apply to the skin) or oral medications (which you take by mouth).
Topical Antifungals
If athlete’s foot fails to respond to over-the-counter topical antifungals, your healthcare provider will usually a prescribe prescription-strength version of the same drug.
Prescription topical antifungal options include:
Ertaczo (sertaconazole)Exelderm (sulconazole)Lamisil (terbinafine)Lotrimin (clotrimazole)Luzu (luliconazole)Mentax (butenafine)Micatin (miconazole)Naftin (naftifine)Spectazole (econazole)Tinactin (tolnaftate)
Treatment is usually prescribed for four weeks or at least one week after skin symptoms have all cleared.
Oral Antifungals
If the athlete’s foot fungus is resistant to topical antifungals, oral antifungals may be used to support the treatment. They are less commonly used on their own for fungal skin infections.
Prescription oral antifungal options include:
Diflucan (fluconazole)Lamisil (terbinafine)Sporanox (itraconazole)
Treatment may be prescribed for anywhere from one to nine weeks depending on the severity of the infection.
Other Athlete’s Foot Treatments
There are other topical or oral medications that may be prescribed for specific purposes to support antifungal therapy.
Examples include:
Oral antibiotics: These may be used needed to treat secondary bacterial infections. Options include Augmentin (amoxicillin-clavulanate), cephalexin, dicloxacillin, and clindamycin. Penlac (ciclopirox) nail polish: This is used to treat infections that have spread to the toenails. Penlac is commonly used for six to 12 weeks with topical and possibly oral antifungal. Topical corticosteroids: Steroid creams or ointments may be needed to treat skin conditions like eczema or psoriasis that aggravate athlete’s foot. Options include Kenalog (triamcinolone) and Temovate (clobetasol).
Possible Side Effects
As with all drugs, prescription topical and oral athlete’s foot treatments carry a risk of side effects. Many of these tend to be mild, but, with oral antifungals especially, some can be severe.
Topical Antifungals
Topical antifungals are generally considered safe when used as prescribed. Because prescription antifungals are stronger, it is even more important to adhere to your healthcare provider’s instructions.
Possible side effects of topical antifungals include:
Skin redness and irritationBurning or stingingItchinessPimple-like bumpsTendernessFlakingSwelling
Oral Antifungals
While oral antifungals can be extremely effective, they carry a greater risk of side effects than their topical counterparts. Side effects can vary by the drug used,
Diflucan: Side effects include headaches, diarrhea, nausea, upset stomach, vomiting, and changes in taste. Lamisil: Side effects are similar to Diflucan but also include diarrhea, gas, stuffy nose, cough, and dizziness. Long-term use can cause liver damage. Sporanox: Side effects are similar to Lamisil but also include constipation and joint pain. It should not be used if you have congestive heart failure.
Summary
Athlete’s foot is a common fungal infection of the foot.
Mild cases can usually be treated with over-the-counter ointments, but severe or persistent cases may require topical or oral prescription medications like Spectazole (econazole) and Lamisil (terbinafine).
A Word From Verywell
If your healthcare provider recommends a prescription drug for athlete’s foot, be sure to advise them about any medical conditions you have or any medications you may be taking. In some cases, the drug may need to be avoided or used with extreme caution.
This includes the avoidance of oral Lamisil in people with advanced liver disease, as well as oral Sporanox if you have congestive heart failure.
The more that your healthcare provider knows about your medical history, the safer the treatment will be.
