How to use antifungal foot cream

We prescribe terbinafine cream to treat most variants of athletes foot. This is a common foot skin condition as a result of the feet being enclosed in socks and shoes in a warm, dark moist environment perfect for fungal growth.

Terbinafine cream is the most common cream we prescribe but it has to be used correctly:

• Apply the cream to both feet (least infected first)
• Apply twice a day
• Continue for at least 8 days and ideally finish the tube to last 14 or more days
• Use a large pea sized amount per foot (toothpaste sized for large feet)
• Apply to the entire foot – Start at the back of the foot and come forwards to include the heel, arch, ball of foot, top of foot, nails and between the toes.
• Apply after a bath/shower if having and you can put socks/tights straight on afterwards.

We may also give a tube of clotrimazole to use either after the terbinafine treatment is complete or instead. This is applied in the same way but needs to be continued for 3-4 weeks.

Ingredients and Side Effects

For reference the active ingredient is terbinafine hydrochloride 1%w/w. The other ingredients are sodium hydroxide, benzyl alcohol, sorbitan stearate, cetyl palmitate, cetyl alcohol, stearyl alcohol, polysorbate 60, isopropyl myristate, purified water. If you are allergic to any of these then don’t use the cream (or apply a small amount to your arm as a patch test).

The most common side effect (1 in 10) people is peeling or itching skin and an uncommon side effect (1 in 100) is redness or a burning sensation.

Review

If you feel there has been minimal improvement then we suggest another tube of the cream in the first instance so the cream is used for 3-4 weeks in total. It takes around 30 days for skin to grow through the layers so a review after 6 weeks is advised.

The skin should peel away and then look less scaly, itchy and red. Using a moisturiser helps the skin recovery.