Although most cases of ringworm are relatively easy to treat, some cases can be more difficult. When the fungus infects the skin it spreads through the uppermost layer. Mild infections usually respond to topical over-the-counter treatments. Some ringworm infections are more pervasive and require a systemic approach.
Allylamines
Dr. Dana Nadalo, assistant professor at the Baylor College of Medicine, reports in The Journal of Family Practice that anti-fungal allylamines treat ringworm more quickly than other remedies but are more expensive. Some allylamines are available as over-the-counter topical treatments, while other topical and oral allylamines require a prescription. Allylamines include Lamisil cream, solution and oral medication and Naftin cream and gel. The Mayo Clinic reports that oral medications my cause side effects including gastrointestinal upset and abnormal liver function.
Azoles
Azoles take longer to work than allylamines, according to Dr. Nadalo. They are generally less expensive than allylamines. Topical azoles include Lotrimin lotion, cream and solution; Nizoral cream and shampoo; and Micatin cream, spray, lotion and powder. The longer treatment increases the likelihood that patients will discontinue treatment prematurely, Dr. Nadalo says.
Other Treatments
Other treatments that are neither azoles nor allylamines include the benzylamine Mentax cream. Ciclopirox, known as Loprox cream or lotion, and tolnaftate, sold as Tinactin powder, are two others. Griseofulvin, available as Grifulvin V and Gris-Peg, taken orally, is an older type of anti-fungal. It takes longer than azoles and allylamines. The Mayo Clinic reports that griseofulvin is sometimes prescribed for people who are allergic to other anti-fungal medications and those who may not be able to take other anti-fungal medications because of other drugs they are taking or liver disease.
Considerations
Medline Plus reports that ringworm can often be cured in about four weeks with over-the-counter anti-fungal medications. Persistent infections may need medical care and systemic medications. As part of ringworm treatment, skin should be kept clean and dry. Sheets, towels and clothing should be washed daily. Further, infected pets should be treated at the same time, because people can catch ringworm from pets.
