Tinea Versicolor Medication

Updated: Jun 09, 2020
  • Author: Christopher Sayed, MD; Chief Editor: Dirk M Elston, MD  more...
  • Print

Medication Summary

Tinea versicolor responds well to both topical and oral antimycotic therapies. Many patients prefer oral therapy because of its convenience.



Class Summary

Topical antifungals temporarily eradicate the condition, although treatment may need to be intermittently repeated to prevent recurrence. Oral therapy for tinea versicolor is convenient and effective, but it does not prevent recurrences. A once-monthly (for 6 mo) oral dose of fluconazole is a popular alternative.

Terbinafine topical (Lamisil)

Terbinafine topical inhibits squalene epoxidase, which decreases ergosterol synthesis, causing fungal cell death. Use this medication until symptoms significantly improve. The duration of treatment should be greater than 1 week but not greater than 4 weeks.

Clotrimazole topical (Mycelex, Lotrimin-AF)

Clotrimazole topical is a broad-spectrum antifungal agent that inhibits yeast growth by altering cell membrane permeability, causing fungal cell death. Reevaluate the diagnosis if no clinical improvement is seen after 4 weeks.

Ketoconazole topical (Extina, Ketozole)

Ketoconazole is an imidazole broad-spectrum antifungal agent. It inhibits the synthesis of ergosterol, causing cellular components to leak, resulting in fungal cell death. Ketoconazole achieves excellent skin levels with minimal oral dosing, but oral treatment with this agent for skin infections is contraindicated because of safety concerns. M furfur is eradicated by the presence of ketoconazole in outer skin layers.

Ciclopirox (Loprox)

Ciclopirox interferes with the synthesis of DNA, RNA, and protein by inhibiting the transport of essential elements in fungal cells.

Butenafine (Mentax)

Butenafine damages fungal cell membranes, causing fungal cell growth to arrest.

Naftifine (Naftin)

Naftifine is a broad-spectrum antifungal agent and synthetic allylamine derivative; it may decrease the synthesis of ergosterol, which, in turn, inhibits fungal cell growth. If no clinical improvement is seen after 4 weeks, reevaluate the patient.

Econazole topical (Ecoza)

Econazole is effective in cutaneous infections. It interferes with RNA and protein synthesis and metabolism. It disrupts fungal cell wall membrane permeability, causing fungal cell death.

Oxiconazole (Oxistat)

Oxiconazole damages the fungal cell wall membrane by inhibiting the biosynthesis of ergosterol. Membrane permeability is increased, causing nutrients to leak out and resulting in fungal cell death.