Tinea Nigra Medication

Updated: May 15, 2019
  • Author: Robert A Schwartz, MD, MPH; Chief Editor: William D James, MD  more...
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Medication

Medication Summary

Because tinea nigra is caused by a superficial fungal infection of the skin, topical medicines designed to eradicate the dermatomycosis are used, [32] including topical butenafine. [28]

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Dermatologic agents

Class Summary

These agents are used to treat tinea nigra because of their action on the skin. They may either aid in the removal of excessive keratin in hyperkeratotic skin disorders or increase epithelial cell turnover. These agents are used in conjunction with fungicidal or fungistatic medications.

Salicylic acid topical (Compound W, Salactic Film, Sal-Plant, Panscol)

Salicylic acid topical causes desquamation of the horny layer of skin by dissolving intercellular cement substance, while not affecting structure of viable epidermis. Hydrate the skin and enhance the effects of medication; soak the affected area in warm water for 5 minutes prior to use; remove any loose tissue with a brush, washcloth, or emery board, and dry thoroughly. Improvement should occur in 1-2 weeks.

Tretinoin topical (Avita, Retin-A)

Topical tretinoin decreases the cohesiveness of follicular epithelial cells and stimulates their mitotic activity, resulting in quicker turnover of the epithelial layer.

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Topical imidazoles

Class Summary

These medications are broad-spectrum antifungals that are commonly used in the treatment of tinea pedis, but they are also effective in the treatment of tinea nigra.

Clotrimazole (Lotrimin, Mycelex, Femizole-7)

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

Ketoconazole topical (Nizoral)

Ketoconazole is an imidazole broad-spectrum antifungal agent; it inhibits the synthesis of ergosterol, causing cellular components to leak and resulting in fungal cell death.

Miconazole (Micatin, Femizol-M)

Miconazole damages the fungal cell wall membrane by inhibiting the biosynthesis of ergosterol. It increases membrane permeability, causing nutrients to leak out and resulting in fungal cell death.

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Topical pyridones

Class Summary

Topical pyridones are broad-spectrum agents with antidermatophyte, antibacterial, and anticandidal activity.

Ciclopirox (Loprox)

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

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Topical allylamines

Class Summary

These drugs are effective in treating a variety of fungal infections. Because they have demonstrated potent activity against dermatophytes, they are often used in recalcitrant infections.

Terbinafine topical (Lamisil)

Terbinafine is an allylamine derivative that inhibits squalene epoxidase, a key enzyme in sterol biosynthesis in fungi. This effect results in a deficiency in ergosterol in the fungal cell wall, causing fungal cell death.

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Fungistatic agents

Class Summary

These medications do not kill the fungus, but rather, they prevent their growth and replication.

Undecylenic acid & derivatives (Blis-To-Sol powder, Caldesene, Cruex)

These are fungistatic. They are indicated for superficial dermal fungal infections.

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