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Topical antifungals

Medically reviewed on June 1, 2018

What are Topical antifungals?

Topical antifungals are products that treat fungal infections and which are applied directly to the skin, nails, or hair; vaginally; or inside the mouth. They are available as creams, gels, lotions, nail lacquers, ointments, powders, shampoos, sprays, and tinctures.

Fungal infections are caused by dermatophytes, yeasts, or molds.

There are about 40 different species of dermatophyte, and they obtain their nutrients from keratinized material, so typically are the organisms responsible for fungal infections of the skin, scalp or nails.

Yeasts are normal inhabitants of our skin but sometimes they grow unheeded which can result in symptomatic infections. Molds are an uncommon cause of fungal infections but they can cause tinea nigra (painless brown or black patches on the skin) or hard-to-treat nail infections.

Most antifungal agents treat both dermatophyte and yeast infections; however, some, such as nystatin, are not suitable for dermatophyte fungal infections.

What are topical antifungals used for?

Topical antifungals may be used to treat fungal infections of the skin, scalp, mucous membranes, nails, and vagina. Examples of infections that topical antifungals may treat include:

Other fungal infections not listed here may also be treated with topical antifungals.

What are the differences between topical antifungals?

Antifungal agents may be classified into a number of different types, depending on their structure and the way that they work. Many topical antifungals work by inhibiting production of ergosterol, a fundamental component of the fungal cell membrane and wall.

Note that only the antifungals that are available topically are listed here.

Azole antifungals

Azole antifungals are further classified into imidazoles and triazoles. Although all azoles work in the same way (by inhibiting an enzyme that converts lanosterol into ergosterol), there are differences in the spectrum of activity between imidazoles and triazoles.

Azole antifungals are metabolized through cytochrome p450 liver enzymes and are particularly susceptible to clinically-significant drug interactions with other medications metabolized through the same pathway, although this tends to only apply to topical products used inside the mouth, such as miconazole oral gel.

Generic name Brand name examples
Imidazoles
clotrimazole FungiCURE, Lotrimin
econazole Ecoza, Spectazole
ketoconazole Nizoral topical
miconazole Azolen, Zeasorb
miconazole/zinc oxide Rash Relief AntifungalVusion
oxiconazole Oxistat
sertaconazole Ertaczo
tioconazole 1-day, Vagistat-1
Triazoles
efinaconazole Jublia

Polyene antifungals

Polyenes work by binding to ergosterol, disrupting the integrity of the fungal cell membrane. Nystatin is the only polyene antifungal available topically. Note that nystatin is not effective against dermatophyte infections but can be used to treat Candida infections.

Generic name Brand name examples
nystatin Mycostatin topical, Nyamyc

Allylamine antifungals

Allylamines work in a similar way to azoles but have their effect earlier on in the ergosterol synthesis pathway. They inhibit the enzyme squalene epoxidase which converts squalene into ergosterol, disrupting synthesis of the fungal cell wall.

Terbinafine is also metabolized by cytochrome p450 liver enzymes and is particularly susceptible to clinically-significant drug interactions with other medications metabolized through this pathway, although this tends not to apply to topical products.

Generic name Brand name examples
amorolfin Not available in the U.S.
naftifine Naftin
terbinafine Lamisil

Other antifungals

Several other topical antifungals are available. Their mechanism of action differs to the antifungals listed above.

Generic name Brand name examples
Benzoic acid and salicylic acid Bensal HP
ciclopirox Ciclodan, Loprox
tavaborole Kerydin
tolnaftate Tinactin
undecylenic acid Blis-To-Sol, Protectol

Are topical antifungals safe?

Topical antifungals are considered safe when used exactly as directed according to the product label. However, certain topical antifungals have been associated with serious side effects, for example:

  • Miconazole oral gel: Should not be used in infants with an impaired swallowing reflex or in preterm infants in their first six months of life, or in babies less than four months old, because of the potential for airway obstruction
  • Miconazole oral gel: May also cause clinically significant interactions with medicines (such as warfarin) metabolized through the same liver pathway because miconazole oral gel is absorbed through the mouth.

For a complete list of severe side effects, please refer to the individual drug monographs.

What are the side effects of topical antifungals?

Not everybody will experience side effects from topical antifungals. Some of the more commonly reported side effects include:

  • Burning or stinging
  • Rash
  • Sensitivity reactions
  • Skin irritation (redness, peeling, swelling).

Some vaginal topical antifungal preparations have been associated with burning, cramping, itching, pain, and bleeding.

For a complete list of side effects, please refer to the individual drug monographs.

List of Topical antifungals:

Filter by:
Drug NameView by: Brand | Generic Reviews Avg. Ratings
Bensal HP (More...)
generic name: benzoic acid/salicylic acid
3 reviews
   
10
Blis-To-Sol Powder (More...)
generic name: undecylenic acid
0 reviews
   
10
Extina (Pro, More...)
generic name: ketoconazole
1 review
   
10
Mycostatin Topical (Pro, More...)
generic name: nystatin
0 reviews
   
10
Naftin (Pro, More...)
generic name: naftifine
2 reviews
   
10
Nizoral Topical (Pro, More...)
generic name: ketoconazole
2 reviews
   
10
Nyamyc (Pro, More...)
generic name: nystatin
1 review
   
10
Tinactin (More...)
generic name: tolnaftate
0 reviews
   
10
Zeasorb-AF (More...)
generic name: miconazole
1 review
   
10
Zeasorb-AF Drying Gel (More...)
generic name: miconazole
1 review
   
10
Vusion (Pro, More...)
generic name: miconazole/zinc oxide
4 reviews
   
9.8
Spectazole (Pro, More...)
generic name: econazole
3 reviews
   
9.7
Loprox (Pro, More...)
generic name: ciclopirox
2 reviews
   
9.3
Lotrimin AF Athlete's Foot Powder (More...)
generic name: miconazole
1 review
   
9.0
Oxistat (Pro, More...)
generic name: oxiconazole
2 reviews
   
9.0
Pedi-Dri (Pro, More...)
generic name: nystatin
1 review
   
8.0
Penlac (Pro, More...)
generic name: ciclopirox
1 review
   
8.0
Xolegel (Pro, More...)
generic name: ketoconazole
8 reviews
   
8.0
Ertaczo (Pro, More...)
generic name: sertaconazole
1 review
   
7.5
Nizoral Shampoo (More...)
generic name: ketoconazole
2 reviews
   
7.0
Nizoral A-D (More...)
generic name: ketoconazole
2 reviews
   
6.3
Micon 7 (More...)
generic name: miconazole
1 review
   
6.0
Jublia (Pro, More...)
generic name: efinaconazole
126 reviews
   
5.8
Nystop (Pro, More...)
generic name: nystatin
3 reviews
   
5.5
Penlac Nail Lacquer (More...)
generic name: ciclopirox
3 reviews
   
5.5
Lamisil AT (Pro, More...)
generic name: terbinafine
6 reviews
   
5.0
Kerydin (Pro, More...)
generic name: tavaborole
25 reviews
   
4.9
Pedipirox-4 (More...)
generic name: ciclopirox
1 review
   
3.0
Dermagran AF (More...)
generic name: miconazole
0 reviews
   
2.0
M-Zole 3 (More...)
generic name: miconazole
1 review
   
1.0
Absorbine Athlete's Foot (More...)
generic name: tolnaftate
0 reviewsAdd rating
Absorbine Jr Antifungal (More...)
generic name: tolnaftate
0 reviewsAdd rating
Aftate (More...)
generic name: tolnaftate
0 reviewsAdd rating
Aloe Vesta (More...)
generic name: miconazole
0 reviewsAdd rating
Aloe Vesta 2 in 1 Antifungal (More...)
generic name: miconazole
0 reviewsAdd rating
Athletes Foot Cream (More...)
generic name: terbinafine
0 reviewsAdd rating
Azolen (More...)
generic name: miconazole
0 reviewsAdd rating
Baza Antifungal (More...)
generic name: miconazole
0 reviewsAdd rating
Blis-To-Sol (More...)
generic name: tolnaftate
0 reviewsAdd rating
Canesten (More...)
generic name: clotrimazole
2 reviewsAdd rating
Clarus Antifungal (More...)
generic name: tolnaftate
0 reviewsAdd rating
CNL8 Nail (Pro, More...)
generic name: ciclopirox
0 reviewsAdd rating
Critic-Aid Clear AF (More...)
generic name: miconazole
0 reviewsAdd rating
Cruex (More...)
generic name: undecylenic acid
0 reviewsAdd rating
Cruex Prescription Strength (More...)
generic name: miconazole
0 reviewsAdd rating
DermaFungal (More...)
generic name: miconazole
0 reviewsAdd rating
Desenex Antifungal Atheletes Foot Spray Liquid (More...)
generic name: miconazole
0 reviewsAdd rating
Desenex Antifungal Cream (More...)
generic name: clotrimazole
0 reviewsAdd rating
Desenex Antifungal Foot Cream (More...)
generic name: miconazole
0 reviewsAdd rating
Desenex Jock Itch (More...)
generic name: miconazole
0 reviewsAdd rating
Ecoza (Pro, More...)
generic name: econazole
0 reviewsAdd rating
Elon Dual Defense Anti-Fungal Formula (More...)
generic name: undecylenic acid
0 reviewsAdd rating
Exelderm (Pro, More...)
generic name: sulconazole
0 reviewsAdd rating
Exoderm (More...)
generic name: salicylic acid/sodium thiosulfate
0 reviewsAdd rating
Fungi-Guard (More...)
generic name: tolnaftate
0 reviewsAdd rating
FungiCURE Pump Spray (More...)
generic name: clotrimazole
0 reviewsAdd rating
Fungoid (More...)
generic name: miconazole
0 reviewsAdd rating
Ketodan (Pro, More...)
generic name: ketoconazole
0 reviewsAdd rating
Kuric (More...)
generic name: ketoconazole
0 reviewsAdd rating
Lamisil AF Defense (More...)
generic name: tolnaftate
0 reviewsAdd rating
Lamisil AT Cream (More...)
generic name: terbinafine
0 reviewsAdd rating
Lamisil AT Cream for Jock Itch (Pro, More...)
generic name: terbinafine
0 reviewsAdd rating
Lamisil AT Spray (Pro, More...)
generic name: terbinafine
0 reviewsAdd rating
Loprox TS (More...)
generic name: ciclopirox
0 reviewsAdd rating
Lotrimin AF Athlete's Foot Cream (More...)
generic name: clotrimazole
0 reviewsAdd rating
Lotrimin AF Deodorant Powder Spray (More...)
generic name: miconazole
0 reviewsAdd rating
Lotrimin AF Jock Itch Powder Spray (More...)
generic name: miconazole
0 reviewsAdd rating
Lotrimin Ultra Athlete's Foot Cream (More...)
generic name: butenafine
0 reviewsAdd rating
Luzu (Pro, More...)
generic name: luliconazole
0 reviewsAdd rating
Mentax (Pro, More...)
generic name: butenafine
0 reviewsAdd rating
Micaderm (More...)
generic name: miconazole
0 reviewsAdd rating
Micatin (More...)
generic name: miconazole
0 reviewsAdd rating
Micro-Guard (More...)
generic name: miconazole
0 reviewsAdd rating
Miranel AF (More...)
generic name: miconazole
0 reviewsAdd rating
Mitrazol (More...)
generic name: miconazole
0 reviewsAdd rating
Monistat-Derm (Pro, More...)
generic name: miconazole
0 reviewsAdd rating
Mycelex (Pro, More...)
generic name: clotrimazole
0 reviewsAdd rating
Mycocide NS (More...)
generic name: tolnaftate
0 reviewsAdd rating
Naftin-MP (More...)
generic name: naftifine
0 reviewsAdd rating
NuZole (More...)
generic name: miconazole
0 reviewsAdd rating
Nyata (More...)
generic name: nystatin
0 reviewsAdd rating
Ony-Clear (More...)
generic name: miconazole
0 reviewsAdd rating
Pediaderm AF (Pro, More...)
generic name: nystatin
0 reviewsAdd rating
Podactin (More...)
generic name: tolnaftate
0 reviewsAdd rating
Protectol (More...)
generic name: undecylenic acid
0 reviewsAdd rating
Q-Naftate (More...)
generic name: tolnaftate
0 reviewsAdd rating
Rash Relief Antifungal (More...)
generic name: miconazole/zinc oxide
0 reviewsAdd rating
Secura Antifungal (More...)
generic name: miconazole
0 reviewsAdd rating
Secura Antifungal Extra Thick (More...)
generic name: miconazole
0 reviewsAdd rating
Soothe & Cool Inzo (More...)
generic name: miconazole
0 reviewsAdd rating
Tetterine (More...)
generic name: miconazole
0 reviewsAdd rating
Tinactin Jock Itch (More...)
generic name: tolnaftate
0 reviewsAdd rating
Tinaderm (More...)
generic name: tolnaftate
0 reviewsAdd rating
Tinamar (More...)
generic name: tolnaftate
0 reviewsAdd rating
Tinaspore (More...)
generic name: tolnaftate
0 reviewsAdd rating
Ting (More...)
generic name: tolnaftate
0 reviewsAdd rating
Triple Paste AF (More...)
generic name: miconazole
0 reviewsAdd rating
Undelenic (More...)
generic name: undecylenic acid
0 reviewsAdd rating
Versiclear (More...)
generic name: salicylic acid/sodium thiosulfate
0 reviewsAdd rating
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