Topical Antifungals

There are several classes of topical antifungal medications
Some classes are fungistatic (stop fungi from growing), others are fungicidal (they kill the fungi)
Not all conditions are treatable with topical antifungals (specifically, hair infections and nail infections do not respond to topical treatment and require systemic treatment)

Examples of Topical Antifungals

The following are some examples of topical antifungals:
1. Imidazoles (fungistatic): Ketoconazole (Rx & OTC), Econazole, Oxiconazole, Sulconazole, Clotrimazole (Rx & OTC), Miconazole (OTC)
  - Useful to treat candida and dermatophytes
2. Allylamines and benzylamines (fungicidal): Naftifine, Terbinafine (OTC), Butenafine
  - Better for dermatophytes, but not candida
3. Polyenes (fungistatic in low concentrations): Nystatin
  - Better for candida, but not dermatophytes

Topical antifungals are preferred for most superficial fungal infections of limited extent.
Advantages include:
1. Relatively low cost
2. Acceptable efficacy
3. Ease of use
4. Low potential for side effects, complications, or drug interactions

The efficacy of any topical medication is related to the strength, location, vehicle, and concentration
Topical medications can be very expensive
When writing a prescription for a topical medication, include: generic name, vehicle, concentration, directions, amount, # of refills
Corticosteroids are organized into classes based on their strength (potency)
Skin atrophy, acne, striae, and telangiectasias are potential local side effects of corticosteroid use