Indications for topical or oral therapy for tinea

Tinea is treated topically or systemically depending on its extent and location.

Topical antifungal therapy is appropriate for recent onset of localised tinea affecting the trunk (including groin), limbs, face, or between the fingers or toes.

Oral antifungal therapy is appropriate for tinea that:

• is widespread or established (particularly on the feet)
• has not responded to topical antifungal therapy
• recurs soon after treatment
• has been inappropriately treated with a topical corticosteroid
• is on the scalp, palms or soles
• is inflammatory, hyperkeratotic, vesicular or pustular.

Confirm diagnosis of tinea with microscopy and cultures before starting oral antifungal therapy, or before starting topical antifungal therapy (if there is any doubt about diagnosis).