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Clinician’s Corner: Fungal infections of the skin

Below is a chart, that describes the mechanism of actions for treatment of fungal infections of the skin and yeast infections.  Although there are other agents available, we are highlighting the most common and most effective agents we use over the counter, in community pharmacy practice.

Topical over the counter agents used in the treatment of topical fungus infections.

Topical Azole Antifungals Impairs the synthesis of ergosterol, the main sterol of fungi. This causes a breakdown in the cell wall of the fungus and kills it.
Miconazole (Micatin, Monistat) Topical use for fungal infections of the skin or vaginal yeast infections. Caution with warfarin (blood thinner). This interaction may cause excess bleeding.
Clotrimazole (Lotrimin), Butoconazole(Gynazole) OTC available for treatment of vaginal yeast infections.  Clotrimazole cream for topical fungus infections.
Topical Squalene Epoxidase Inhibitors These antifungal agents block squalene epoxidase.  The buildup of squalene is toxic to the cell wall. This disrupts the cell wall and kills the fungus.  Works faster than other anti-fungal remedies.
Terbinifine (Lamisil) Most effective OTC treatment for topical fungal infections.
Zinc Pyrithione-ZPT (Head & Shoulders) Shown to significantly reduce the numbers of yeast organisms. Helps prevent the dandruff-causing microbe, Malassezia globosa, from forming scalp irritants.
Selenium Sulfide (Selsun) 1% For treatment of dandruff through its anti-Malassezia effect and significantly reduces the rate of cell turnover.

There are also a lot of prescription anti-fungal drugs that are available, and your Thompson Pharmacist can work with your doctor to get what is the best treatment for different kinds of fungal infections.  In the coming weeks, we will post information about jock itch, athletes feet, ringworm and yeast infections.  Your Thompson Pharmacist is your best source for questions about anti-fungal therapy.  Go AHEAD and ASK!

At Thompson Pharmacy it’s all for you!