Signs You Need Prescription Medication for Athlete's Foot

When over-the-counter remedies aren't enough

Athlete's foot treatments range from home remedies like hydrogen peroxide to over-the-counter (OTC) antifungal products and prescription medications. The one that will work best for you depends on the severity of your case and the fungus you're infected with.

There are more than 40 different types of fungus that cause athlete's foot, and some are more stubborn than others. These may require prescription drugs like Lamisil (terbinafine) or Diflucan (fluconazole).

This is especially true if the infection is severe or you have a weakened immune system.

This explains when you might need a topical or oral prescription athlete's foot treatment. It also reviews the various options and possible side effects.

Woman applying foot cream
PhotoAlto / Odilon Dimier / Getty Images

Who Needs a Prescription Athlete's Foot Treatment?

People tend to regard athlete's foot as a relatively minor and common skin infection, and that's largely true. Studies suggest that anywhere from 15% to 25% of people will get athlete's foot at some point in their life.

This doesn't mean that an infection can't turn serious, however.

Standard over-the-counter antifungal remedies are often enough to clear the fungus. When that's not the case, prescription antifungals may be needed to clear the infection and prevent secondary infections (i.e., those that arise as a result of the primary infection).

Generally speaking, prescription medications are needed to treat athlete's foot if:

  • The infection hasn't cleared after four weeks of self-treatment.
  • The infection goes away but comes back repeatedly.
  • The infection has spread to other parts of the body (such as the nails, groin, or hands).
  • You have developed a secondary infection, such as cellulitis.

Athlete's Foot and Diabetes

If you have athlete's foot and diabetes, see your healthcare provider immediately; do not bother with home treatments. Athlete's foot can cause breaks in the skin that can lead to potentially serious complications like foot ulcers and cellulitis in people with diabetes.

Prescription Treatment Options

Depending on the severity and location of the infection, your healthcare provider may prescribe topical medications (which you apply to the skin) or oral medications (which you take by mouth).

Topical Antifungals

If athlete's foot fails to respond to over-the-counter topical antifungals, your healthcare provider will usually a prescribe prescription-strength version of the same drug.

Prescription topical antifungal options include:

  • Ertaczo (sertaconazole)
  • Exelderm (sulconazole)
  • Lamisil (terbinafine)
  • Lotrimin (clotrimazole)
  • Luzu (luliconazole)
  • Mentax (butenafine)
  • Micatin (miconazole)
  • Naftin (naftifine)
  • Spectazole (econazole)
  • Tinactin (tolnaftate)

Treatment is usually prescribed for four weeks or at least one week after skin symptoms have all cleared.

Oral Antifungals

If the athlete's foot fungus is resistant to topical antifungals, oral antifungals may be used to support the treatment. They are less commonly used on their own for fungal skin infections.

Prescription oral antifungal options include:

  • Diflucan (fluconazole)
  • Lamisil (terbinafine)
  • Sporanox (itraconazole)

Treatment may be prescribed for anywhere from one to nine weeks depending on the severity of the infection.

Other Athlete's Foot Treatments

There are other topical or oral medications that may be prescribed for specific purposes to support antifungal therapy.

Examples include:

Possible Side Effects 

As with all drugs, prescription topical and oral athlete's foot treatments carry a risk of side effects. Many of these tend to be mild, but, with oral antifungals especially, some can be severe.

Topical Antifungals

Topical antifungals are generally considered safe when used as prescribed. Because prescription antifungals are stronger, it is even more important to adhere to your healthcare provider's instructions.

Possible side effects of topical antifungals include:

  • Skin redness and irritation
  • Burning or stinging
  • Itchiness
  • Pimple-like bumps
  • Tenderness
  • Flaking
  • Swelling

Oral Antifungals

While oral antifungals can be extremely effective, they carry a greater risk of side effects than their topical counterparts. Side effects can vary by the drug used,

  • Diflucan: Side effects include headaches, diarrhea, nausea, upset stomach, vomiting, and changes in taste.
  • Lamisil: Side effects are similar to Diflucan but also include diarrhea, gas, stuffy nose, cough, and dizziness. Long-term use can cause liver damage.
  • Sporanox: Side effects are similar to Lamisil but also include constipation and joint pain. It should not be used if you have congestive heart failure.

Oral Antifungals and Pregnancy

High doses of Diflucan and other oral antifungals are typically avoided as they cause harm to a fetus. When used for athlete's foot, the benefits of treatment will rarely outweigh the risks.

Summary

Athlete's foot is a common fungal infection of the foot.

Mild cases can usually be treated with over-the-counter ointments, but severe or persistent cases may require topical or oral prescription medications like Spectazole (econazole) and Lamisil (terbinafine).

A Word From Verywell

If your healthcare provider recommends a prescription drug for athlete's foot, be sure to advise them about any medical conditions you have or any medications you may be taking. In some cases, the drug may need to be avoided or used with extreme caution.

This includes the avoidance of oral Lamisil in people with advanced liver disease, as well as oral Sporanox if you have congestive heart failure.

The more that your healthcare provider knows about your medical history, the safer the treatment will be.

Frequently Asked Questions

  • Why is my athlete’s foot not responding to any treatment?

    It could be that you need a stronger medication, or you may not have athlete’s foot after all. Eczema, dry skin, and other conditions are similar to athlete’s foot but require different treatments. See your healthcare provider to get the right diagnosis.

  • What is the best prescription athlete's foot treatment?

    There's no clear-cut best prescription medicine for athlete's foot, but common prescriptions known to be successful in treating the condition include Lamisil (terbinafine), Sporanox (itraconazole), and Diflucan (fluconazole).

12 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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By Naveed Saleh, MD, MS
Naveed Saleh, MD, MS, is a medical writer and editor covering new treatments and trending health news.