Non-prescription drugs

For the treatment of fungal infections there is a wide variety of drugs available, which can be purchased without a prescription from a doctor. A distinction must be made between over-the-counter and pharmacy-only medicines. Pharmacy-only drugs can only be bought in a pharmacy, while over-the-counter drugs are also sold in a drugstore, for example.

For most types of athlete’s foot it is sufficient to use a topical antimycotic (medicine against athlete’s foot). Topically acting athlete’s foot remedies are locally applied creams, ointments, sprays, gels and other forms that must be applied to the respective area. It should be noted that the antimycotics have quite different modes of action.

Depending on which drug is used, there are different application durations and also frequencies with which the drug must be used. A frequently used active ingredient is clotrimazole (Canesten®, Antifungal Hexal®). This is a fungostatic agent – this means that the fungi are not killed, but their reproduction is inhibited.

It is applied one to three times a day over a period of 2-4 weeks until the infection has subsided. Bifonazole (Canesten Extra®, Bifon Creme®) is also a fungostatic agent. Like clotrimazole, this interferes with the metabolism of the fungal cell wall and prevents further growth of the fungi. Other over-the-counter topical (local) active ingredients are Nystatin(Nystaderm®, Mornonal®) and Miconazole (Miconazole acis®). While miconazole also has a fungostatic effect, niystatin is a fungicidal active ingredient (pore formation in the fungal cell wall by binding a membrane component that is very important there – ergosterol; the fungi lose their protective skin layer and die).

Treatment duration

In some cases, the skin symptoms on the affected foot will slowly fade a few minutes after application of the medication and will soon no longer be visible. In some cases, the duration of treatment is long and requires a lot of patience from the affected person. Numerous studies have shown that about 25% of the patients who suffered from athlete’s foot and treated it showed renewed symptoms of athlete’s foot infection some time after the end of the treatment.

The results make it clear that the athlete’s foot seems to still be on the skin when symptoms are obviously no longer present. The reason for the frequent reinfection is that the duration of treatment is often not consistently maintained. If one has started a fungus treatment and sees first successes, the treatment should be continued at first, even if no skin symptoms or itching on the affected skin area appear.There are different opinions about the final treatment duration.

After symptom-free, the medication should be applied to the skin areas for 2-3 weeks to prevent re-infection. If a reinfection occurs, the drug should be changed and the treatment prolonged. Sometimes it can happen that an antimycotic treatment has to be carried out for 1-2 months to ensure lasting success.