Antifungal creams: Uses, safety, and what to do if swallowed
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The bottom line
Antifungal creams treat skin and mucosal infections caused by fungi. Nonprescription creams include butenafine, clotrimazole, miconazole, terbinafine, and tolnaftate. Nystatin and ketoconazole creams require a prescription. If antifungal creams don’t work within 2 weeks, an oral antifungal drug may be prescribed. Antifungal creams are relatively safe if they are accidentally swallowed or get in the eyes.
Prevention tips
Store antifungal creams up, away, and out of reach of children.
Follow label directions.
Wash the area and dry thoroughly before applying the cream.
Wash your hands with soap and water after applying the cream.
Keep your skin clean and dry.
Use the cream for the full recommended time, even if symptoms resolve early. Stopping use of the cream too soon can lead to fungal infections that are resistant to available treatments.
Avoid mixing steroids with antifungal creams.
This really happened
A 2-year-old child climbed onto the bathroom counter, opened a tube of nystatin cream, and swallowed some cream. The mother found him with nystatin on his hands and in his mouth. She removed the tube from the child and wiped out his mouth. She called her poison center. The poison specialist asked when it happened, how much he swallowed, and whether he had symptoms. The mother said it had happened 10 minutes earlier, the tube was now half full, but there was cream on his hands so she could not determine how much was swallowed. He had no symptoms. The poison specialist recommended giving him some water to drink. He might get a mild stomach upset but should otherwise be fine.
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What are antifungal creams used for?
Antifungal creams are used to treat skin and mucosal infections caused by fungi. Fungi grow as molds, yeasts, or a combination of both. The affected area develops ring-shaped scales or plaques, flat patches, itchy skin, and hair loss. Antifungal creams kill fungi by destroying their cell walls or by stopping their growth. This relieves burning, itching, and redness.
Common types of skin infections
A group of fungi called dermatophytes causes ringworm infections, including athlete’s foot (tinea pedis), jock itch (tinea cruris), scalp ringworm (tinea capitis), hand ringworm (tinea manuum), beard ringworm (tinea barbae), and toenail or fingernail ringworm (tinea unguium). Candida albicans, a yeast, causes most vaginal and skin yeast infections.
Different types of antifungal and yeast creams
Over-the-counter antifungal creams, gels, and powders include butenafine, clotrimazole, miconazole, terbinafine, and tolnaftate. Terbinafine is best for athlete’s foot and jock itch. Butenafine, clotrimazole, and tolnaftate also work. Hand ringworm can be treated with clotrimazole or terbinafine.
Vaginal and skin yeast infections can be treated with miconazole or clotrimazole, both available without a prescription. Prescription antifungal creams include nystatin for vaginal and skin yeast infections, ketoconazole (2%) for ringworm and skin yeast infections that don’t resolve with nonprescription creams, and econazole nitrate and ciclopirox for persistent or recurring fungal rashes.
Antifungal creams don’t work for scalp and beard ringworm. Treatment is oral antifungal pills and possibly a prescription shampoo (ketoconazole 2% or selenium sulfide). Ketoconazole 1% shampoo is available without a prescription for dandruff. Antifungal creams also don’t work for fingernails and toenails. These need prescription pills, a medicated nail polish, or a liquid that soaks through the nail.
What to do if someone swallows antifungal cream
If someone swallows a small amount of antifungal cream, wipe out their mouth with a soft, wet cloth and rinse the mouth with water. They may notice an unpleasant taste or have a mild stomach upset, including nausea, vomiting, or diarrhea.
Get expert help
If someone swallows antifungal cream, gets it in their eyes, or you have questions about using antifungal cream safely, use the webPOISONCONTROL® online tool to get help, or call your poison center at 1-800-222-1222. Whether online or by phone, expert guidance is always free, confidential, and available 24 hours a day.
What happens if antifungal cream gets in the eyes?
Rinse the eyes with water for 10–15 minutes. Antifungal cream in the eyes can cause burning, irritation, redness, and stinging. It should not cause permanent damage. Vision may be blurred or you may have mild pain, but these should resolve on their own. If redness, pain, or vision changes do not go away, call a doctor or your poison center.
Is it safe to use antifungal cream on a baby's diaper rash?
Yes, if the rash is caused by a fungal or yeast infection, it is safe to use antifungal cream on a baby’s diaper rash.