Other Topical Antifungals

Generic Name
  • Ciclopirox Olamine (hydroxypyridone)
  • Pregnancy Category B
Formulation
  • Cream (0.77%), gel, shampoo (1%), suspension, nail lacquer (8%)
Mechanism of Action
  • Fungicidal & Fungistatic
  • Chelates polyvalent cations such as iron that have important function in fungal cytochrome, catalases, peroxidase inhibiting respiration, transport of amino acids & alters cell membrane integrity
Spectrum of Activity
  • Antifungal: dermatophytes, yeasts, saprophytes
  • Antibacterial: gram positive & gram-negative bacteria (strongest out of all antifungals)
  • Anti-inflammatory: inhibits 5-lipoxygenase & COX, decreasing prostaglandin & leukotriene synthesis by neutrophils
Adverse Effects
  • Burning, pruritis, allergic hypersensitivity
Other
  • Lacquer is approved for onychomycosis (9–12 month treatment)
    Shampoo for Seborrhea

Generic Name
  • Selenium Sulfide
  • Pregnancy Category C
Formulation
  • 1%, shampoo (over the counter)
  • 2.5% solution
Mechanism of Action
  • Shedding of fungi via reduction in corneocyte adhesion & anti-mitotic properties
  • Fungicidal activity against M. furfur
Spectrum of Activity
  • Anti-yeast: Malassezia spp. for tinea versicolor & seborrheic dermatitis
Adverse Effects

* For further reading refer to a pharmacology source

Other
  • Treatment of CARP (confluent and reticulated papillomatosis of Gougerot and Carteaud)

Generic Name
  • Tavaborole (class = oxaborole)
  • Pregnancy Category C
Formulation
  • 5% solution
Mechanism of Action
  • Inhibits protein synthesis by binding to Leucyl-tRNA synthetase
Spectrum of Activity
  • Anti-fungal: dermatophytes, Candida
  • FDA approved for onychomycosis
Adverse Effects
  • Application site reaction
  • Ingrown nail
Other
  • Can penetrate polished nail
  • Applied to affected area once daily for 48 weeks

Generic Name
  • Zinc Pyrithione
Formulation
  • Shampoo (over the counter)
Mechanism of Action
  • Increases cellular levels of copper, damaging iron-sulphur clusters of proteins essentials for fungal metabolism
Spectrum of Activity
  • Seborrhea & seborrheic dermatitis
Adverse Effects

* For further reading refer to a pharmacology source

Other

* For further reading refer to a pharmacology source