Over-the-counter recommendations for treating athlete’s foot with effective topical antifungal options. First-line treatments include clotrimazole 1% cream, applied twice daily for 2 weeks, and butenafine 1% cream, used once or twice daily for 1 week. Learn when prescription oral antifungals like terbinafine may be necessary for severe or recurrent cases.
January 9, 2025

Athlete's Foot: Best Over-the-Counter Treatments Doctors Recommend

Evidence-Based Over-The-Counter Guide

William Shen

William Shen

Co-founder & CPO

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Topical antifungal treatments are the first-line therapy for mild to moderate cases of athlete’s foot.

First-line recommendations:

  • Clotrimazole: An antifungal cream with broad-spectrum activity against dermatophytes. Apply 1% cream topically twice daily for up to 2 weeks. Lotrimin clotrimazole 1% cream (FDA M005).

  • Butenafine: An allylamine antifungal with high efficacy. Apply 1% cream topically once or twice daily for 1 week. Lotrimin butenafine 1% cream (FDA NDA 21307).

Prescription medications:

For severe or recurrent cases, oral antifungals like terbinafine or itraconazole may be prescribed.

Citations:

Gupta, A. K., & Cooper, E. A. (2008). Update in antifungal therapy of dermatophytosis. Mycopathologia, 166, 353-367.

What OTC evidence is reviewed?

  • For each condition, we performed a literature review to find a recent widely cited expert group guideline published in the leading specialty-specific peer-reviewed journal or top general medical journal.

  • Based on the recommendations in the publication, we identify recommended active ingredients and devices that are available over-the-counter per FDA regulations.

What evidence is prioritized?

Levels of evidence considered:

  • Tier 1 (Safe and Definitely Effective): Professional field consensus or multiple randomized controlled clinical trials showing the same conclusion. Wherever possible, we use Tier 1 evidence for "first-line" recommendations.

  • Tier 2 (Safe and Probably Effective): Individual clinical trials which may be discordant or large-scale observational experience. Tier 2 evidence may inform "first-line", "second-line", or "supplement" recommendations.

  • Tier 3 (Safe and Maybe Effective): Mechanistic plausibility without high-quality clinical evidence of efficacy but high-quality evidence of safety. Tier 3 evidence may inform "second-line" or "supplement" recommendations.

How does MDandMe select recommended products?

  • Based on the top clinical recommendation, we evaluate products containing the recommended active agent with FDA-approved dosage based on price, average customer reviews, how often it is purchased, and how quickly it will ship to home. 

  • We provide public documentation of the active ingredients in our recommendations, using all 32 FDA monographs, Prescription-to-Nonprescription (Rx-to-OTC) Switches, as well as New Drug Application (NDA) approvals.

How does MDandMe select recommended devices?

  • Based on the top clinical recommendation, we evaluate devices that are FDA-cleared or comply with other medical guidelines (if not a FDA-regulated category) by reputability, price, and average customer reviews.

  • We provide public documentation of supporting evidence for each device.  

Where do I view other OTC guides?

Browse topic list here:

You can view all of our published OTC guides here.

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