Topical antifungal

The topical antifungals are used to treat superficial mycoses (fungal infections of the skin and mucosal membranes). They are also used to treat fungal scalp, mouth and female genital infections.

How do the local topical antifungals act?

Generally, the topical antifungals are available as ointments, gels, sprays, lotions, creams or vaginal pessaries. The great majority are azoles (imidazoles and triazoles). They are applied topically and inhibit the synthesis of ergosterol, an essential membrane component of some fungi. This then leads to the direct destruction of the cytoplasmic membrane. Other compounds such as ciclopiroxolamine, naftifine, terbinafine and the polyenes... are all as effective as the azoles on skin candidiasis.

Do they have side effects?

Side effects are rare. The topical antifungals can occasionally increase the irritation.

Sources:

• Interview with Dr Marie-Anne Sollier, 20 June 2011
• Principles of Internal Medicine, ed TR Harrison. Flammarion