What is the best antifungal cream? A guide to choosing your treatment

October 12, 2025 •

4 min read

According to the Centers for Disease Control and Prevention, fungal skin infections are common and often treatable with over-the-counter topical medications. To determine what is the best antifungal cream for a particular condition, it's essential to understand the different active ingredients, their strengths, and the specific infection being treated.

Quick Summary

Comparing antifungal creams requires understanding ingredients and matching them to the specific fungal infection. This guide examines leading active ingredients, OTC versus prescription options, and effective treatments for common conditions like athlete's foot, jock itch, and ringworm.

Key Points

Active Ingredients Matter: Terbinafine is often the most effective and fastest-acting OTC option for dermatophyte infections like athlete's foot.
Match the Cream to the Infection: Clotrimazole and Miconazole are excellent broad-spectrum choices, particularly for yeast infections, while terbinafine targets dermatophytes.
Complete the Treatment: Even if symptoms improve, it is crucial to finish the entire course of medication as directed to prevent the infection from returning.
Know When to See a Doctor: For severe, persistent, or nail/scalp infections, topical creams are often ineffective, and prescription medication is needed.
Consider the Formulation: Creams are ideal for localized, dry patches, while sprays can be better for widespread or hard-to-reach areas.
Practice Good Hygiene: Keep affected areas clean and dry and wear breathable footwear to aid in treatment and prevent reinfection.

Understanding the Types of Fungal Infections

Fungal skin infections, also known as mycosis or tinea, are caused by various fungi and manifest differently depending on their location on the body. The most common types include:

Athlete's Foot (Tinea Pedis): An infection of the feet, particularly between the toes. It causes itching, burning, cracking, and peeling skin.
Jock Itch (Tinea Cruris): A fungal infection of the groin area, causing an itchy, red, and often ring-shaped rash.
Ringworm (Tinea Corporis): A contagious infection that causes a circular, red, scaly rash on the skin.
Yeast Infections (Candidiasis): Can occur in skin folds, causing red, irritated, and moist patches.
Tinea Versicolor: A yeast infection that results in discolored patches on the skin.

Key Active Ingredients in Antifungal Creams

The effectiveness of an antifungal cream is primarily determined by its active ingredient. There are several categories of active ingredients available in both over-the-counter (OTC) and prescription-strength formulas.

Azoles (Clotrimazole, Miconazole, Ketoconazole)

Azoles are a class of antifungal agents that work by disrupting the fungal cell membrane, which prevents the fungus from growing and reproducing.

Clotrimazole: Often found in brands like Lotrimin AF, Canesten, and Desenex. It is effective for a broad range of fungal infections, including athlete's foot, ringworm, and yeast infections. Treatment typically lasts for 2 to 4 weeks.
Miconazole: The active ingredient in brands like Micatin and Monistat. It is also a broad-spectrum antifungal, commonly used for athlete's foot, jock itch, ringworm, and vaginal yeast infections. Treatment duration and formulation vary, with some vaginal treatments being as short as 1 to 7 days.
Ketoconazole: Available in both OTC (usually 1%) and prescription-strength (2%) creams and shampoos. It is highly effective for fungal skin infections and seborrheic dermatitis.

Allylamines (Terbinafine, Butenafine)

Allylamines kill the fungus directly rather than just inhibiting its growth, making them often faster-acting for certain infections, particularly those caused by dermatophytes.

Terbinafine: Marketed under the brand name Lamisil AT, it is considered one of the most potent OTC antifungals for dermatophyte infections like athlete's foot, jock itch, and ringworm. For athlete's foot between the toes, a one-week, once-daily regimen is highly effective.
Butenafine: Found in products like Lotrimin Ultra, this antifungal is also very effective for athlete's foot and jock itch, often requiring a shorter treatment time than azoles.

Choosing the Right Antifungal Cream

The best antifungal cream depends on the specific infection. For most common, mild cases, an OTC treatment is sufficient. Here's a breakdown to help you decide:

For Athlete's Foot: Terbinafine (Lamisil AT) is often recommended due to its faster action, but Clotrimazole (Lotrimin AF) and Miconazole are also effective. Consistent application for the full duration is crucial.
For Jock Itch and Ringworm: Terbinafine, butenafine, clotrimazole, and miconazole are all suitable choices. For widespread or stubborn ringworm, prescription-strength ketoconazole may be necessary.
For Skin Yeast Infections (Cutaneous Candidiasis): Miconazole or Clotrimazole creams are effective choices. Prescription Nystatin cream is another option for Candida infections.
For Tinea Versicolor: Prescription-strength ketoconazole cream or shampoo is a standard treatment.

Antifungal Cream Comparison Table


Active Ingredient	Brand Examples	Primary Target Infections	Typical Treatment Duration (OTC)	Efficacy Notes
Terbinafine	Lamisil AT	Dermatophytes (Athlete's Foot, Ringworm, Jock Itch)	1-2 weeks (Athlete's Foot)	Highly effective; kills fungus.
Clotrimazole	Lotrimin AF, Canesten	Broad spectrum (Athlete's Foot, Ringworm, Jock Itch, Candidiasis)	2-4 weeks	Very effective; prevents fungal growth.
Butenafine	Lotrimin Ultra	Dermatophytes (Athlete's Foot, Jock Itch)	1-2 weeks	Fast-acting for certain conditions.
Miconazole	Micatin, Monistat	Broad spectrum (Athlete's Foot, Ringworm, Jock Itch, Candidiasis)	1-4 weeks	Comparable efficacy to clotrimazole.
Ketoconazole	Nizoral (shampoo), various creams	Broad spectrum (including Tinea Versicolor, Seborrheic Dermatitis)	Varies by condition	Prescription-strength often required for stubborn cases.

When to Consider Prescription Treatment

While many infections clear up with OTC creams, certain situations warrant a doctor's visit and a prescription:

Persistent or severe infections: If symptoms do not improve after a few weeks of consistent OTC treatment.
Nail or scalp infections: These infections are often deeper and do not respond well to topical creams alone. They typically require oral antifungal medication.
Spread of the infection: If the rash is spreading or worsening.
Uncertain diagnosis: If you are unsure what kind of infection you have.

Stronger prescription creams may include higher concentrations of active ingredients or different compounds like ciclopirox, which has a broad-spectrum action. Some conditions may also require combination therapy, such as an antifungal cream with a mild topical steroid like hydrocortisone to reduce inflammation and itching.

Proper Application and Prevention

Correct application is key to success. You should apply a thin layer to the affected area and the surrounding skin. Continue treatment for the full recommended duration, even if symptoms disappear early, to prevent recurrence. Preventing future infections involves keeping the affected area clean and dry, wearing breathable footwear, and changing socks frequently.

Conclusion: Making the Right Choice

There is no single "best" antifungal cream for all situations. The most effective treatment depends on the type and severity of the fungal infection. For common conditions like athlete's foot and ringworm, OTC products with terbinafine or clotrimazole are highly effective and readily available. Terbinafine, in particular, offers a faster treatment duration for dermatophyte infections. For yeast infections, clotrimazole and miconazole are reliable choices. If an infection is severe, persistent, or involves the nails or scalp, consulting a healthcare provider for prescription-strength or oral medication is the best course of action. Following proper hygiene and completing the full treatment regimen will maximize your chances of a successful recovery.

For more detailed guidance on treatments for various fungal conditions, consult a medical professional or visit the Centers for Disease Control and Prevention (CDC) website.

Frequently Asked Questions

Terbinafine (found in Lamisil AT) is often considered more effective and faster-acting for dermatophyte infections such as athlete's foot and ringworm, as it kills the fungus. Clotrimazole (in Lotrimin AF) is a broad-spectrum antifungal that is also highly effective but typically takes longer to work, as it inhibits fungal growth rather than killing it outright.

The time it takes for antifungal cream to work varies by active ingredient and infection. Terbinafine for athlete's foot can work in as little as a week, while many clotrimazole treatments require two to four weeks. It is vital to continue the full course of treatment even if symptoms improve quickly to prevent recurrence.

No, different antifungals are best for different types of fungi. For instance, terbinafine is very effective against dermatophytes but not always the best for yeast infections, where clotrimazole or miconazole are preferred. Scalp and nail infections often require oral medication, as creams cannot penetrate effectively.

You should see a doctor if your infection does not improve after a few weeks of consistent OTC treatment, if it spreads, or if it involves the nails or scalp. A doctor can provide a correct diagnosis and prescribe stronger oral or topical medication if needed.

The best choice depends on the infection's location and extent. A cream may be better for small, localized dry patches. A spray is often more convenient for widespread or hard-to-reach areas and helps keep the area dry, which can inhibit fungal growth.

No, you must complete the full course of treatment as indicated on the package or by a healthcare professional. Stopping early can cause the infection to return, potentially stronger and more resistant.

Side effects are typically mild and localized to the application area. They can include burning, itching, or redness. If you experience a severe reaction, discontinue use and consult a doctor.