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Topical antifungal (allylamine) Pregnancy: Caution — limited data; topical use on small areas considered low risk.

Terbinafine 1% Topical

Brand names: Lamisil Once (single-application film for tinea pedis), Lamisil (1% cream / spray)

Adult dose

Dose: 1% cream or spray: apply once or twice daily
Route: Topical
Frequency: Once daily (Lamisil Once single application); BD for standard cream
Max: Apply to affected area and 1 cm surrounding margin
Tinea pedis (athlete's foot): apply OD–BD for 1 week (cream) or single application (Lamisil Once). Tinea corporis/cruris (ringworm, jock itch): apply OD–BD for 2 weeks. Extend to 4 weeks if slow response. Apply beyond visible border of infection. Keep skin dry.

Paediatric dose

Route: Topical
Frequency: Once or twice daily
Max: Apply to affected area
Concentration: 1% cream Application/ml
Children ≥12 years: adult dose. Limited data in younger children — seek specialist advice for tinea capitis (scalp requires oral terbinafine).

Dose adjustments

Renal

N/A — topical use.

Hepatic

N/A — topical use.

Clinical pearls

  • Fungicidal (kills fungi) rather than fungistatic — shorter treatment courses than azoles for tinea infections
  • Tinea capitis and onychomycosis require systemic oral terbinafine — topical is inadequate for nail and scalp infections
  • Lamisil Once: single application gel forms a film that releases drug for 13 days — useful for adherence in tinea pedis
  • Tinea incognito (steroid-modified ringworm): may appear unusual — always consider fungal infection before prescribing topical steroids
  • Recurrence prevention: keep feet dry, change socks daily, use antifungal powder in shoes

Contraindications

  • Hypersensitivity to terbinafine
  • Tinea capitis (scalp ringworm — requires oral treatment)

Side effects

  • Local irritation, burning, and itching
  • Contact dermatitis (rare)
  • Dry skin at application site

Interactions

  • No clinically significant interactions with topical use

Monitoring

  • Clinical response at 2–4 weeks
  • Signs of contact dermatitis

Reference: BNFc; BNF; BAD Tinea Guidelines; NICE CKS Fungal Skin Infection. Verify against your local formulary and the latest BNF before prescribing.

Related

Curated clinical cross-links plus same-class fallbacks.

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