Every once in a while a friend or family member is in a bind and asks me if I can prescribe them some medication. When people have a case of painful otitis externa (external ear infection), some tinea corporis (ringworm), or just need an allergy medicine refill, for example, and can’t get an appointment to see their doctor for weeks, I generally feel badly and offer to prescribe them something to tide them over. I know it’s not right to prescribe medications to folks who aren’t technically your patients, but it just seems worse to watch them suffer with a time-sensitive illness that has a simple cure.
Today I had to look up all the various and sundry treatments for ringworm. According to my Pharmacopoeia (and eMedicine.com) pretty much any antifungal cream on the market is a possible treatment for it… so how is a doc to choose the best therapy? Is it trial and error? Is it pick the cheapest medicine on the list and cross your fingers?
There are times when many different medicines are appropriate treatment options, and the best choice requires a bit of guess work mixed with past experience. Since I can’t find any literature suggesting that one topical treatment is more effective than another, I just chose a common, inexpensive cream. Sometimes medical decision making has its gray areas… Wouldn’t it be nice if everything had one clear answer?
Oh, and if you do have ringworm, keep in mind that 1) you can catch it from your dog – and yeah, Fido could catch it from you 2) you are contagious to others 3) it’s easy to treat with pretty much any anti-fungal cream or lotion (apply twice a day for 2 weeks or so) 4) if you can’t get to see your doctor, using over the counter Monistat may do the trick in a pinch. If your skin is not responding to the cream – better get checked out to make sure it really is a fungal infection and not something else.This post originally appeared on Dr. Val’s blog at RevolutionHealth.com.