Clotrimazole Dusting Powder as adjuvant with Antifungal Creams/Orals for Better Outcome

New findings from an Indian real-world investigation emphasize the increasing clinical relevance of clotrimazole dusting powder in dermatophytosis, notably in terms of patient-reported outcomes (PROs). The findings were published as a Letter to the Editor in the Journal of Dermatology Research in February 2026. This study provides valuable insights into symptom alleviation, adherence, and quality-of-life improvements and clinical application in dermatophytosis, relevant in Indian real-world practice.

Sweat-Itch-Dermatophytosis; The Vicious Cycle: Need to Look Beyond Anti-Fungal Creams & Orals

Dermatophytosis is one of the most frequent superficial fungal infections worldwide, with India experiencing a significant increase in recent years. High humidity, rising temperatures, and shifting pathogen profiles all contribute to illness complications and increased recurrence rates (1). Excessive sweat and moisture promote fungal growth, causing irritation and raising the chance of recurrence in dermatophytosis (2,3). Persistent sweating contributes to dermatophytosis recurrence and treatment failure, and antifungal creams and orals may not provide a complete cure in the absence of efficient sweat management (2). While clotrimazole is a well-established broad-spectrum antifungal drug effective against Trichophyton species, Microsporum canis, and Candida species, its dusting powder formulation is primarily used as an adjuvant treatment. The latest Indian study provides real-world evidence to examine the role of clotrimazole dusting powder in dermatophytosis care.

Large Multicentric Real-World Indian Evidence

The nationwide, Indian real-world study, published in 2026, sought to assess patient-reported outcomes and clinical value of clotrimazole dusting powder in dermatophytosis across routine practice settings. This study evaluated 697 patients from 233 dermatology clinics, capturing a broad and real-world patient population. The cohort, with a mean age of 40.15 years and a male predominance (~64%), mostly presented with tinea cruris (38.59%) and tinea corporis (32.71%). Notably, the reasons for considering clotrimazole dusting powder went beyond antifungal action, nearly half of patients (49.78%) reported using it to manage excessive perspiration associated with itching, while others took it for sweating alone (23.39%) or an active fungal infection (13.63%), emphasizing its involvement in moisture regulation, a major aggravating factor in fungal infections.

The key findings from the study include:

• High level of patient awareness and counselling on appropriate care of the affected areas, with 97.7% of patients receiving instructions on proper usage and hygiene practices.

• About 66.71% reported recurrent dermatophytosis, indicating that the illness is chronic and recurring.

• The most frequent application site of clotrimazole dusting powder was groin (58.39%), followed by axillae and feet, which is consistent with intertriginous propensity.

• About 86.95% of patients agreed or strongly agreed that clotrimazole dusting powder effectively helped in managing their condition.

• 90.10% of patients using clotrimazole dusting powder reported a reduction in nocturnal itching, which translated into improved sleep quality.

• Overall quality of life improved in 87.51% of patients, and 95.55% were satisfied with clotrimazole dusting powder therapy.

• Nearly all patients (98.57%) were willing to continue using clotrimazole dusting powder, demonstrating high acceptance and adherence potential.

• The tolerability profile remained acceptable, with approximately 24% of patients experiencing minor side symptoms such as burning or redness (1).

Figure 1- Key findings from the study (Reference 1)

Clotrimazole Powder as Adjunct with Clotrimazole Cream in Dermatophytosis: Indian & International evidence

• An IJORD 2026 drug-utilization research in 8,079 patients found clotrimazole dusting powder is commonly used as a co-prescription, mainly for perspiration management, itch relief, and limiting infection spread, supporting its adjunctive role in dermatophytosis (4).
• A randomized trial conducted in Thailand adds to the evidence supporting this adjunctive role. The study included 67 patients in which clotrimazole cream plus powder was compared to clotrimazole cream alone. The combination achieved significantly higher complete cure rates (~44% more patients at 4 weeks), supporting the clotrimazole powder as an effective adjunct for better outcomes in fungal infections. The powder's ability to minimize moisture in intertriginous regions likely improves antifungal activity and speeds up clinical response (5).

Expert Opinion on the study

What are the key highlights of this study?

Responding to this, Dr. Rachna Jagia, MBBS, MD - Dermatology , Venereology & Leprosy, DNB - Dermatology & Venereology, M.D, DNB Dermatologist, Cosmetologist, Aesthetic Dermatologist, Dermatosurgeon, Pediatric Dermatologist, said that this real-world multicentric Indian study evaluated patient-reported outcomes with clotrimazole dusting powder in dermatophytosis management across routine Indian dermatology practice. Beyond symptom relief, we observed strong patient acceptance, good adherence, and meaningful improvements in comfort, itching, sleep quality, and day-to-day functioning- clinically relevant patient-centric endpoint measures. The study also highlights the importance of addressing sweating and moisture control in recurrent fungal infections, especially in Indian climatic conditions, where dermatophytosis remains highly prevalent.

What are the clinical practice implications of this study in the context of effectively applying clotrimazole powder in dermatophytosis management?

In reply, Dr. Rachna Jagia, said that these findings reinforce that clotrimazole dusting powder can serve as a valuable adjunct in dermatophytosis management, particularly in patients with excessive sweating, recurrent infections, or involvement of flexural areas. For Indian clinicians, practical counselling on hygiene and moisture reduction measures is equally important alongside antifungal therapy. Incorporating clotrimazole powder formulations appropriately may help improve patient comfort, compliance, and overall treatment satisfaction in routine clinical practice.

The emerging evidence indicates a move toward more comprehensive dermatophytosis management, where addressing contributing factors, such as moisture and patient comfort, is just as important as antifungal medication. These findings establish clotrimazole dusting powder as a co-prescription along with anti-fungal creams and orals to improve complete cures, particularly for patients with intertriginous involvement or recurrent disease under humid conditions.