Piedra Treatment & Management

Updated: Mar 26, 2021
  • Author: Robert A Schwartz, MD, MPH; Chief Editor: Dirk M Elston, MD  more...
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Medical Care

Shaving or cutting the hair is the treatment of choice. Antifungal agents and terbinafine also are used in the treatment of piedra.

Black piedra is treated by using oral terbinafine.

White piedra can be treated by using topical antifungals, including imidazoles, ciclopirox olamine, 2% selenium sulfide, 6% precipitated sulfur in petroleum, chlorhexidine solution, Castellani paint, zinc pyrithione, and amphotericin B lotion.


Long-Term Monitoring

Spontaneous remissions are common. Treatment is effective in patients without spontaneous remission. Removal of hair is curative and requires no follow-up treatment. Recurrences are rare.