Ofloxacin 0.75%, Ornidazole 2%, Itraconazole 1% + Clobetasol propionate 0.05%Itrasil

How Itrasil works

This is a combination, and each component handles a different part of the problem. Itraconazole blocks the fungal enzyme lanosterol 14-alpha-demethylase, which the fungus needs to build ergosterol for its cell membrane. Without ergosterol the membrane becomes leaky and the cell cannot survive. Human cells use cholesterol instead of ergosterol, which is what keeps the action confined to the fungus. Ofloxacin blocks the DNA gyrase that aerobic bacteria need to copy their DNA, and ornidazole is activated inside anaerobic organisms into fragments that break theirs. Between them the aerobic and anaerobic bacteria that colonise broken, inflamed skin are covered. Clobetasol propionate is a super-potent topical corticosteroid. It enters the skin cell, binds the glucocorticoid receptor and switches off the genes producing inflammatory mediators, so redness, thickening and itch subside quickly. Potency of this order is reserved for thick, resistant plaques and for short courses, because prolonged use thins the skin. Infected, inflamed skin rarely has a single cause, which is why these are formulated together rather than applied one after another.