How Is a Yeast Infection Treated?

Yeast infections, caused by the overgrowth of Candida yeast, can manifest in various parts of the body, including the skin, mouth, throat, or vagina. The symptoms of yeast infections depend on their location and may include inflamed and itchy skin, white patches in the mouth, or thick white vaginal discharge. These infections can be effectively treated with antifungal medications, available as creams, suppositories, or oral tablets, either over-the-counter or by prescription.

Before attempting to self-treat a yeast infection, it is essential to consult a healthcare provider for a proper diagnosis. Whether it’s a vaginal yeast infection or another type, a healthcare provider can perform an examination and oversee the appropriate treatment. Treatment options vary depending on the type, area, and severity of the yeast infection.

Vaginal Yeast Infections

Vaginal yeast infections occur when natural yeast in the vagina overgrows, leading to an infection. The primary medications used to treat vaginal yeast infections belong to the azole drug class of antifungals, including:

  • Lotrimin (clotrimazole)
  • Micatin (miconazole)
  • Trosyd (tioconazole)
  • Terazol 7 (terconazole)
  • Gynazole 1 (butoconazole)
  • Diflucan (fluconazole)

Lotrimin, Micatin, and Trosyd are available as over-the-counter vaginal creams or suppositories. These treatments come in one-, three-, or seven-day courses. Terazol 7 and Gynazole 1 are prescription alternatives typically used for more severe infections.

Diflucan, an oral medication, is particularly effective for severe yeast infections or recurrent cases. However, it is not recommended during pregnancy due to potential harm to the developing fetus. Diflucan may also interact with certain medications, such as blood thinners. For some individuals, Diflucan can cause mild side effects like headaches, rashes, or upset stomach.

For recurrent vaginal yeast infections, healthcare providers may suggest using boric acid suppositories, although this use is not currently approved by the U.S. Food and Drug Administration (FDA). Research has indicated that combining antifungal treatment with boric acid suppositories can be effective in treating recurrent yeast infections.

Skin Yeast Infections

Yeast infections on the skin often occur in areas with moisture and skin folds. These infections can also affect the groin, penis, or fingernails. Treatment involves keeping the infected skin clean and dry and applying a cream azole antifungal for approximately two weeks. Commonly used medicated creams include:

  • Micatin (miconazole)
  • Lotrimin (clotrimazole)
  • Nizoral (ketoconazole)

In cases where the infection is close to a wetter area like the mouth, Nystop (nystatin), a different type of antifungal called polyenes, may be recommended. Severe skin infections might require oral tablets such as Diflucan or Sporanox (itraconazole).

For individuals with uncircumcised penises experiencing recurrent yeast infections, healthcare providers may suggest hygiene practices, including daily cleansing under the foreskin. In some cases, foreskin tightness may contribute to the infections, requiring different treatment approaches.

Oral Thrush

Oral thrush results from yeast overgrowth in the mouth or throat, leading to white patches and a sore throat. Treatment typically involves the use of azoles or polyenes, including:

  • Micatin (miconazole)
  • Diflucan (fluconazole)
  • Nystop (nystatin)

Micatin and Nystop liquids are commonly used for thrush, applied to the mouth or throat four times daily for seven to 14 days. Nystop tablets may also be prescribed for oral yeast infections. In rare cases, severe oral thrush or non-responsive infections may necessitate oral Diflucan tablets.

Yeast Diaper Rash

Yeast diaper rashes, often characterized by scaly yellow or red patches in the diaper area and skin folds, should be managed by frequent diaper changes, maintaining dryness, and applying antifungal polyene or azole creams such as:

  • Nystop (nystatin)
  • Lotrimin (clotrimazole)
  • Micatin (niconazole)
  • Nizoral (ketoconazole)

Nystop, a prescription cream, is typically applied four times daily for two weeks. If there is no improvement within three days, healthcare providers may recommend switching to an azole antifungal. Over-the-counter options like Lotrimin and Micatin are applied twice daily for up to 10 days.

In severe cases of yeast diaper rash, healthcare providers may suggest the use of a 1% hydrocortisone topical steroid ointment.

Esophageal Candidiasis

Individuals with compromised immune systems are susceptible to yeast infections in the esophagus. Treatment involves oral or intravenous (IV) medications such as:

  • Diflucan (fluconazole) oral tablets or IV
  • Sporanox (itraconazole) tablets
  • Vfend (voriconazole) tablets
  • Mycamine (micafungin) IV

Diflucan tablets are the primary choice for treating esophageal yeast infections and are typically taken for 14 to 21 days. In cases where swallowing medication is uncomfortable, daily Diflucan IVs may be administered until oral medications are tolerable. Mycamine daily IVs for two weeks or once-daily Sporanox or twice-daily Vfend tablets for 14 to 21 days are alternative options.

Invasive Candidiasis

Invasive candidiasis, a rare but severe yeast infection affecting the bloodstream or internal organs, is treated with IV antifungal medications, including echinocandins (e.g., Cancidas and Mycamine), Diflucan (fluconazole), or Abelcet (amphotericin B). Diflucan is commonly the initial treatment choice, with blood yeast infections treated for about two weeks until symptoms and blood tests indicate the absence of Candida yeasts. Invasive candidiasis affecting bones, joints, heart, or the central nervous system requires longer treatment durations.

Some Candida yeast strains have developed resistance to common treatments like Diflucan, leading to reduced effectiveness. In such cases, echinocandin IVs may be employed, as they can combat some azole-resistant yeasts while causing fewer side effects and drug interactions. Abelcet, an option for life-threatening fungal infections, is used with caution due to potential kidney damage and is not typically the first choice of treatment.

Living With and Managing Yeast Infections

Yeast infections, while uncomfortable, are typically not emergencies and can be effectively managed with appropriate treatment. Consulting a healthcare provider is crucial for a proper diagnosis and treatment plan. In cases of recurrent yeast infections (four or more per year), underlying health conditions like diabetes or weakened immune systems may be contributing factors, and lifestyle changes or alternative treatments may be recommended.

Maintaining good hygiene practices, such as changing out of sweaty clothes and avoiding hot baths, can help prevent vaginal yeast infections. For individuals prone to recurrent infections, healthcare providers may offer guidance on additional measures to reduce their occurrence.

In summary, yeast infections, although common and often treatable with antifungal medications, require careful diagnosis and treatment tailored to the specific type and severity of the infection. Seeking medical guidance ensures effective management and, when necessary, prevents complications associated with severe yeast infections.

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