Treating a yeast infection often involves a two-step plan: killing the overgrowth of yeast cells with an antifungal drug, and reducing the itching and burning with an anti-inflammatory Merely killing the yeast does not always end the itching and burning.
Antifungal drugs, available over the counter and by prescription, come as pills, creams, or suppositories that are inserted into the vagina and allowed to melt. Their primary pharmaceutical agents are miconazole, clotrimazole, and butoconazole. They usually provide relief within a day or so, but since yeast infections are notorious for recurring, be sure to follow the prescribed course for the medication even if your symptoms have disappeared. Creams and vaginal suppositories can leak out of your vagina, but a panty liner will protect your clothing.
Nonprescription medications that kill yeast cells include Monistat (miconazole); Gyne-Lotrimin, Lotrimin, and Mycelex (clotrimazole); and Femstat (butoconazole) and Vagistat. The most commonly used prescription antifungal drug is Terazol (terconazole), which comes in cream or suppository form. If you choose suppository form, be aware that the base in which the medication is used can interact with rubber latex products, such as diaphragms and condoms. So use some other form of birth control while you are taking this medication.
The most widely used prescription oral medication is Diflucan, the trade name for fluconazole. Members of this family of pharmaceuticals are also used to treat serious systemic yeast infections, including infections of the urinary tract, pneumonia, and certain kinds of meningitis. While therapy for these conditions may last days or weeks, a single small dose of fluconazole will usually cure common everyday yeast infections. One 150-mg pill might be the equivalent of three days of over-the-counter therapy. Diflucan does not increase the risk of recurrence, and since most people would rather swallow one pill than use creams or suppositories for a week, it is a useful option. Your symptoms should go away in a few days.
Medications to subdue inflammation include some worthwhile over-the-counter choices. One is a simple antihistamine, such as Benadryl. Some women notice that they feel worse in the morning, even after using an antifungal drug at bedtime, and it is possible that they scratched while they slept. Taking Benadryl at bedtime can help with this problem.
Over-the-counter steroid creams like Cortaid can also relieve inflammation. If you go this route, be extremely careful to avoid the vicious circle of steroid dependency. That is, if you use a steroid cream repeatedly, you run the risk of thinning out the tissue on the vulva and making it dependent on the steroid. If that happens, you experience burning and itching when you do not apply the steroid. If the steroid fails to relieve the itching in two to three days, contact your physician.
If your inflammatory symptoms continue even after antifungal medications kill off all the yeast, your doctor may prescribe a double-acting medication like Mycolog, which contains an antifungal (nystatin) plus an anti-inflammatory Lotrisone lotion is another combination drug aimed at both killing yeast and taming inflammation; you should only use it for a few days.
Myth If you have frequent yeast infections, it means that you have human immunodeficiency virus.
Fact Most women who get recurrent yeast infections are simply unlucky. However, women with HIV are prone to get frequent yeast infections.