From the Guidelines
If Canesten and hydrocortisone cream have not worked for vaginal itchiness and discharge, it is recommended to consult a healthcare professional for further evaluation and guidance.
Alternative Treatment Options
- For a fungal infection, alternative treatment options include miconazole or terconazole creams, which can be applied intravaginally for 3-7 days 1.
- For bacterial vaginosis, metronidazole cream 0.75% can be applied twice a day for 5-7 days, or clindamycin cream 2% can be applied once a day for 7 days 2, 3.
- For allergic or irritant contact dermatitis, a cream like clobetasol propionate may be considered, and can be applied 1-2 times a day for 1-2 weeks.
Important Considerations
It's essential to use any new cream under the guidance of a healthcare professional, as they can provide a proper diagnosis and recommend the most suitable treatment. Self-medication can lead to further complications, and a proper diagnosis by a healthcare professional is necessary to determine the underlying cause of the symptoms and recommend the most effective treatment.
Treatment Duration and Dosage
- For fungal infections, treatment duration can range from 3-14 days, depending on the severity of the infection and the specific treatment regimen 1.
- For bacterial vaginosis, treatment duration is typically 5-7 days 2, 3.
- For allergic or irritant contact dermatitis, treatment duration is typically 1-2 weeks. It's crucial to follow the recommended treatment regimen and dosage to ensure effective treatment and minimize the risk of complications.
From the Research
Alternative Treatment Options
When Canesten (clotrimazole) and Hydrocortisone cream have been ineffective in treating vaginal pruritus and discharge, several alternative treatment options can be considered:
- Lactoferrin cream: A study published in 2008 4 found that a vaginal cream containing lactoferrin was clinically effective in treating acute vulvovaginal candidiasis, with 27 out of 34 patients completely recovering from the infection.
- Antifungal medications: Although increasing resistance of Candida sp. to imidazoles is a concern 5, antifungal medications may still be effective in treating vaginal candidiasis.
- Diagnostic testing: Accurate diagnosis is crucial in determining the underlying cause of vaginal symptoms 6. Office laboratory tests, such as microscopy of vaginal discharge, can be useful in diagnosing vaginal candidiasis, bacterial vaginosis, and trichomoniasis.
Considerations for Treatment
When considering alternative treatment options, it is essential to:
- Evaluate the patient's symptoms and medical history to determine the underlying cause of vaginal pruritus and discharge 6.
- Consider the potential for delayed diagnosis and treatment of sexually transmitted diseases 5.
- Be aware of the increasing resistance of Candida sp. to imidazoles and the potential for indiscriminate use of over-the-counter products 5.
Educational Interventions
Educational interventions can also play a crucial role in promoting vaginal health and improving treatment outcomes:
- A study published in 2020 7 found that an educational intervention for family healthcare workers significantly improved their knowledge, attitude, and health education competency regarding vulvo-vaginal discharge.
- Such interventions can help healthcare workers provide better guidance and support to patients experiencing vaginal symptoms, leading to more effective treatment and improved health outcomes.