From the Guidelines
Lip fungal infections can be effectively treated with antifungal medications such as clotrimazole 1% cream or miconazole 2% cream applied to the affected areas 2-3 times daily for 7-14 days, as recommended by the Infectious Diseases Society of America 1. For more severe cases, oral fluconazole 150mg taken once weekly for 2-3 weeks may be necessary. Some key points to consider when treating lip fungal infections include:
- Keeping the affected area clean and dry
- Avoiding licking your lips
- Maintaining good oral hygiene
- Cleaning dentures thoroughly each night, if applicable
- Being aware of the potential for bacterial co-infection, which may require antibiotic treatment alongside antifungal therapy The infection typically appears as red, cracked corners of the mouth and may be painful or itchy. Fungal infections on the lips often occur due to moisture accumulation in lip folds, compromised immune systems, or nutritional deficiencies, particularly B vitamins or iron. If symptoms don't improve within two weeks of treatment, or if you experience fever or spreading infection, it is essential to consult a healthcare provider. According to the guidelines, fluconazole is a highly effective treatment option for oropharyngeal candidiasis, with a recommendation level of A-I 1. Additionally, itraconazole solution and posaconazole suspension are also effective treatment options for fluconazole-refractory disease, with recommendation levels of A-II and B-II, respectively 1. It is crucial to note that the treatment of lip fungal infections should prioritize the reduction of morbidity, mortality, and improvement of quality of life, and therefore, the most recent and highest quality study should be considered, which in this case is the 2016 update by the Infectious Diseases Society of America 1.
From the FDA Drug Label
INDICATIONS AND USAGE Nystatin Oral Suspension, USP, is indicated for the treatment of candidiasis in the oral cavity. The answer to Lip fungal infection is that nystatin (PO) is indicated for the treatment of candidiasis in the oral cavity, which may include the lips.
- Key points:
- Candidiasis can cause lip fungal infections
- Nystatin (PO) is used to treat candidiasis in the oral cavity, including the lips 2
From the Research
Lip Fungal Infection
- Lip fungal infections can be caused by various fungal strains, including Candida albicans, C. tropicalis, C. glabrata, and C. krusei 3
- These infections can range from superficial mucocutaneous overgrowths to invasive bloodstream infections with a high mortality rate 3
- Antifungal agents are available in various forms, including oral suspensions, pastilles, creams, capsules, and intravenous forms 3, 4
Treatment Options
- Polyenes (nystatin, amphotericin B), azoles (ketoconazole, miconazole, clotrimazole, fluconazole, itraconazole, voriconazole, posaconazole, isavuconazole), and echinocandins (caspofungin, micafungin, anidulafungin) are commonly used to treat fungal infections 3
- Topical antifungal agents, such as Whitfield's ointment, Castellani paint, gentian violet, potassium permanganate, undecylenic acid, and selenium sulfide, can be effective in treating superficial infections 4
- Itraconazole is a triazole antifungal agent with broad-spectrum activity, available in both oral and intravenous forms 5
Resistance and Sensitivity
- Resistance to antifungal agents, such as nystatin, itraconazole, fluconazole, ketoconazole, clotrimazole, voriconazole, and posaconazole, has been reported in Candida species 6
- Amphotericin B has been shown to have no resistance in some studies 6
- Combination therapy, such as amphotericin B plus flucytosine, may be beneficial in treating invasive fungal infections 7