What is the treatment for a skin yeast infection?

From the Guidelines

Treatment for a skin yeast infection typically involves antifungal medications applied directly to the affected area, with over-the-counter topical antifungals like clotrimazole, miconazole, or terbinafine being effective for mild to moderate infections. For more severe or persistent infections, prescription-strength topical medications such as ketoconazole cream or oral antifungals like fluconazole may be necessary 1. It is essential to keep the affected area clean and dry, as yeast thrives in warm, moist environments. Wearing loose-fitting clothing and avoiding scratching the area can also help prevent recurrence.

When using topical treatments, it is crucial to continue applying for the full recommended duration, even if symptoms improve earlier, to prevent recurrence. These medications work by disrupting the fungal cell membrane or inhibiting essential fungal proteins, effectively killing the yeast or preventing its reproduction. For recurrent infections, identifying and addressing underlying causes such as diabetes, immunosuppression, or antibiotic use is important for long-term management 1.

Some key considerations for treatment include:

• For mild to moderate infections, over-the-counter topical antifungals like clotrimazole, miconazole, or terbinafine are effective when applied twice daily for 1-3 weeks.
• For more severe or persistent infections, prescription-strength topical medications such as ketoconazole cream or oral antifungals like fluconazole (150mg once weekly for 2-4 weeks) may be necessary.
• Keeping the affected area clean and dry, and wearing loose-fitting clothing can help prevent recurrence.
• Identifying and addressing underlying causes such as diabetes, immunosuppression, or antibiotic use is important for long-term management of recurrent infections 1.

It is also important to note that the treatment of skin yeast infections should prioritize the use of the most recent and highest quality evidence, with a focus on minimizing morbidity, mortality, and improving quality of life 1.

From the FDA Drug Label

Fluconazole has been shown to be active against most isolates of the following microorganisms both in vitro and in clinical infections Candida albicans Candida glabrata (Many isolates are intermediately susceptible) Candida parapsilosis Candida tropicalis Cryptococcus neoformans

The treatment for a skin yeast infection may include fluconazole, as it has been shown to be active against various Candida species, which are commonly responsible for skin yeast infections. However, the effectiveness of fluconazole in treating clinical infections due to these fungi has not been established in adequate and well-controlled clinical trials for all species 2.

• Candida albicans is susceptible to fluconazole.
• Candida glabrata has intermediate susceptibility.
• Candida krusei should be considered resistant to fluconazole.

From the Research

Treatment Options for Skin Yeast Infections

• Topical therapies are often used to treat skin yeast infections, with azole drugs such as miconazole, clotrimazole, and ketoconazole being effective against yeast infections like those caused by Candida albicans 3
• Allylamines and benzylamines such as terbinafine, naftifine, and butenafine are also used, but are often less effective against yeast infections 3
• Treatment should continue for at least one week after clinical clearing of infection, and may need to be adjusted based on the presence of inflammation or other factors 4

Topical Treatments

• Clotrimazole, nystatin, and miconazole are commonly used topical treatments for cutaneous candidiasis, with complete cure rates of 73%-100% 5
• Single-drug therapy is often as effective as combinations of antifungal, antibacterial, and topical corticosteroid 5
• Topical azoles such as clotrimazole and miconazole are useful in many clinical situations, including acute and recurrent vulvovaginal candidiasis 6

Systemic Treatments

• Oral fluconazole is an effective systemic treatment for cutaneous candidiasis, with similar efficacy to topical clotrimazole and oral ketoconazole 5
• Systemic treatment may be necessary for extensive or resistant infections, and should be chosen based on the specific needs of the patient 4
• New antifungal agents and formulations are being developed to address the challenges of treating vulvovaginal candidiasis, including infections caused by non-Candida albicans and recurrent infections 6