From the Guidelines
Nystatin is an effective treatment for hot patches in folds of skin, which is a fungal infection occurring in skin folds, and the recommended treatment is nystatin cream or ointment (100,000 units/g) applied to the affected areas 2-3 times daily for 7-14 days. The medication should be applied to clean, dry skin after gently washing and thoroughly drying the area. A thin layer should be spread over the entire affected region, extending slightly beyond the visible infection. For optimal results, patients should continue treatment for at least 48 hours after symptoms resolve to prevent recurrence.
Key Considerations
- Keeping the affected skin folds dry is crucial for treatment success, so patients should pat the area dry after bathing and may use absorbent powders (not containing nystatin) to reduce moisture 1.
- Loose-fitting clothing helps reduce friction and moisture accumulation.
- Nystatin works by binding to sterols in the fungal cell membrane, creating pores that lead to cell death, and it's specifically effective against Candida species and has minimal systemic absorption, making it safe for most patients including pregnant women and immunocompromised individuals.
Treatment Approach
- The treatment approach should include gentle washing and drying of the affected area, application of nystatin cream or ointment, and keeping the area dry to prevent recurrence.
- Patients should be advised to seek further medical evaluation if symptoms persist beyond two weeks of treatment, as a different antifungal or additional interventions may be needed 1.
From the FDA Drug Label
INDICATIONS AND USAGE Nystatin Topical Powder is indicated in the treatment of cutaneous or mucocutaneous mycotic infections caused by Candida albicans and other susceptible Candida species. The treatment for intertriginous candidiasis (fungal infection in skin folds) requiring nystatin is Nystatin Topical Powder.
- Key points:
- Indicated use: Cutaneous or mucocutaneous mycotic infections caused by Candida albicans and other susceptible Candida species.
- Formulation: Topical Powder 2
From the Research
Intertriginous Candidiasis Treatment
The treatment for intertriginous candidiasis, a fungal infection in skin folds, often requires the use of antifungal agents.
- Nystatin is one such agent that has been used to treat fungal infections, including those caused by Candida species 3, 4.
- The effectiveness of nystatin in treating intertriginous candidiasis can be attributed to its ability to inhibit the growth of Candida species 4.
- However, other antifungal agents like miconazole and clotrimazole have also been shown to be effective in treating Candida infections, including intertriginous candidiasis 5, 6.
- A study comparing the effects of nystatin, clotrimazole, and miconazole on vaginal candidiasis found that nystatin and clotrimazole were equivalent to miconazole in curing the infection, but more patients relapsed in the nystatin and clotrimazole groups 6.
- Another study found that nystatin was effective in treating perianal candidosis, with all Candida organisms being eradicated within 5 days 7.
Nystatin Usage
- Nystatin can be used topically to treat intertriginous candidiasis, and its effectiveness has been demonstrated in various studies 3, 4, 7.
- The dosage and duration of nystatin treatment may vary depending on the severity of the infection and the individual patient's response to treatment.
- It is essential to follow the recommended dosage and treatment duration to ensure effective treatment and minimize the risk of relapse or adverse effects.
Alternative Treatments
- Other antifungal agents like miconazole, clotrimazole, and econazole may also be effective in treating intertriginous candidiasis 5, 6, 4.
- The choice of treatment may depend on various factors, including the severity of the infection, the patient's medical history, and the presence of any underlying conditions.
- In some cases, alternative treatments like mupirocin may be considered, especially if the infection is caused by a non-albicans Candida species 7.