From the FDA Drug Label
A published survey of 96 breastfeeding women who were treated with fluconazole 150 mg every other day (average of 7.3 capsules [range 1 to 29 capsules]) for lactation-associated candida of the breasts reported no serious adverse reactions in infants.
The treatment for Candida (fungus) intertrigo (inflammatory skin condition) of the breasts is fluconazole.
- The dose is not specified in the label for this particular condition, but it has been used in a survey of breastfeeding women with lactation-associated candida of the breasts at a dose of 150 mg every other day 1.
- Caution should be exercised when fluconazole is administered to a nursing woman.
- There is no direct information on the treatment of intertrigo, but the survey suggests that fluconazole may be effective for candida infections of the breasts.
From the Research
Candida intertrigo of the breasts should be treated with topical antifungal medications, such as clotrimazole 1% cream or miconazole 2% cream, applied twice daily for 2-3 weeks, as this approach has been shown to be effective in managing the condition while minimizing the risk of morbidity, mortality, and impact on quality of life 2.
Treatment Approach
The treatment of Candida intertrigo of the breasts involves:
- Topical antifungal medications, such as clotrimazole 1% cream or miconazole 2% cream, applied twice daily for 2-3 weeks
- Keeping the affected area clean and dry by gently washing with mild soap and thoroughly drying afterward
- Wearing a supportive cotton bra to reduce skin-to-skin contact
- Applying absorbent powders like zinc oxide or cornstarch between washings to help maintain dryness
Rationale
The rationale for this approach is based on the fact that Candida intertrigo is a fungal infection that thrives in warm, moist environments, and that topical antifungal medications are effective in managing the condition while minimizing the risk of side effects and interactions associated with oral antifungals 3.
Considerations
It is essential to note that people with larger breasts, obesity, diabetes, or those who sweat heavily are at higher risk of developing Candida intertrigo, and that if symptoms do not improve within a week of treatment or if fever or spreading redness develops, consultation with a healthcare provider is necessary to rule out secondary bacterial infection or the need for stronger medication 4.
Evidence
The evidence supporting this approach includes studies that have demonstrated the efficacy of topical antifungal medications in managing Candida intertrigo, as well as the importance of addressing predisposing factors, such as moisture and friction, to prevent recurrence 5, 6.