From the Research
Perianal candidiasis is best treated with topical antifungal medications applied directly to the affected area, with fluconazole being a viable option for more severe cases, as supported by the most recent study 1.
Treatment Approach
The treatment of perianal candidiasis involves the use of antifungal medications. Topical antifungal creams or ointments are typically the first line of treatment.
- Clotrimazole 1% cream or miconazole 2% cream applied twice daily for 1-2 weeks are common treatment options.
- For more severe cases, fluconazole 150mg taken orally as a single dose may be necessary, as it has shown effectiveness in treating candidiasis, including oral candidiasis, with a clinical cure rate of 100% in one study 1.
Management and Prevention
During treatment, it is essential to keep the perianal area clean and dry, washing gently with mild soap and water and thoroughly drying afterward.
- Avoid tight-fitting clothing and synthetic underwear; instead, opt for loose cotton underwear to reduce moisture and heat that promote fungal growth.
- For patients with recurrent infections, addressing underlying risk factors is essential, including controlling diabetes if present, avoiding unnecessary antibiotics, and maintaining good hygiene practices.
Pathophysiology and Rationale
Perianal candidiasis occurs when the yeast Candida albicans, which normally lives on skin in small amounts, overgrows in the warm, moist environment around the anus, causing symptoms like itching, burning, redness, and occasionally a white discharge.