What is the treatment for a Candida (fungal) infection in the axilla (armpit)?

Treatment of Candida Infection in the Axilla

Topical azoles and polyenes, including clotrimazole, miconazole, and nystatin, are effective for treating Candida infections in the axilla. Keeping the area dry is also important for successful treatment. 1

First-Line Treatment Options

• Topical antifungal agents are the treatment of choice for Candida intertrigo in the axilla, as they act by direct contact with the fungus 1, 2
• Effective topical treatments include:
  • Azole creams (clotrimazole, miconazole) applied to the affected area 1, 3
  • Nystatin cream or powder applied to the affected area 1, 2
• Apply the topical agent 1-2 times daily until the infection resolves, typically for 7-14 days 1

Important Adjunctive Measures

• Keep the axillary area clean and dry, as moisture promotes fungal growth 1, 3
• Wear loose-fitting, breathable clothing to reduce moisture and friction 3
• Consider using absorbent powders (non-medicated) after the application of antifungal creams to keep the area dry 3

Treatment for Resistant or Extensive Infections

• For widespread or resistant infections, oral antifungal therapy may be necessary 4:
  • Fluconazole 150-200 mg once weekly for 2-3 weeks 5
  • Itraconazole 100 mg daily for 2 weeks or 200 mg daily for 7 days 5

Special Considerations

• For patients with diabetes or obesity, more aggressive treatment and preventive measures may be needed as these conditions are risk factors for Candida intertrigo 1
• Recurrent infections may require longer courses of therapy and more aggressive preventive measures 1
• If the infection does not respond to topical therapy within 2 weeks, consider:
  • Obtaining a culture to confirm the diagnosis and identify potential resistant species 1
  • Switching to an oral antifungal agent 4
  • Evaluating for underlying conditions that may predispose to fungal infections 1

Prevention of Recurrence

• After successful treatment, preventive measures include:
  • Maintaining good hygiene and keeping the axilla dry 1
  • Using antifungal powders prophylactically in patients prone to recurrence 3
  • Addressing underlying risk factors such as obesity, diabetes, or immunosuppression 1

Candida infections in the axilla typically respond well to topical therapy when combined with good hygiene practices. Systemic therapy should be reserved for extensive disease, immunocompromised patients, or cases that fail to respond to topical treatment 4, 5.