From the Guidelines
For vaginal burning, the most effective treatment is an over-the-counter antifungal cream, specifically clotrimazole 1% or 2% cream, or miconazole 2% or 4% cream, as recommended by the 2021 Centers for Disease Control and Prevention guidelines 1.
Treatment Options
- Clotrimazole 1% cream: 5 g intravaginally daily for 7–14 days
- Clotrimazole 2% cream: 5 g intravaginally daily for 3 days
- Miconazole 2% cream: 5 g intravaginally daily for 7 days
- Miconazole 4% cream: 5 g intravaginally daily for 3 days It is essential to note that these treatments are specifically for vulvovaginal candidiasis, and if the burning persists or is accompanied by other symptoms, a healthcare provider should be consulted for proper diagnosis and treatment.
Important Considerations
- Vaginal burning can result from various causes, including infections, allergic reactions, hormonal changes, or irritation from products.
- If symptoms persist beyond 3 days or are accompanied by unusual discharge, odor, or fever, consult a healthcare provider for proper diagnosis and treatment.
- Avoid potential irritants like scented soaps, douches, and tight synthetic underwear.
- Drink plenty of water and wear cotton underwear to promote healing.
Diagnosis and Treatment
The diagnosis of vulvovaginal candidiasis can be challenging, and microscopy and clinical suspicion have been used for decades, but culture remains the gold standard for diagnosis of vaginal fungal infections 1. However, molecular testing, such as polymerase chain reaction (PCR), has shown high clinical accuracy and may become a valuable tool in the diagnosis of VVC 1.
From the FDA Drug Label
• treat dryness, itching, and burning in or around the vagina, difficulty or burning on urination associated with menopause The vaginal cream used to treat vaginal burning is estriol (PV), however the label does not specify that it is a cream, it only mentions that it is used to treat dryness, itching, and burning in or around the vagina. 2
From the Research
Vaginal Creams for Vaginal Burning
- Nettle vaginal cream has been shown to reduce subjective symptoms of vaginal atrophy, including vaginal burning, in postmenopausal women 3.
- Clotrimazole 1% vaginal cream has been used to treat vulvovaginal candidiasis, and while it may cause burning sensations in some patients, it has been found to be effective in treating the condition with no adverse reactions in one study 4.
- Chamomile extract cream has been compared to clotrimazole vaginal cream in the treatment of vulvovaginal candidiasis, and both have been found to significantly improve symptoms such as burning sensations 5.
- A plant-based, multi-component cream (Ginetrox®) has been found to be effective in reducing vaginal burning and pain in postmenopausal women with genitourinary syndrome of menopause 6.
- Hyaluronic acid has been found to be effective in improving vulvovaginal symptoms, including burning, in women with vulvovaginal atrophy 7.
Comparison of Vaginal Creams
- The efficacy of different vaginal creams in treating vaginal burning may vary, and more research is needed to determine the most effective treatment options.
- Some vaginal creams, such as nettle vaginal cream and chamomile extract cream, may be considered as alternative treatments for vaginal burning, especially in postmenopausal women or those who prefer herbal medicine 3, 5.