From the Guidelines
The next treatment option for a suspected armpit yeast infection that is not responding to clotrimazole should be an oral antifungal medication, such as fluconazole, given at a dose of 100-200 mg daily for 7-14 days. This recommendation is based on the clinical practice guideline for the management of candidiasis by the Infectious Diseases Society of America 1. The guideline recommends fluconazole for moderate to severe disease, which may be applicable in this case if the infection is not responding to topical treatment.
When considering treatment options, it's essential to note that the condition might not be a yeast infection but rather bacterial folliculitis, contact dermatitis, or intertrigo, which would require different treatments. Keeping the armpit clean and dry is crucial during treatment, as moisture promotes fungal growth. Wearing loose-fitting, breathable clothing and using antiperspirants rather than deodorants can help create an environment less conducive to yeast growth.
Some key points to consider when treating suspected armpit yeast infections include:
- The importance of proper diagnosis to rule out other conditions that may require different treatments
- The need to keep the affected area clean and dry to prevent fungal growth
- The potential for fluconazole to be an effective treatment option for moderate to severe cases or cases that are not responding to topical antifungals, as recommended by the guideline 1
- The possibility of considering other antifungal medications, such as itraconazole or posaconazole, if fluconazole is not effective, although these options are typically reserved for fluconazole-refractory disease 1.
From the FDA Drug Label
The daily dose of fluconazole tablets for the treatment of infections other than vaginal candidiasis should be based on the infecting organism and the patient’s response to therapy Treatment should be continued until clinical parameters or laboratory tests indicate that active fungal infection has subsided.
The FDA drug label does not provide information on the treatment of armpit yeast infections. However, fluconazole can be considered for the treatment of fungal infections.
- The dosage of fluconazole should be based on the infecting organism and the patient's response to therapy.
- Treatment should be continued until clinical parameters or laboratory tests indicate that the active fungal infection has subsided 2.
From the Research
Alternative Treatments for Armpit Yeast Infection
If clotrimazole is not effective in treating an armpit yeast infection, alternative treatments can be considered.
- Oral antifungal agents such as fluconazole, itraconazole, and terbinafine can be used to treat fungal infections of the skin 3.
- Fluconazole has been shown to be effective in treating pityriasis versicolor, tinea corporis, and tinea cruris 3.
- Itraconazole has also been effective in treating pityriasis versicolor, tinea corporis, and tinea pedis 3, 4.
- Terbinafine has been shown to be effective in treating tinea pedis, but its effectiveness in treating vulvovaginal candidiasis is limited 5, 4.
Considerations for Treatment
When considering alternative treatments, it is essential to note that:
- The effectiveness of oral antifungal agents can vary depending on the specific infection and the individual patient 3, 5, 4.
- Adverse effects, such as gastrointestinal disturbances and neurological reactions, can occur with oral antifungal agents 6, 4.
- The choice of treatment should be based on the specific diagnosis and the patient's medical history 3, 6, 5, 4.