Over-the-counter (OTC) treatments may be adequate for milder yeast infections. However, symptoms can sometimes be caused by other conditions, so you should get a diagnosis before treating yourself. If your yeast infection is severe or a chronic problem, your provider may prescribe an oral or topical medication.
This article covers the various OTC and prescription medications available to treat vaginal yeast infections. It also discusses some home remedies and lifestyle changes you can try to speed healing along and help prevent future yeast infections.
Over-the-Counter Therapies
The OTC products available for vaginal yeast infections typically have one of four active ingredients:
ButoconazoleClotrimazoleMiconazoleTioconazole
These drugs are all in the same anti-fungal family. They work in similar ways to break down the Candida organism, which is the type of fungus that most commonly causes yeast infections. Eventually, the organism dissolves and the infection clears up.
These drugs are generally considered safe to use if you are pregnant.
When you visit your healthcare provider for your vaginal yeast infection, discuss the pros and cons of the different types of medications available and ask which is best for you.
Treatments for yeast infection are available as:
Vaginal suppositories (inserts) Vaginal tablets Creams with special applicators
Once you start using an OTC anti-fungal medication, your yeast infection symptoms will probably begin to resolve within a few days.
Some antifungal inserts and creams can damage condom material, diaphragms, and spermicide. A warning about this should be listed on product labels, so be sure to read them. To prevent sexually transmitted infections and pregnancy, talk to your healthcare provider about alternative treatments that don’t come with the same risk.
In addition, vaginal intercourse during treatment could displace medication from the vagina, causing irritation and reducing the medication’s effectiveness.
Make sure you read the label on OTC products. You should only use products for the area of the body they are meant to be used on. Do not use products on your vagina if they are meant to be used only on other areas of the body.
Abdominal pain, fever, or a foul-smelling dischargeIncreased irritation of the vagina or nearby skinNo improvement within three days
These OTC products are not intended for use by men. They should also not be used for other types of infections, such as fungal infections under the fingernails or inside the mouth (known as thrush).
Prescriptions
If you see your healthcare provider for a mild or moderate yeast infection, they may prescribe a single dose of Diflucan (fluconazole).
Diflucan is appropriate for uncomplicated cases. It can cause mild to moderate side effects, including headache, diarrhea, heartburn, and stomach pain.
Oral fluconazole should generally be avoided if you are pregnant since high doses can cause birth defects.
Severe and Recurrent Infections
For severe or frequent Candida vaginal yeast infections, your healthcare provider may prescribe two to three doses of Diflucan given 72 hours apart.
Another oral medication that can be used in these cases is Nizoral (ketoconazole). It is taken for seven to 14 days, either once or twice daily, depending on your healthcare provider’s recommendations.
If you have recurring yeast infections, your healthcare provider may recommend prolonged vaginal or oral treatment. For example, you may take two to three doses of the oral Diflucan pill, then weekly doses of Diflucan for six months or possibly a topical medication.
The Food and Drug Administration (FDA) approved Vivjoa (oteseconazole) in 2022 for recurrent or chronic yeast infections in nonreproductive women. The drug is intended for use by women who are permanently infertile and postmenopausal. Vivjoa is administered in capsule form and may be taken alone or with Diflucan.
Sometimes a yeast infection is caused by the species Candida glabrata, which doesn’t respond to the usual oral medications. The alternatives include 14 days of intravaginal treatment with a boric acid gelatin capsule, nystatin suppository, 17% flucytosine cream, or a cream with 17% flucytosine and 3% amphotericin B.
Home Remedies and Lifestyle
Some home remedies may help ease symptoms and eliminate sources of vaginal irritation. These include:
Sitting in a warm (not hot) bath. The warm water might help to relieve some symptoms. You may want to avoid soap and just rinse with water. Avoiding perfumed bath additives, feminine hygiene sprays, and body powders. These can irritate the genital area. Wearing cotton underwear and avoiding too-tight pants and pantyhose. You may want to switch to wearing skirts or loose pants until the infection is cleared. This can help speed healing by keeping the area cool and dry. Changing out of wet swimwear or sweaty clothes as soon as possible. Also, be sure to wash these items between each wear.
Vaginal Care During Treatment
Your healthcare provider may advise you to avoid vaginal sex during the treatment. Be sure you know when you can resume safely.
It is possible for a male partner to get a yeast skin infection on his penis or have irritation from a vaginal treatment product. Condom or oral dam use can prevent the passing of yeast to and from your sexual partner. If you’re using one, remember to read medication instructions to ensure that it doesn’t damage the condom.
If you are using a vaginal cream or suppository for treatment, refrain from using tampons, as they can block or remove the medication. Opt for a deodorant-free pad or liner if menstruating.
You can always wear a pad to protect your clothes from leakage. Just be sure to change it often to prevent additional moisture build-up.
Douching is never advised, and it is especially to be avoided while you are clearing a yeast infection.
Complementary Medicine (CAM)
You may choose to consider one or more of the following complementary remedies. Some are supported by research, but others require further study to determine their effectiveness.
Boric Acid Suppository
Boric acid suppositories can be used to treat the Candida albicans species of yeast. They can be purchased online or in drugstores, but you should check with your healthcare provider before you take them to ensure you are using a reputable brand.
You can also get instructions on how to make your own boric acid suppositories using over-the-counter boric acid and a fillable size 0 or 00 gelatin capsule. You should be sure that you get medical advice on using this; 600 milligrams, once or twice daily for seven to 14 days is usually recommended.
You should never take boric acid by mouth or use it on open wounds. It is not safe to use while pregnant. Even when used as recommended, you may have some skin irritation.
Probiotics and Active-Culture Yogurt
The health of the vagina relies on beneficial probiotic bacteria (lactobacilli, including L. acidophilus) to maintain a slightly acidic pH and keep yeast from overgrowing.
Some research suggests that consuming probiotics or taking probiotic supplements can help relieve yeast infection symptoms or prevent recurrent yeast infections. Other studies, however, show there may be no benefit at all.
You can consume probiotics naturally by adding more yogurt, kefir, sauerkraut, miso, and sourdough bread to your diet.
People with a suppressed immune system or recent abdominal surgery should avoid probiotic supplements. Supplements aren’t regulated by the FDA so check with your doctor before using them.
More Research Needed
You may see suggestions for using coconut oil, oregano oil, tea tree oil, other essential oils, or garlic supplements for yeast infections. Clinical studies are needed to show that they are safe and effective in humans, especially in pregnant women. These either haven’t been done, or there is no evidence that they are effective.
A wide variety of plant oils and extracts have antifungal effects in the test tube, but many can be irritating or toxic to the body.
Summary
Mild vaginal yeast infections can be treated with over-the-counter anti-fungal creams, inserts, and tablets.
Severe or recurring yeast infections may require prescription treatments. Your healthcare provider may prescribe a one-time dose or a multi-day dose depending on the nature of your yeast infection.
Good vaginal hygiene will reduce your risk. This includes bathing regularly, keeping your vaginal area dry, and avoiding tight-fitting clothing.
A Word From Verywell
Most cases of vaginal candidiasis are mild. However, it’s possible for the infection to become severe, resulting in redness, swelling, and cracks in the vaginal walls.
To avoid these complications, it’s important to get a proper diagnosis from your healthcare provider if you have vaginal yeast infection symptoms. This will ensure that you get treated for the right condition since symptoms can be similar to other conditions, including some sexually transmitted infections.
