The recommended first-line treatment for thrush is a type of anti-fungal cream called topical imidazole. Topical imidazoles work by breaking down the membranes (walls) of the fungi cells.
Examples of topical imidazoles include:
- clotrimazole
- econazole
- ketoconazole
- miconazole
Most of these medications are available from your pharmacist without a prescription. Your pharmacist can advise you on which treatment is most suitable for your needs.
The most common side effect of a topical imidazole is a mild burning sensation when you apply the cream.
In a few people, some topical imidazoles have caused a more severe burning sensation and a serious skin irritation. If this happens, stop using the cream and contact your GP for advice.
If you are having symptoms of itchiness, your GP may prescribe a corticosteroid cream as an additional treatment. Corticosteroids reduce levels of inflammation within the affected tissue. This should help to resolve the symptoms of itchiness.
Fluconazole
If your symptoms do not improve within 14 days, you may need an alternative antifungal medication. Fluconazole is one example of this type of medication, and it is available as a cream and as a tablet. Most products that contain fluconazole are available over-the-counter (OTC) without the need for a prescription.
Fluconazole works by destroying some of the enzymes (a type of protein that triggers useful chemical reactions inside the body) that fungi cells need to survive and reproduce.
The most common side effects of fluconazole are:
- nausea
- abdominal (tummy) pain
- diarrhoea
- flatulence (excessive wind)
Contact your GP for advice if your symptoms do not improve after 14 days of taking fluconazole. You may need to be referred to a dermatologist for specialist treatment. A dermatologist is a doctor who specialises in treating skin conditions.
Good hygiene
If you have thrush, practising good personal hygiene can help to clear up the infection. Wash the affected area carefully using warm water. Showers are a better option than baths. Avoid using perfumed shower gels or soaps on your genitals because they can cause irritation.
After washing, make sure that you dry the affected area carefully as the candida fungus thrives in damp conditions. Wearing loose-fitting cotton underwear can help to keep your skin and penis dry and cool, which helps to prevent the build-up of the candida fungus on your skin and under your foreskin.
