This is a common condition usually caused by the yeast candida albicans. Predisposing factors include antibiotics, pregnancy and poorly controlled diabetes. However, the most common cause is use of soap based perfumed body washing products.
Main symptoms and signs are:
- Vulval itch, burning, erythema and sometimes fissures
- A curdy white non-odorous discharge
Examination: Not always necessary if typical symptoms.
Investigations:
HVS or patient self-taken low vaginal swab: yeasts on microscopy and culture.
Treatment: please see formulary advice.
Note that for severe infection, what can help is either Fluconazole 150mg or Clotrimazole 500mg pessary on day 1 and again on day 4.
Partner treatment is only necessary if symptomatic.
Do not use oral therapies in pregnancy.
Information to be given to patient:
- Caused by an overgrowth of Candida species, which are a bowel commensal.
- Treating partner does not improve outcomes
- May recur.
See genital skin washing advice leaflet in resources and links – and follow that advice to reduce recurrence rate.
Switch to a soap substitute to wash the entire body – not just the genital skin and avoid all products in bath water including shampoo.
Stop fabric softener, wet wipes, feminine hygiene products, douching etc.
