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What are the best treatments for vaginal thrush?
Medically reviewed by
Craig Marsh, Independent Prescriber
Vaginal thrush is a common yeast infection, affecting around 75% of women at some stage of their life. It can cause itching, burning, and a thick, white discharge.
Infections are caused by an overgrowth of the fungus candida albicans, and can develop for lots of reasons. It’s sometimes referred to as vaginal candidiasis.
Taking antibiotics, using contraceptive pills, being pregnant, or having poorly managed diabetes can all contribute to vaginal thrush. You might be more susceptible to it if your immune system is weakened, or if you use perfumed products that irritate the skin on and around your vagina. Sometimes, thrush occurs as a result of wearing clothes that trap moisture and heat, creating the perfect environment for fungi to grow in. Sex is also a vaginal thrush trigger, and can make symptoms worse if you already have an infection.
When it comes to treatment, there are lots of options available. Internal and external creams, tablets, capsules and pessaries are also commonly prescribed.
The right medication for managing vaginal thrush will depend on your individual needs. Talking to a clinician can help you choose the one that seems like the best fit for you. Here, we’ll take a closer look at the different options available, what to do if you get infections often, and whether vaginal thrush can lead to complications.
What treatments are there for vaginal thrush?
Azoles, which are a type of antifungal medication, are commonly used to treat vaginal thrush. Fluconazole and clotrimazole are two popular types that are prescribed to control fungal infections.
Treatments usually come in the form of oral tablets and capsules, or topical creams. Both work in a similar way, by targeting ergosterol. Ergosterol is a key component in the structure of fungi, and azoles work by weakening fungal cell membranes. Sometimes, creams and tablets or capsules are used together. The one that works best for you will depend on your symptoms — external infections might only affect your skin, and respond well to creams. Internal infections, where you have discharge or stinging while urinating, might respond better to systemic treatments.
Best internal creams for vaginal thrush
Internal creams are used with an applicator you insert into your vagina. They might be your preferred option for treating thrush if you can’t use pessaries, oral tablets or capsules.
| Active Ingredient | Brand names | How to use it |
|---|---|---|
| Clotrimazole | Canesten Internal Thrush Cream | Pharmacy-strength treatment, which means you can start using it after a short assessment with a pharmacist. In order for the internal cream to work properly, you’ll need to avoid using tampons and other vaginal products that have the potential to remove the cream |
| Miconazole nitrate | Gyno-Daktarin Cream | Antifungal azole applied daily, usually before bed, for seven days. OTC medication that doesn’t need a prescription. |
Best external creams for vaginal thrush
External creams can be applied to any affected areas of skin, usually in a thin layer. Formulas that are used externally are often used internally too, and a clinician might recommend you use them both ways.
| Active Ingredient | Brand names | How to use it |
|---|---|---|
| Clotrimazole | Canesten Thrush External Cream, Boots Thrush 1% w/w Cream | Cream formulas containing clotrimazole. Can be applied several times a day to soothe itching and irritation. Sometimes used alongside a vaginal tablet for a more thorough treatment. |
| Miconazole nitrate | Gyno-Daktarin Cream | Azole cream that treats infections and clears symptoms. Used for other fungal conditions like athlete’s foot and ringworm. Apply a thin layer twice a day. |
Best Treatments for persistent vaginal thrush
If you get vaginal thrush infections more than four times a year, a clinician will try to help you find out what could be causing them.
Some conditions, like diabetes, can make you more prone to a vaginal thrush infection. With this in mind, you might be referred for tests to monitor your blood sugar levels and rule diabetes out as a cause. Further tests might also be suggested if you have other symptoms alongside your vaginal thrush, such as coloured discharge or unusual bleeding.
If you get persistent vaginal thrush infections, you might need to use a medication for longer than the usual course of treatment. This could mean taking medication for around six months, but it will depend on your symptoms and how you respond to the treatment you use.
Creams and tablets are sometimes prescribed at the same time to manage vaginal thrush. Canesten Thrush Duo, for example, is a dual-medication treatment — the packs contain an oral capsule (fluconazole) and a topical cream (clotrimazole). Both medications are azoles, a type of antifungal. The capsules target fungus systemically, while the cream can relieve itching and discomfort when rubbed into the affected area.
Although it’s not a sexually transmitted infection (STI), vaginal thrush can be triggered by sex. Having sex while you have an infection can also irritate and damage the skin around your vagina, which could leave you vulnerable to future infections.
A clinician might also ask you about your hygiene routine, and if any products you use regularly could be contributing to recurrent infections. Perfumed soaps and detergent are known to aggregate vaginal skin, so it might be worth switching to products that are gentler on your skin.
Will vaginal thrush go away on its own?
Mild vaginal thrush infections can clear up on their own. If you suspect thrush symptoms are developing, keeping the area clean and dry might be enough to stop them getting any worse.
Wear loose-fitting, breathable underwear and avoid anything that might irritate the area.
The severity of your symptoms is usually a good indicator of whether your infection needs treatment. Vaginal thrush can be unpleasant — the itching and burning it causes can interfere with your routine and be uncomfortable.
Sexual health clinics might also be able to help when you have an infection. They might also test to see if you have any other STIs.
It’s recommended you seek help for vaginal thrush when you get symptoms for the first time. This is especially important if you have a weakened immune system, or experience hormonal fluctuations. Anyone over the age of 60 should also get help from a medical professional if they develop vaginal thrush symptoms, as they might find it harder to keep an infection under control.
How do you know when vaginal thrush is serious?
Most women won’t need to worry about a vaginal thrush infection becoming serious. They’re often uncomfortable while you have them, but can clear up without treatment, or respond well to antifungal creams and tablets.
In rare cases, candida albicans can cause sepsis, which can lead to septic shock. It infects the bloodstream and can be life-threatening for critically ill patients. Fungi are responsible for around 15% of infections in healthcare settings, and can pose a serious threat to people in intensive care units.
Sepsis is a risk for anyone with a weakened immune system. It can cause fever, a high heart rate, and shortness of breath. It’s usually caused by a bacterial infection, and can be prevented by treating an infection early.
So while vaginal thrush won’t usually be a serious risk to your health, it’s important to manage an infection when it develops.
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Thrush in men and women. nhs.uk.
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Delaloye, J. and Calandra, T. (2014).
Invasive candidiasis as a cause of sepsis in the critically ill patient. Virulence, pp.161–169.
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World Health Organization (2024).
Sepsis. World Health Organisation.
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