Can Using OTC Yeast Infection Cream Cause Yeast Infection? What Creams should be used for treatment?

Treatment of yeast infection does not cause yeast infection, but treats the yeast infection.  Re-infection occurs if the treatment course is not completed, or if one partner with an active yeast infection is not treated.  It is best to finish the entire treatment course and to recommend partner treatment if they are infected.  An allergic reaction to treatment may produce additional lesions, so it is important to note if the infection is not getting better during treatment.  Recurrent or relapsing Candida balanitis that present after a full course of medications is not uncommon and it may be due to an increased susceptibility to chronic yeast infections (e.g. diabetes, uncircumcised penis, etc).  Despite therapy, recurrent vulvovaginal candidiasis, defined as 4 or more episodes of infection per year, can occur in less than 5% of healthy women. Recurrences may be caused by other species of Candida that are not equally susceptible to the usual first-line treatments with antifugal creams.  Appropriate fungal cultures may be taken to identify the species.  Yeast infection medications are the same for men and women, and can be prescribed by the doctor or obtained over the counter (OTC).  The medications prescribed by the doctors may have a shorter course than OTC yeast infection creams, however both still do a good job of treating yeast infections in both men and women.  Recurrent infections require longer courses of antimycotic therapy for 10 to 14 days.Non-medical treatmentTreatment for recurrent yeast infections depend on controlling and or identifying the underlying cause.  Controlling blood sugar levels for diabetics and regular inspection of any new skin infections for immunocompromised patients are suggested.  Patients at risk for yeast infection can be treated with antifungals prophylatically (before they contract the infection).  Studies have shown that dietary sucrose (sugar) and lactose (milk sugar) may support and promote the growth of yeast in women.  Limiting dietary intake of these sugars may help.  Women are advised to wear loose-fitting nonocclusive clothing and cotton underwear to avoid providing the warm moist climate in which Candida tends to thrive.  Some physicians recommend washing clothing in hot water and using panty liners to avoid creating a reservoir for yeast.Men with Candida blanitis that is caused by poor hygiene should keep the area clean, especially if they are uncircumcised.  Circumcision is also an option for recurrent infections.  It is not an uncommon procedure, even in adult males, and it will cure balanitis caused by Candida.  For immunocompromised patients, taking medications and keeping the area clean will decrease infection occurrence.Medical Treatments Candida infection is very common in women, and over 75% of women can have an episode in their lifetime.  This is the reason why medications are readily available at many pharmacies and retail stores.  Antifugals work by blocking the formation of the cell wall in yeast.  Azole compounds work through this action.  Topical antimycotic drugs can achieve cure rates in excess of 80%.   Candida balanitis  and Candida vaginitis responds quickly with twice-a-day application for 7 days of miconazole (Monostat), or clotrimazole (Lotrimin, Gyne-Lotrimin) cream which can be purchased OTC.  It is recommended to complete the full course to prevent recurrence.  Doctors may prescribe fluconazole (Diflucan), for one day, or 5 days, and it is just as effective as the 7 day treatments of the OTC medications.  It can concentrate in vaginal secreations for at least 72 hours after the tablet is taken.  Women can also be treated with nystatin vaginal tablets, miconazole, clotrimazole, butoconazole, and terconazole vaginal creams, or Ketaconazole or fluconozole tablets.  These medications range from taking a single oral dose or 3 to 14 days of treatment.  For recurrent yeast infections in women, some patients are placed on treatment for several months.  Therapy includes ketoconazole (400 mg/d), itraconazole (50-100 mg/d), fluconazole (100 mg/wk) for 6 weeks, and clotrimazole (500-mg vaginal suppositories once per wk).  These regimens have been used for up to 6 months to achieve maximal results.