Antifungal medications, such as fluconazole, can often treat yeast infections. However, medications can take a week to work, and some infections can become resistant, resulting in recurrent symptoms.

A yeast infection is a fungal infection that can cause itching and painful burning around the genitals. Yeast infections can affect anyone, but they are more common among women. In fact, around 75% of women will experience at least one yeast infection during their lifetime.

Yeast infections typically go away following treatment with antifungal medications. However, some infections may persist or recur despite treatment. Doctors refer to such infections as chronic.

This article outlines the potential causes of chronic yeast infections and provides information on when to see a doctor. It also lists some home remedies and medical treatments for yeast infections.

A type of fungus called Candida is responsible for most yeast infections. These fungi usually live harmlessly on the skin and mucous membranes. However, certain factors can cause them to multiply out of control, causing an infection.

Candida thrive in warm, moist places, so the genitals are a common site of infection.

Sometimes, the symptoms of a yeast infection may persist or recur despite a person receiving medical treatment. Below are some reasons that this may happen:

  • The medication may need more time to work: It can take up to 7 days for an antifungal medication to eradicate a yeast infection.
  • The infection could be treatment resistant: Some yeast may be more resilient to antifungal treatment. This resilient yeast will go on to multiply while the less resilient yeast dies off. This process may result in an infection that is resistant to treatment.
  • The person may have a genetic susceptibility: Familial candidiasis (FC) is an inherited tendency to develop Candida infections. People with FC typically begin experiencing chronic or recurrent yeast infections in early childhood.
  • The person may have a weakened immune system: Certain conditions can weaken the immune system, making a person more susceptible to infections. Some conditions that may increase the likelihood of recurrent yeast infections include:
    • AIDS
    • severe combined immunodeficiency
    • autoimmune polyendocrinopathy-candidiasis-ectodermal dystrophy
    • autosomal dominant hyper-IgE syndrome
  • It may not be a yeast infection: Many infections can cause itching and burning in and around the vagina. The most common is a type of bacterial infection called bacterial vaginosis. Such infections require antibiotic treatment.

A person who meets any of the following criteria should see their doctor about a yeast infection:

  • They are experiencing their first yeast infection.
  • The symptoms are severe enough to interfere with daily functioning.
  • The symptoms have not completely gone away following 7 days of home treatment.
  • They have had a yeast infection before, but the symptoms are different this time.
  • They experience symptoms that are not consistent with a yeast infection, such as:
  • They are pregnant or breastfeeding, in which case they should talk to a doctor or midwife before trying home treatments.

In most cases, the primary treatment for a yeast infection is an over-the-counter (OTC) antifungal medication. These are available in oral form or as topical creams, ointments, or suppositories.

An OTC antifungal treatment should begin working within a few days. The symptoms should slowly improve over the course of a week.

Some people may experience recurrent yeast infections, which experts define as more than two yeast infections within a 6-month period. People who experience recurrent infections may need to continue taking antifungal medication for up to 6 months.

For people with a history of recurrent yeast infections, it is important to begin treating the infection as soon as it appears. This will help prevent it from getting worse.

A person who suspects that they have a yeast infection should see their doctor for diagnosis and appropriate treatment.

Applying a vaginal anti-itch cream may help ease the pain and itching until the treatment takes effect, but it will not cure the underlying infection.

Some home remedies that may speed up the healing or reduce the risk of contracting another infection include:

  • Taking probiotics: Probiotics promote the growth of healthy bacteria. Having an abundance of healthy bacteria may help prevent yeast overgrowth, though there is insufficient research to support this claim.
  • Practicing good vaginal care: Certain vaginal hygiene practices can change the pH of the vagina, making it more susceptible to infections. People should avoid:
    • douching
    • using perfumed soaps on or near the vagina
    • applying deodorants to the delicate skin of the vulva
  • Wearing appropriate underwear: Both men and women should avoid wearing tight or restrictive underwear that traps heat close to the skin. They should opt for loose, cotton underwear that allows air to circulate around the genitals. This will help reduce the risk of infections.
  • Keeping the skin of the genitals dry: A person should keep the skin of their genitals dry to prevent the overgrowth of yeast. For example, people should avoid sitting in a wet bathing suit. They should also gently pat themselves dry with a clean towel after taking a bath or shower.
  • Taking OTC medications: Some oral medications contain both a probiotic and a pain reliever. Although these will not cure a yeast infection, they may ease itching and help speed up the healing.

The type of medical treatment a person receives for a yeast infection will depend on whether the infection is sudden (acute) or persistent (chronic).

Acute yeast infection

An acute yeast infection is one that appears suddenly. A person who experiences such an infection may benefit from an OTC antifungal treatment.

A pharmacist may recommend one of the following:

  • a single-dose antifungal tablet containing the antifungal agent fluconazole
  • topical antifungal creams or ointments
  • an antifungal suppository

Each antifungal formula may have a different required treatment period. A person should follow the packet instructions or talk to their pharmacist for advice.

Chronic yeast infection

A chronic yeast infection is one that does not go away or goes away and returns more than twice in 6 months.

The same treatments that work for acute yeast infections may work for chronic infections. However, a doctor may recommend a higher dosage of medication or a regular repeat dosage to prevent reinfection.

According to an older review from 2000, people who experience recurrent yeast infections should take preventive treatment for about 6 months. People who experience such infections should also seek treatment from a doctor as opposed to treating the infection with OTC medications.

It is possible for a person to transmit a yeast infection to a sexual partner. The partner may then transmit it back to the person later on. In order to break this cycle, both partners should see a doctor for diagnosis and appropriate treatment.

People with chronic yeast infections should also focus on lifestyle remedies to reduce the risk of future infections. Examples include:

  • not douching or using fragranced soaps on or around the genitals
  • keeping the skin of the genitals dry
  • taking a probiotic

Many conditions mimic the symptoms of a yeast infection. Because of this, it is important to seek medical care if symptoms persist or worsen.

Some conditions that may cause symptoms similar to those of a vaginal yeast infection include:

Most yeast infections require treatment with antifungal medication. These medications should take a few days to begin working, though a person may only experience full symptom relief after a week.

Receiving prompt treatment may help reduce the severity of itching and pain.

Certain home remedies can speed up the healing process and prevent the risk of recurrent infections. These include wearing loose-fitting underwear, avoiding the use of harsh soaps and deodorants on the genitals, and ensuring that the skin of the genitals remains dry.

A person who experiences persistent or recurrent yeast infections should talk to their doctor. They may have a separate or underlying medical condition that requires an alternative treatment approach.