Antifungal medications, such as fluconazole, can often treat yeast infections. However, some infections can become resistant, resulting in recurrent symptoms or a yeast infection that seems like it is not going away. Doctors refer to such infections as chronic.

A yeast infection is a fungal infection that can cause itching and painful burning around the genitals. Yeast infections typically go away following treatment with antifungal medications. However, some infections may persist or recur despite treatment.

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

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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 thrives 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 why this may happen.

More time is necessary

The medication may need more time to work. It can take at least 7 days for an antifungal medication to eradicate a yeast infection. A person may need to continue taking the medication for longer to reduce the risk of the infection returning.

Treatment resistance

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.

Genetic susceptibility

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.

Weakened immune system

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 (APECED)
  • autosomal dominant hyper-IgE syndrome (AD-HIES)

It may not be a yeast infection

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:

Many infections can cause itching and burning in and around the genital area. One of the most common is bacterial vaginosis, which is a type of bacterial infection. Such infections require antibiotic treatment.

If symptoms do not respond to treatments for a yeast infection, it is best to contact a doctor. They will be able to order tests to confirm the diagnosis and advise on a suitable treatment plan.

Learn more about how long it takes a yeast infection to go away.

It is best for a person to contact a doctor if:

  • they are experiencing a yeast infection for the first time
  • the symptoms are severe enough to interfere with daily functioning
  • the symptoms have not completely gone away with home treatments
  • 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, breastfeeding, or nursing, as some home treatments may not be suitable

In most cases, the primary treatment for a yeast infection is an over-the-counter (OTC) antifungal medication. These are available 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 1–2 weeks.

Some people may experience recurrent yeast infections, which can involve more than one yeast infection in a year. A person may need to take medication for longer if this is the case.

It is best for a person who suspects that they have a yeast infection to contact their doctor for an accurate 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 hygiene: Certain 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: Avoiding wearing tight or restrictive underwear can help prevent heat from becoming trapped close to the skin. It is best to 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. It is also best to gently pat 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 contact their pharmacist for advice.

Chronic yeast infection

A chronic yeast infection is one that does not go away or goes away and returns.

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.

People who experience recurrent yeast infections may need to take maintenance 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 a diagnosis and appropriate treatment.

Lifestyle remedies can also help reduce the risk of future infections. These include:

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

Learn more about how to get rid of a yeast infection.

View the slideshow below for photos of yeast infections.

Here are some frequently asked questions about yeast infections.

What does it mean if a yeast infection does not go away?

A yeast infection may not go away if treatment has not had enough time to take effect. Treatment resistance, genetic susceptibility, and weakened immune systems can also affect how a yeast infection resolves.

How long is too long for a yeast infection?

With the right treatment, yeast infections can resolve within 1–2 weeks. For persistent yeast infections, or for symptoms that resemble a yeast infection but which do not respond to treatment, it is important to contact a doctor. The doctor can provide an accurate diagnosis and advise on treatments that may help.

Can a yeast infection get worse not better?

If a yeast infection does not respond to home remedies or OTC treatments, it may worsen. It is best to contact a doctor for an accurate diagnosis and suitable treatment plan.

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 1–2 weeks.

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 contact their doctor. They may have a separate or underlying medical condition that requires an alternative treatment approach.