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Candida - skin - Management
How should I treat skin candida infection?

Adults

  • Treat candida infection of the skin with a topical imidazole cream (clotrimazole, econazole, ketoconazole, or miconazole). Topical terbinafine is not recommended.
    • Apply only a thin layer of cream to prevent moisture entrapment.
    • The frequency of application and duration of treatment depends on the imidazole used. For more information, see Prescriptions.
  • If inflammation or itch are particularly problematic, consider prescribing a mildly potent corticosteroid cream in addition to a topical imidazole, or using a combined imidazole and mildly potent corticosteroid cream. If after 7 days of treatment:
    • Symptoms have resolved, stop the corticosteroid.
    • There has been a significant improvement in symptoms, continue the corticosteroid for a further 7 days.
    • There is no response, discontinue corticosteroid treatment and seek specialist advice.
  • Consider oral fluconazole treatment 50 mg daily for 2 weeks in adults if:
    • Topical treatment is not effective.
    • The infection is widespread.
    • The person is immunocompromised (depending on the severity of infection and the level of immunocompromise).
  • Review after 2 weeks of fluconazole treatment.
    • If the infection has completely resolved, stop treatment.
    • If there is improvement, but the infection has not completely resolved, continue treatment for a further 2 weeks.
    • If there is no improvement, seek specialist advice.
  • CKS does not recommend oral itraconazole, ketoconazole, or griseofulvin for primary care treatment of candida infection of the skin.

Children

  • Treat with topical preparations, as for adults.
  • Seek specialist advice if oral treatment is being considered for children less than 16 years of age.

Immunocompromised people

  • Immunocompromised people should be treated as outlined above, but earlier referral may be appropriate, depending on the severity of the infection and the level of immunocompromise.

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