Candidiasis, men - Treating thrush in men

The recommended treatment for thrush in men depends on which area of the body is affected.

For thrush that doesn't affect the penis, a type of anti-fungal cream called topical imidazole is usually recommended.

Fluconazole is the first-choice treatment for thrush that affects the penis. It's also used as an alternative anti-fungal medication if your symptoms do not improve within 14 days of using a topical imidazole.

Topical imidazole

Topical imidazoles work by breaking down the membranes (walls) of the fungi cells.

Examples of topical imidazoles include:

  • clotrimazole
  • econazole
  • ketoconazole
  • miconazole

Most of these are available from your pharmacist without a prescription. Your pharmacist can advise which treatment is most suitable for you.

The most common side effect of a topical imidazole is a mild burning sensation when you apply the cream.

In a few people, some topical imidazoles have caused more severe burning and a serious skin irritation. If this happens, stop using the cream and contact your GP for advice.

If your skin feels itchy, your GP may prescribe a corticosteroid cream as an additional treatment. Corticosteroids reduce levels of inflammation within the affected tissue. This should help to resolve the symptoms of itchiness.

Fluconazole

Fluconazole is usually taken as a tablet and is often available over the counter without a prescription.

Fluconazole works by destroying some of the enzymes (a type of protein that triggers useful chemical reactions inside the body) that fungi cells need to survive and reproduce.

The most common side effects of fluconazole are:

  • nausea
  • abdominal (stomach) pain
  • diarrhoea
  • flatulence (excessive wind)

Contact your GP for advice if your symptoms do not improve after 14 days of taking fluconazole. You may need to be referred to a dermatologist for specialist treatment. A dermatologist is a doctor who specialises in treating skin conditions.

Avoid having sex

If you have thrush, avoid sex until the infection has cleared up, as your infection can be spread or made worse during sex.

If you do have sex, use a condom to avoid infecting your partner.

Some heterosexual men get a mild form of balanitis (inflammation of the head of the penis) after having sex. This is probably caused by an allergy to the candida fungus in your partner’s vagina. However, it will usually clear up if your partner gets treatment.

Gay men may also get thrush by having unprotected sex. The infection will usually clear up with treatment. Avoid sex until the infection has cleared up, and always use a condom.

Good hygiene

If you have thrush, practising good personal hygiene can help clear up the infection. Wash the affected area carefully using warm water. Showers are a better option than baths. Avoid using perfumed soaps or shower gels on your genitals, because they can cause irritation.

After washing, make sure you dry the affected area carefully, as the candida fungus thrives in damp conditions. Wearing loose-fitting cotton underwear can help keep your skin and penis dry and cool, which helps prevent the candida fungus building up on your skin and under your foreskin.

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