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Candidiasis, men - Treating thrush in men

NHS Choices Medical Reference

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The recommended first-line treatment for thrush in areas apart from the penis is a type of anti-fungal cream called 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 you are having symptoms of itchiness, your GP may prescribe a corticosteroid cream as an additional treatment. Corticosteroids reduce levels of inflammation within the affected tissue. This should help resolve the symptoms of itchiness.

Doctors report re-infection is common so during treatment it is best to avoid sex or use a condom. Occasionally both sexual partners may need treatment to prevent re-infection. Seek advice about this from a pharmacist or your GP.


If your symptoms do not improve within 14 days, you may need an alternative antifungal medication. Fluconazole taken in tablet form is the preferred treatment. Fluconazole is also the first choice treatment for treating thrush which affects the penis. Most products that contain fluconazole are available over-the-counter (OTC) 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 (tummy) 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.

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 shower gels or soaps 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 build-up of the candida fungus on your skin and under your foreskin.

Medical Review: June 09, 2012
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