Antifungals are a category of medication that targets the breakdown of unwanted fungi from the body. Simple treatments can involve topical treatments with over the counter medication but more complex treatments can involve treating fungal infections with tablets, creams or other methods. Although antifungals are all one topic, they can be subcategorized into different types of antifungals – we’ll go through this in more detail below.
The most used type of antifungals are known as the 'azole' group of antifungals. These work to kill the fungus by disrupting the production of important components needed for its cell membrane and are the active ingredients in all over the counter medication you can buy to treat fungal conditions.
The second type of antifungals are the 'polyenes' group. These work by killing fungal cells by making the fungal cell wall more likely to break apart and are used for a wider range of harder to treat fungal infections. The other types of antifungals are used more sparingly for more complex cases.
Depending on the treatment required, the antifungal formulation can vary. There are many topical formulations available to buy over the counter for treating simple fungal infections. Lacquer and gel pens are used to treat simple nail fungal infections, oral gels are available for treating thrush in the mouth and pessaries are available for treating vaginal thrush.
Creams, ointments, and powders are used to treat fungal infections limited to the surface of the skin. If the infection spreads to the layers below the skin and into the body, it needs to be treated with systemic treatments (tablets) which are only available on prescription. There are also different topical medications that are only available with a prescription from your doctor.
Tablet antifungals are taken orally (by mouth) to treat fungal infections. They can be prescribed by a doctor when topical (creams and washes) antifungals don’t clear up the infection, or if a tablet is believed to be the best way to target the area of the infection. In certain cases, if the infection is severe or widespread or internal, then oral antifungals may be prescribed first-line by your doctor.
The only tablet available to buy over the counter is fluconazole, used to treat genital thrush in both men and women. However, before starting this medication it’s important to check whether it’s suitable for you by discussing it with your doctor or pharmacist.
When considering using an over the counter antifungal treatment, it’s very important to make sure the treatment is suitable for you and that you don’t have any specific reasons to avoid the medication – if you’re unsure, speak to your pharmacist or doctor for advice.
In terms of side-effects, there are fewer side effects with topical treatments as only a small amount enters the body, with the most common side effect usually being mild irritation around the affected area of skin.
With tablets, the side effects can be more serious and so taking fungal tablets regularly requires regular monitoring such as blood tests to check your liver is working normally. Common side effects of systemic treatments include a loss of appetite, pain in your joints or muscles and an upset stomach.
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