Intravaginal boric acid is a mainstay of treatment for chronic candidiasis.

I have used intravaginal boric acid to treat chronic candidiasis for the past 33 years and have found it to be highly effective. I tell my patients to purchase empty "00" size gelatin capsules at a health food store and to buy boric acid powder from a pharmacy. Patients can then fill the capsules at a cost of only a few cents per capsule.

I generally prescribe intravaginal boric acid thrice weekly for 4 to 6 months to prevent reinfection. It also may be used nightly over 5 nights to treat current infection.

Jonathan Ralph, MD

Fort Lauderdale, Florida

Dr. Barbieri responds

I thank Dr. Firestone for his recommendation to use a probiotic to treat chronic BE Dr. Swor and Dr. Tolley recommend the use of topical gentian violet for chronic Candida vaginitis. Gentian violet inhibits the germination and growth of Candida organisms and is a good addition to our armamentarium. (1,2)

I also appreciate the treatment plan recommended by Dr. Ralph for chronic candidiasis: boric acid capsules placed in the vagina three times weekly for 4 to 6 months. Vaginal boric acid may cause a sensation of vaginal burning, watery discharge, and vaginal erythema. (3)

References

(1.) Traboulsi RS, Mukherjee PK, Chandra J, Salata RA, Jurevic R, Ghannoum MA. Gentian violet exhibits activity against biofilms formed by oral Candida isolates obtained from HIV-infected patients. AntimicrobAgents Chemother. 2011;55(6):3043-3045.

(2.) Kondo S, Tabe Y, Yamada T, Misawa S, Oguri T, Ohsaka A, Miida T. Comparison of anfifungal activities of gentian violet and povidine-iodine against clinical isolates of Candida species and other yeasts: a framework to establish topical disinfectant activities. Mycopathologia. 2012;173(1):21-25.

(3.) Iavazzo C, Gkegkes ID, Zarkada IM, Falagas ME. Boric acid for recurrent vulvovaginal candidiasis: the clinical evidence. J Women's Health. 2011;20(8):1245-1255.