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. More complex treatments can involve treating with tablets, creams or other methods. Although antifungals are all one topic, they can be subcategorized into different types of antifungals – and we will go through this in more detail below.
The most used type of antifungals are the 'azole' group of antifungals. They work by killing the fungus by disrupting the production of important components needed for its cell membrane. They are the active ingredients in all over the counter medication used to treat self-help fungal conditions. The second type of antifungals are 'polyenes'. Polyenes work by killing fungal cells by making the fungal cell wall more prone to rupturing. These 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. Also, 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, they will need to be treated with systemic treatments which are prescription only. 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 are not helping to clear up the infection, or a tablet is 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. This is used for the treatment of genital thrush in both men and women, however, before starting the medication it is important to check whether it is suitable for you by discussing it with your doctor or pharmacist.
When treating over the counter, it is very important to ensure the treatment method is suitable for yourself and that you do not have any specific reasons to avoid the medication. If you are 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, therefore the most common side effects involve irritation around the affected area. With tablets, the side effects are more serious and therefore taking fungal tablets regularly requires regular monitoring such as checking your liver function via blood tests. Common side effects of systemic treatments include a smaller appetite than usual, pain in your joints or muscles and an upset stomach.