There are two types of thrush creams, internal and external. The internal cream treats the infection and the external soothes the itching.

The internal cream, containing clotrimazole 10%, comes as a single dose in a pre-filled applicator that is inserted as high as possible into the vagina. It is available as an internal which is often preferred by women who don't like to use pessaries. It is recommended that the internal cream is used at night and should not be used during menstruation. 

The external cream, containing clotrimazole, should be used in combination with one of the internal treatments. It should be applied to the vulva and surrounding area to relieve itching and soreness.  A woman is recommended to apply a thin layer to the affected area, and rub in gently, two to three times a day until symptoms of the infection disappear. Customers whose symptoms do not improve within seven days of treating the internal infection should be referred to the pharmacist. 

The external cream can also be applied to the penis of a sexual partner to prevent reinfection of the woman. The cream should be applied two or three times a day for a maximum of fourteen days. This treatment can be used even if the male partner does not have any symptoms of thrush.

Pessaries and creams are effective products and have very few side effects but there are a number of issues to be aware of, they:

• Can be awkward to use and messy.
• Are best used at night which can restrict their use.
• Are not always convenient, for example when at work.
• Can sometimes cause mild irritation such as a burning sensation, itchiness and slight redness.
• Can leave a whitish chalky stain on underwear which does wash out.
• Can damage latex based contraceptives such as condoms and diaphragms which means other forms of contraceptives should be used during treatment or the customer advised to abstain from sexual intercourse.

Combination treatments

The treatments outlined above (with the exception of the external cream) can be used singularly, but it is recommended to use them in combination with an external cream as it is more effective at soothing and clearing infection.