Boric acid safe for chronic yeast infections?

Dear Reader,

Considering how common yeast infections are, you’d think the yeast that could be done is coming up with an easy, reliable way to get rid of them. Luckily, there are several potential options for treatment. The first step is to confirm that your symptoms are actually due to a vaginal yeast infection (and not some other issue with similar symptoms, such as bacterial vaginosis or some sexually transmitted infections), which will likely involve a visit to a health care provider, such as a gynecologist, primary care provider, or sexual health clinic. After confirming that yeast is the true culprit, there are a variety of treatment options available to you, including over-the-counter remedies and prescription antifungal treatments. One such treatment option is boric acid suppositories, which may be especially helpful for yeast infections that are recurrent or resistant to other antifungal treatments. Recurrent infections are those that can be treated temporarily but come back (versus chronic infections, which persist for long periods at a time). Boric acid is widely considered to be safe when used properly, although like any medication, there are some possible exceptions and potential side effects.

Boric acid is a chemical that acts as both an antifungal and antiviral agent and is effective against a broad swath of vaginal yeast strains. Whereas some strains of yeast (such as Candida albicans) can be easily treated by a variety of antifungal medications, other strains (such as Candida glabrata) are more resistant to a whole class of common antifungal drugs called azoles, which include fluconazole, buconazole, and miconazole. Recurrent yeast infections are more likely to involve these azole-resistant yeast strains, and that’s where boric acid comes in. Boric acid vaginal suppositories are available over-the-counter (without a prescription); these suppositories are essentially gelatin caps filled with boric acid that are inserted into the vagina. Usually, they're used once per night for a week, but there may be different instructions listed on the package depending on the manufacturer. Boric acid is also relatively affordable in comparison to some other common antifungal treatments, which is always a bonus!

Though this treatment option may be suitable for many people who haven't had success with more common yeast infection treatment options (such as azole medications), there are a few exceptions. Boric acid suppositories aren't safe to take orally or when used by children or pregnant people. Additionally, there’s limited research into the risks of long-term use of boric acid, so it’s not recommended to use these suppositories for long periods of time or too many times over the course of a year. Instead, if symptoms don’t improve after a few days or they return after treatment, you may consider speaking with a health care provider to identify other potential treatment options. Mild to moderate side effects are also possible, including skin irritation or a burning sensation in the vagina. Before starting treatment, it’s recommended to speak with a health care provider, who can perform testing to confirm whether symptoms are caused by a yeast infection (or something else entirely) and provide guidance on the best treatment method for you. For more information about yeast infections and treatment options, you may want to check the related Q&As and the Go Ask Alice! General Health archives.