What Is Nystatin Cream Used For?
Dr. Gerardo Sison
None of us like to think about it, but fungus is everywhere, and the potential for fungal infections is lurking around us constantly. When you think of fungal infections, you probably think of things like athlete’s foot or jock itch, both of which are common fungal infections that are uncomfortable and inconvenient. Fungal infections can be more than uncomfortable, however - they can be deadly. What may start as a simple yeast infection of the skin, known as candidiasis, can become a severe invasive infection within the bloodstream. Yeast infections are the cause of more than 3.6 million U.S. healthcare visits each year, resulting in an estimated 3 billion dollars in direct medical costs, according to the Centers for Disease Control and Prevention (CDC). Some species of fungus are becoming increasingly resistant to antifungal treatment because patients do not complete their recommended course of treatment, allowing the fungus to adapt and change to improve its immunity to the medication. However, if caught early, most fungal infections of the skin can be treated with topical medications like nystatin cream and other similar drugs. If you find yourself wondering what is nystatin cream used for, you may be surprised by the applications it has to a very common problem affecting infants and adults alike.
Nystatin cream is a topical medication that belongs to a class of drugs called antifungals. Antifungal medications are used to kill a fungus that may be infecting the skin and to prevent the growth of the fungus. Nystatin is sold under several brand names, including Mycostatin, Nystex, and Pediaderm AF. It can be used on its own, but it is often combined with corticosteroid creams that are used to treat inflammation. When sold as nystatin topical cream, it is for use as an antifungal medication only. Combination medications, such as nystatin and triamcinolone, are sold under brand names like Mycolog-II, Mytrex, and Quenalog.
Nystatin cream is an antifungal medication that is used to treat certain fungal infections, including Candida (Monilia), or yeast infections. It can also be used to treat diaper rash in infants. Fungal infections, called mycosis, are caused by an infestation of fungus on the skin. Fungi can be found everywhere in our environment, including on household surfaces, in dirt, on plants, and on the skin. Nystatin cream treats a type of fungal infection called cutaneous candidiasis, which is caused by yeast. Yeast infections aren’t contagious, but they can be uncomfortable. They are most commonly found in warm areas of the body that are creased and are regularly moist, such as the armpits or groin. People who are obese and have folds of skin that are difficult to clean may experience yeast infections within the folds. People with diabetes and those taking antibiotics are also considered to be at a higher risk of yeast infection. Signs of a yeast infection on the skin include:
- Pimple-like bumps
- Oozing patches
Yeast infections can also occur in the nail beds, in the mouth (called thrush), or in the vagina. However, nystatin cream is only used for the treatment of yeast infections on the skin. In some cases, fungal infections can become severe and become more serious. You should seek medical attention if you notice any of the following symptoms in addition to those listed above:
- Flu-like symptoms
- Body aches and pains
- Night sweats
- Respiratory issues
- Shortness of breath
- Symptoms of meningitis
- Severe headache
- Stiff neck
- Light sensitivity
Because we are always surrounded by fungus, anyone can get a fungal infection at any time. However, fungal infections are most common in people with weakened immune systems or certain other characteristics. People considered at increased risk of a fungal infection include:
- People who are currently hospitalized
- Patients living with HIV or AIDS
- Transplant recipients
- People taking immunosuppressant medications
- People with compromised immune systems
- Patients undergoing treatment for cancer
- People suffering from obesity
In addition to skin infections, fungi can also cause other types of illnesses, including asthma or allergies, lung infections, infections of the nail bed, bloodstream infections, meningitis, and more. However, most fungal infections are minor in their early stages and can be treated effectively if caught early.
Antifungal medications like nystatin cream work by directly attacking and killing fungal cells and by preventing fungal cells from growing. In order to kill the fungal cells and stop the growth of new cells, medications like nystatin cream specifically attempt to destroy cellular structures and functions that are critical to fungal cells but not to human cells. This way, fungal medications do not cause additional damage to your skin or other parts of the body. Fungal medications commonly target the cell membrane and cell wall of the fungus, both of which are responsible for the protection of the cell. The cell membrane and cell wall hold the fungal cell together, so when one or both is destroyed, the fungal cell dies and cannot reproduce. Nystatin cream belongs to a specific subclass of antifungal medications called polyenes, which work by attacking the cell wall of the fungus to make it more porous. Over time, the cells of the fungus burst and die.
Because nystatin cream is produced by a variety of manufacturers in both brand-name and generic forms and in a variety of strengths, it is relatively inexpensive. A 15-gram tube of nystatin cream costs anywhere from 7 to 8 dollars, while a 30-gram tube would cost approximately 13 dollars. Extremely large quantities of the medication at a very high strength can be expensive, but the medication is generally considered highly affordable. It is covered by many insurance plans. Patients who have difficulty affording their prescriptions of nystatin cream may receive additional savings by using a pharmacy discount card like USA Rx, which offers savings on all brand name and generic FDA-approved medications at more than 60,000 participating pharmacies. USA Rx is not insurance, and no personal information or medical history is needed besides your name and contact information. Participants in the USA Rx pharmacy discount program pay a negotiated rate that USA Rx arranges which each drug manufacturer in order to offer the maximum possible discount without complicated paperwork, copays, or coverage limits.
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Nystatin cream is generally well tolerated by most patients, so there are many benefits associated with its use:
- Effective at treating skin yeast infections
- Simple to apply
- Inexpensive and accessible for most patients
- Available in generic form
- Relatively few side effects
- It can be used safely on children and infants for the treatment of diaper rash.
Although there are many benefits associated with nystatin, as listed above, taking the medication also poses some risks. Risks associated with nystatin include:
- The medication should not be applied anywhere besides the skin. Patients should avoid getting the medication in the eyes or mouth.
- Nystatin cream can cause an allergic reaction. Patients should make their doctors aware of any known allergies.
- Patients should avoid wearing clothing that is tight, made of synthetic materials, or doesn’t allow for proper air circulation. Patients should wear loose-fitting clothing with natural fibers until the infection is healed.
- The medication should be taken for the full length of the prescription. Symptoms may improve prior to the end of the prescription, but patients should continue to use the cream as directed. Failure to do so could result in a return of the infection.
- When used on children for diaper rash, children should not wear tight-fitting diapers or plastic pants and make sure to keep it out of the reach of children.
- If used for longer than directed, nystatin cream may begin to cause thinning of the skin and stretch marks on areas with thin skin, such as the face, armpits, and groin. Nystatin cream should be used only as directed.
What Dose of Nystatin Cream Should I Use?
The dosage of nystatin cream recommended for use will vary depending on the patient and the severity of the infection. The amount that is prescribed to you will also vary depending on the strength of nystatin cream that is prescribed by your doctor. In general, nystatin cream should be applied in a quantity that covers the affected area two to four times per day, or as directed by your doctor. No airtight bandages should be used to cover the treated area, but a sterile gauze dressing or bandage is ok. The average length of treatment is between two to eight weeks and is determined by the severity and type of infection. It is important that patients do not skip doses of their medication and wash their hands before and after use in order to prevent further fungal spread and increased resistance of the fungus to medication. Approximately seven percent of bloodstream infections caused by yeast are resistant to antifungals, and one in four patients hospitalized with a bloodstream yeast infection dies of the infection. Therefore, it is absolutely critical that patients apply their medication as directed, do not skip any doses, and continue their treatment until directed to stop by their doctor.
Very few side effects are associated with nystatin cream, and the medication is well tolerated by most people. Skin irritation is the most common possible side effect associated with nystatin cream, and it usually does not require medical attention. Patients should report adverse effects like skin irritation to their doctor or healthcare professional if it continues, gets worse, or becomes bothersome. Some people may experience mild itching. Allergic reactions to nystatin cream are also possible; signs of allergic reactions include hives, difficulty breathing, and swelling of the face, lips, tongue, or throat. Patients who experience severe burning, itching, rash, pain, or other serious side effects on the application site should discontinue the use of nystatin cream immediately and contact their healthcare professional.
Can Women Who Are Pregnant or Breastfeeding Use Nystatin Cream?
Nystatin cream is currently classified by the Food and Drug Administration as a Category C medication, meaning that it is not known whether the medication will harm an unborn baby. Because the effects of nystatin cream on unborn babies are unknown, it is important that women who are pregnant or planning to become pregnant speak with their doctors before applying nystatin cream. It is also unknown whether nystatin cream passes through breast milk and could affect a nursing infant. Women considering using nystatin cream should talk to their doctors before breastfeeding and using the cream.
Do Any Other Drugs Interact With Nystatin Cream?
Nystatin cream carries a low risk of interaction with other drugs taken orally or injected. However, it is important that you give your doctor a comprehensive list of all medications that you are currently taking, including prescription drugs, over the counter medications, vitamins, supplements, and herbal products. You should not start a new medication without checking with your doctor first.
How Do I Know If Nystatin Cream Is Right for Me?
Nystatin cream is generally well-tolerated, but it is not right for everyone, including those patients who are allergic to the medication or its ingredients. Nystatin cream is capable of treating fungal skin infections caused by candida (yeast), including diaper rash. You should get medical advice from your healthcare provider about any prescription drugs, over-the-counter medications, supplements, or herbs that you are taking prior to using nystatin cream. No studies have been conducted regarding the impacts of nystatin cream on pregnant or nursing mothers and their children, so patients should speak to their doctors if they are pregnant, planning to become pregnant, or nursing prior to using nystatin cream. Nystatin cream must be applied multiple times per day consistently, and patients should not skip any doses or end their treatment early. Doing so may cause the fungal infection to get worse, so patients should not use nystatin cream if they cannot commit to applying it appropriately.