# Vulval Symptoms (Itching, Burning, Dryness)

- Category: acute
- Review status: reviewed (every claim checked against a document named on this page)
- Sources: Egyptian National Drug Formulary - antimicrobial-2023.pdf, Clotrimazole monograph, Indications and Dosing: Adult - vulvovaginal candidiasis (chapter PDF p400, printed p390) · Hildebrand JP, Carlson K, Kansagor AT. Vaginitis. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2026 Jan-. Last Update: January 19, 2025. Bookshelf ID: NBK470302, PMID: 29262024.
- Verified date: 2026-08

## Verified against

- Egyptian National Drug Formulary - antimicrobial-2023.pdf, Clotrimazole monograph, Indications and Dosing: Adult - vulvovaginal candidiasis (chapter PDF p400, printed p390)
- Hildebrand JP, Carlson K, Kansagor AT. Vaginitis. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2026 Jan-. Last Update: January 19, 2025. Bookshelf ID: NBK470302, PMID: 29262024.

## Treatment metadata

- Clotrimazole — vaginal

## Complete treatment card

```text
VULVAL SYMPTOMS (ITCHING, BURNING, DRYNESS)
Sources: Egyptian National Drug Formulary - antimicrobial-2023.pdf, Clotrimazole monograph,
         Indications and Dosing: Adult - vulvovaginal candidiasis (chapter PDF p400, printed p390) ·
         Hildebrand JP, Carlson K, Kansagor AT. Vaginitis. In: StatPearls [Internet]. Treasure
         Island (FL): StatPearls Publishing; 2026 Jan-. Last Update: January 19, 2025. Bookshelf ID:
         NBK470302, PMID: 29262024.
Review status: REVIEWED against 2 sources listed above  (2026-08)

1. CLOTRIMAZOLE                                           [1st line]
   Adult    Insert 1 applicatorful of 1% clotrimazole vaginal cream at bedtime for 7 nights (or 2%
            cream for 3 nights), and apply the same cream externally to the vulva twice daily for up
            to 7 days for the itching and irritation. The external cream is an add-on to the vaginal
            course, not a treatment on its own. x 7 nights intravaginally (3 nights if using 2%
            cream); external application up to 7 days
   Peds     Listed only for girls 12 years and older and adolescents, and only as vaginal cream: 1%
            at bedtime for 7 nights (some need 14) or 2% for 3 nights, each with the same twice-
            daily external application for up to 7 days. The monograph carries nothing for
            prepubertal vulval symptoms.
   Source   Egyptian National Drug Formulary - antimicrobial-2023.pdf, Clotrimazole monograph,
            Indications and Dosing: Adult - vulvovaginal candidiasis (chapter PDF p400, printed
            p390)
   Why      The formulary explicitly lists 'relief of associated external vulvar itching and
            irritation' as an indication for clotrimazole vaginal cream, and this external-
            application line is the most specific match for isolated vulval symptoms (as opposed to
            internal vaginal discharge).
   Caution  No tampons, douches, spermicides or intercourse during treatment.
            Avoid with vaginal progesterone — vaginal antifungals may reduce its effect (interaction
            risk X).
            Reassess if symptoms do not improve within 3 days or last more than 7 days, rather than
            repeating the course.
            External cream alone will not clear the vaginal infection; give the intravaginal course
            with it.
            Covers candidal vulvitis only — the label is vaginal yeast infection and the external
            itching associated with it, not vulval dryness or non-candidal causes.
            A persistent lump, ulcer, or skin change on the vulva needs referral to exclude vulval
            cancer - not treated with an antifungal.
            If symptoms do not respond to a standard course, re-evaluate for dermatitis, lichen
            sclerosus, or atrophy rather than repeating antifungal treatment.
            Local irritation or hypersensitivity can occasionally occur with topical azoles.
   Egypt    LOCASTEN 2% VAGINAL CREAM 20 GM  ALEXANDRIA          29.00 EGP
            CANDISTAN 2% VAGINAL CREAM 20 GM ARAB DRUG COM...    40.00 EGP
            CANESTEN 3  2% VAGINAL CREAM 20 GM MEMPHIS > BAYER HEALTHCARE                  51.00 EGP
            CANDISTAN 200 MG  3 VAG.TABS.    ARAB DRUG COM...     8.50 EGP
            CANDISTAN 100 MG  6 VAG.TABS.    ARAB DRUG COM...     9.00 EGP
            LOCASTEN 1 500 MG 1 VAG. TAB.    ALEXANDRIA          10.25 EGP
            KREMA-ROSA 100MG 6 VAG.TABS.     EIPICO              10.50 EGP
            LOCASTEN 100 MG 6 VAG. TABS.     ALEXANDRIA          10.50 EGP

Prices are indicative (dataset snapshot 2026-06); verify with the pharmacy.
```

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Dawaa Reference is a reference for prescribers, not a medical device, and does not replace clinical judgement.

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