Can You Use Boric Acid to Treat a Yeast Infection?

Itching, discharge, and pain down below — vaginal yeast infections are a common annoyance experienced by many people in the U.S. But for some, they can happen more frequently — even several times every year. These are recurrent yeast infections, and they can be an uncomfortable and frustrating experience.

While there are many over-the-counter (OTC) and prescription options for treatment, sometimes first-choice products aren’t enough. Boric acid, a century-old remedy, is often used when other treatments fail to provide relief when infections happen more frequently.

But how does boric acid stack up against other yeast infection treatments — does it really work? Read on to learn more about what the science behind it says.

What is a yeast infection?

A yeast infection happens when a yeast (fungus) that normally grows in your body, called Candida, starts multiplying and causing overgrowth. Vaginal yeast infections are very common — resulting in about 1.4 million outpatient visits every year. They can affect people assigned female at birth, non-binary, intersex, and certain transgender people, including transfeminine people who’ve undergone a vaginoplasty.

Certain factors can raise your risk of vaginal Candida overgrowth, including pregnancy, hormonal birth control, and antibiotics that change the environment where the yeast normally lives. When this happens, you may experience symptoms like itching, discomfort when urinating, and abnormal discharge. 

What treatment options are available for a yeast infection?

A topical or oral azole antifungal medication is typically the first-choice yeast infection treatment. Azole antifungals are medications that work by damaging the fungus’s outer layer, which prevents it from replicating. You can find them OTC or by prescription.

Since OTC options tend to be more convenient, people sometimes skip the provider’s office and turn to topical OTC antifungal treatments, like miconazole (Monistat), which is available as 1-, 3-, and 7-day regimens. Depending on the product, it may come as a cream, suppository, or combination of the two. 

Alternatively, your provider may prescribe a single oral fluconazole (Diflucan) tablet. It’s only one dose, so it’s convenient and less messy than most topical products. However, you’ll need to get a prescription, and you shouldn’t take it if you’re pregnant. If your yeast infection is severe, you may require a second tablet 3 days after the first dose.

Prescription creams are also available, including butoconazole (Gynazole-1) and terconazole (Terazol). However, they’re more expensive than other options, so they may not be the first choice.

Most recently, the FDA approved Brexafemme (ibrexafungerp), another oral prescription option for treating yeast infections. It belongs to a new medication class called triterpenoid antifungals, and it targets the fungus’s outer layer in a way that’s different from azole antifungals.

When do you need a prescription vs. OTC medication to treat a yeast infection?

Yeast infections typically fall into two categories — uncomplicated and complicated. People tend to self-treat uncomplicated yeast infections with OTC medications due to convenience. But it’s usually best to talk to your provider first, especially since yeast infections aren’t always accurately self-diagnosed.

But if it is a yeast infection and you’ve opted for OTC treatments, sometimes that’s not enough — especially if it ends up being a complicated infection. 

There are a few factors that may suggest you have a complicated yeast infection, including:

• Your symptoms are severe (e.g., redness and swelling)

• Your symptoms aren’t getting better with OTC treatments

• Your symptoms come back within 2 months

• You have a condition that weakens your immune system (like HIV)

• You’re pregnant

In this case, you’ll want to pay your provider a visit. They may want to pinpoint the yeast causing the infection, which is sometimes a different Candida strain that doesn’t respond as well to certain treatments. You may be prescribed a different antifungal medication for 1 to 2 weeks.

But if you have recurrent yeast infections (four or more per year) and other antifungal treatments aren’t working, your provider may have you try boric acid — more on this next.

What is boric acid?

Boric acid is a weak acid that occurs naturally in the environment. It’s also used in over 500 products in the U.S., ranging from pesticides to personal care products. It helps control acidity, as well as bacterial and fungal growth in some of these products — effects that can come in handy when you’re treating a yeast infection.

How does it treat yeast infections?

Although it isn’t entirely known how boric acid works for yeast infections, it seems to work against the fungus’s outer later — but in a way that’s different from azole antifungals. For this reason, it may work against certain Candida strains that have developed resistance against other treatments.

How is it dosed?

Boric acid is available OTC as vaginal capsules and suppositories. Your provider may prescribe compounded boric acid capsules or suppositories, which you’ll need to fill at a specialized pharmacy.

The typical boric acid course for recurrent yeast infections is 600 mg (capsule or suppository) inserted vaginally every day for 14 days. Side effects are typically mild and include redness, a burning sensation, and watery discharge.

Like oral fluconazole, it shouldn’t be used if you’re pregnant as it may cause harm to the unborn baby.

When can boric acid be used to treat a yeast infection?

If you have recurrent yeast infections, your provider may have you manage each occurrence as it happens with short-term oral or topical antifungals. 

Another option is maintenance therapy, where you’re taking oral fluconazole weekly for about 6 months. If that doesn’t help with your symptoms, they may have you try other topical azole antifungal medications. 

But if these treatments fail, boric acid may be recommended. In other words, it’s typically reserved for situations of antifungal resistance, infection with other Candida strains, or inadequate response to other treatments.

How does boric acid compare to other yeast infection medications?

As discussed, boric acid isn’t considered a first-choice treatment for vaginal yeast infections. If you have an uncomplicated yeast infection — which is most common — an oral or topical azole antifungal is preferred. Oral and topical products work just as well in this case, and they provide relief for 80% to 90% of people who complete treatment.

For recurrent yeast infections, maintenance therapy with weekly oral fluconazole for 6 months has been shown to prevent recurrence for most people during that time period. But after completing 6 months of treatment, 30% to 50% of people will experience a recurrence.

If all else fails, it has been suggested that boric acid may be an inexpensive alternative. However, there hasn’t been a lot of research looking at its effectiveness, and it’s not FDA-approved for yeast infections. 

A review of 14 studies — mostly case series and reports — showed cure rates ranging from 40% to 100%. The studies looked at boric acid compared to other antifungal treatments, as well as on its own. More research is needed, but your provider may have you give it a try if you’re having difficulty finding relief with other options.

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Written by:

Alyssa Billingsley, PharmD

Alyssa Billingsley, PharmD, is the director of pharmacy content for GoodRx. She has over a decade of experience as a pharmacist and has worked in clinical, academic, and administrative roles.

Reviewed by:

Christina Aungst, PharmD

Christina Aungst, PharmD, is a pharmacy editor for GoodRx. She began writing for GoodRx Health in 2019, transitioning from freelance writer to editor in 2021.

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