What is Mikostat cream?
Mikostat cream, often available in a 15 gm tube, is a topical antifungal medication used to treat certain fungal infections of the skin. While 'Mikostat' is a brand name, its active ingredient is Nystatin, a polyene antifungal antibiotic. Nystatin works by disrupting the cell membrane of susceptible fungi, preventing them from growing and spreading. It is specifically effective against Candida species, a type of yeast that can cause skin infections.
The role of Nystatin in treating fungal infections
Nystatin's primary mode of action is to bind to ergosterol, a vital component of the fungal cell membrane. This binding alters the membrane's structure, causing holes to form and leading to the leakage of essential intracellular components. This process is both fungistatic (inhibits growth) and fungicidal (kills the fungus). The medication is not absorbed from intact skin, meaning its action is localized to the site of application.
What Mikostat cream is used for
Mikostat cream is primarily prescribed for the treatment of cutaneous or mucocutaneous infections caused by Candida species, including Candida albicans. Common conditions it can treat include:
- Cutaneous Candidiasis: A yeast infection that appears on the skin, often in moist, warm areas like the armpits, groin, or between fingers and toes.
- Candidal Diaper Dermatitis: This is a specific type of diaper rash in infants and babies caused by a Candida yeast infection.
- Intertrigo: A red, inflamed rash that forms in skin folds, which can be caused or complicated by a Candida infection.
- Oral Candidiasis (Thrush): Although Mikostat cream is for external use only, other Nystatin formulations, like oral suspension, are used to treat oral thrush.
- Vaginal and Gastrointestinal Candidiasis: Mikostat cream itself is not indicated for vaginal or gastrointestinal infections, but it can be used as a complementary treatment in some cases to reduce intestinal candidiasis, thereby lowering the risk of reinfection in skin and vaginal areas.
How to use Mikostat cream
Proper application is crucial for the successful treatment of fungal infections. Following these steps helps ensure efficacy and prevents the spread of the infection:
- Prepare the area: Wash your hands thoroughly before and after application, even if wearing gloves. Clean the affected skin area with a mild soap and water, then pat it completely dry. Fungal infections thrive in moist environments, so keeping the area dry is essential.
- Apply the cream: Apply a thin film of the cream liberally to the affected area and the skin immediately surrounding it. Gently massage it into the skin until it is absorbed. Avoid using an excessive amount, which can cause pilling.
- Frequency and duration: The frequency and duration of application should be as prescribed by your doctor. Continue treatment for the full prescribed length of time, even if symptoms improve, to ensure the infection is completely cleared. The duration can vary depending on the severity.
- Clothing and covering: Wear loose-fitting, cotton clothing or underwear to promote air circulation in the affected area. Avoid using occlusive bandages or tight-fitting synthetic clothing unless your doctor advises otherwise, as this can trap moisture.
Potential side effects and precautions
Mikostat cream is generally well-tolerated, but some side effects may occur, typically at the application site.
Common side effects (less than 0.1% of patients):
- Skin irritation or redness
- Burning
- Itching
- Rash
- Eczema
- Pain on application
Precautions:
- Allergies: Do not use if you have a history of hypersensitivity to nystatin or any of the cream's inactive ingredients.
- For external use only: This medication is not for oral, systemic, intravaginal, or ophthalmic use. If ingested, contact a poison control center.
- Pregnancy and breastfeeding: Inform your doctor if you are pregnant, planning to become pregnant, or breastfeeding before using this medication. It is unknown whether topical nystatin is excreted in breast milk.
- Persistent symptoms: If irritation or sensitization develops, or if the infection does not improve, discontinue treatment and consult a healthcare provider.
Comparison of Mikostat (Nystatin) with other topical antifungals
| Feature | Mikostat (Nystatin) | Azole-based creams (e.g., Miconazole, Clotrimazole) | Terbinafine (Lamisil) | Ketoconazole (Nizoral) |
|---|---|---|---|---|
| Active Ingredient | Nystatin | Miconazole, Clotrimazole | Terbinafine | Ketoconazole |
| Mechanism of Action | Disrupts fungal cell membrane by binding to ergosterol. | Inhibits an enzyme (C-14 demethylase) to prevent ergosterol synthesis. | Inhibits squalene epoxidase, preventing ergosterol synthesis. | Inhibits ergosterol synthesis. |
| Primary Use | Primarily targets Candida (yeast) infections of the skin. | Broad-spectrum; treats yeast infections, athlete's foot, jock itch, and ringworm. | Treats athlete's foot, jock itch, and ringworm. Ineffective against Candida. | Broad-spectrum; treats yeast infections, seborrheic dermatitis, and tinea infections. |
| Duration of Treatment | Varies based on severity and doctor's orders. | Varies based on condition. | Varies based on condition. | Varies based on condition. |
| Availability | Prescription only. | Some are available over-the-counter (OTC) and by prescription. | Some are available OTC. | Some are available OTC, others are prescription. |
Conclusion
Mikostat cream, leveraging the antifungal properties of Nystatin, is an effective and targeted treatment for cutaneous yeast infections caused by Candida. It provides localized action with minimal systemic absorption, making it a safe option for external fungal skin infections. However, as a prescription medication, its use should always be guided by a healthcare professional, who can provide an accurate diagnosis and ensure the cream is appropriate for the specific type of infection. Consistent and proper application, as directed by the doctor, is key to clearing the infection and preventing recurrence. It is important to note that Nystatin is not effective against all fungal infections, such as ringworm, and other antifungal medications may be more suitable depending on the diagnosis. Always complete the full course of treatment, even if symptoms resolve early, to avoid the infection returning.
For more detailed product information and prescribing details, refer to the Nystatin Cream USP Label on DailyMed.
