Brief Answer:
You may have persistent Candida, but there are other possibilities

Detailed Answer:
Hello, and I hope I can help you today.

There are many possible causes of burning and itching in the vagina. To make an accurate diagnosis you really need a physical examination by a doctor but I want to go over the potential causes for you and the tests that should be done in order to determine the right treatment for you.

For one, it is important that a physician know when all these symptoms started and whether or not you have ever had these symptoms before. If you never had this before you took the antibiotics, then it is most likely from some imbalance in the vagina rather than a skin problem. It is also relevant if you still menstruate. Women who are perimenopausal or in menopause can have skin changes in the vagina that can cause burning and itching without a real infection. This is caused by a condition called atrophy which is a thinning of the skin and is treated with estrogen cream.

Another possibility is that you have an allergy to something you are applying to or using around your vagina. You should use only fragrance-free soap for your laundry and wear cotton underwear as much as possible for the vagina to breathe. Wash only with mild soap, and try not to use panty liners or pads as much as possible because some women are allergic to some pads. There is a brand called Always that many women are allergic to causing them to itch and sting.

Thirdly, you may have another type of infection you have not yet been treated for. Bacterial infections of the vaginally typically cause foul smelling discharge but can also cause burning and itching. I know you took an antifungal pill already, but it is also possible if you had an internal candida infection it may need more than one pill to treat it completely. Also I do not know your sexual history, but certain STDs especially Herpes can also cause burning and an urge to urinate.

Neither of the creams you are already using seem to have helped completely, so I would advise you to see a GYN doctor for an examination so you can hopefully finally get a diagnosis and the correct treatment.
If I were the one treating you- I would first take a full history and then do a pelvic exam, where I could look at the area, take cultures from your vagina for yeast, bacteria and STD's and test the pH of your vagina to help narrow down the cause. I would look at your discharge under a microscope to see if an immediate diagnosis can be made. A skin biopsy is a last resort that can pinpoint the exact problem if none of the cultures show anything. You also should have your urine tested to make sure there is no infection there as well.

So for now, the creams you are using are not harmful and if they make you feel better continue their use, but I advise you to see a GYN doctor to finally get at the root of the problem. You can try taking another antifungal pill also if it has been more than a week since you tried the first one- sometimes it takes a couple of treatments if you had a very bad case of candida to cure it completely.
Your diet, unless you have diabetes, will not affect your propensity for candida infections.

So in summary, I would try one more antifungal pill treatment and if you do not see improvement in a week I would see a GYN doctor. The most common reason a treatment doesn't work is that you have the wrong diagnosis. There are many causes of vaginal itching and burning that are not yeast. A GYN doctor is the best qualified person to make a diagnosis for you, and it is really not possible to know for sure what is wrong without seeing the area and doing some tests to give you an accurate diagnosis.

I hope the information I gave you was helpful and that, if retreating yourself for candida does not work, that you see a physican so you can finally feel better.

If you need me to clarify anything for you, please do not hesitate to contact me further or if you have any further questions.

Best wishes, Dr. Brown.

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