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complementary and alternative medicine, evidence based medicine, vaginal discharge, yeast

How to use gentian violet for a vaginal yeast infection

First of all, it is important to understand that there are no studies telling us exactly how to use gentian violet in the vagina. The information below is extracted from a variety of sources and should be considered a “best guess” based on bench research, some clinical experience, anecdotal reports from patients, an assorted collection of posts on other sites, some papers from the 1950’s and 60’s, and alternative medicine reviews that don’t say how people specifically used gentian violet just that they used it. This is level 5 evidence (the lowest quality) and thus has a grade D recommendation. Caveat emptor.

So why this post as I’m always spouting on about evidence-based medicine? Well, it’s not that gentian violet doesn’t kill yeast, studies tell us that it is fungicidal. It’s just we don’t really know the best concentration, method of application, and duration or use or data on long-term implications of use for the vagina. It’s used effectively in the mouth for HIV patients it’s probably safe for the vagina. However, I recognize women are looking for other options and in addition I’ve been looking into gentian violet for biofilms (I will post on that soon, biofilms may play a role in recurrent yeast and it’s really fascinating stuff). Given I know the relevant studies, am a vulvovaginal expert, and have a fellowship in infectious diseases I felt ideally suited to combine what the best that the literature, common sense, and clinical experience have to offer.

What is gentian violet? It is a coal-tar derivative. It takes chemistry and some nasty chemicals to get from coal to coal-tar and then from coal-tar to gentian violet (the formula is found in textbooks on industrial chemistry). While gentian violet technically starts out as coal, which is natural, whether it’s a natural product is all in how you define “natural” (i.e. marketing).

Concentrations of gentian violet greater than 1% should not be used as this can be very irritating, especially to the delicate tissues of the vagina. Some of the older studies painted the vaginal walls in the office with 1% gentian violet, though how often I just don’t know as these studies are from the 1950’s and I can’t retrieve them (the limitations of 1950’s microbiology and the ethics of pre-IRB studies notwithstanding). I have used 1% in the office, Recent studies with oral use for thrush find that 0.5% is effective and one small study found that a concentration of 0.1% (and even lower) was very effective at killing yeast in the mouth and caused less staining. Unfortunately, we don’t have studies to tell us the optimal concentration for vaginal use, but certainly it suggests that diluting the gentian violet can be considered to reduce irritation and mess (how dilute you can go is unknown, but for those who are chemistry-minded trying a lower dose might be appealing. If you do go lower, please post a reply below).

Gentian violet is very messy. It will stain everything. You should use gloves when applying it and the best way to get it into the vagina at home is with a tampon (instructions below). It will also stain your vulvar skin and even after the tampon is removed you will have a purple discharge that can stain, so wearing a pad at all times and underwear that you don’t care about. Use dark towels to cover the floor when you insert the tampon (or squat very carefully over the toilet). It is not possible to stress enough how messy this is and how much it stains. You can consider putting Vaseline on your labia to prevent staining on your vulva.

You should not be sexually active while using gentian violet. Intercourse can cause small breaks in the skin and when this happens the gentian violet could potentially leave a permanent tattoo. Also, gentian violet will stain your partner and no one wants a purple penis, fingers, or lips.

The tampon should be left in for 3 to 4 hours and then removed. The optimal duration for home use has not been defined; some people think 5 days is enough and others think up to 12 days is needed. Some people say twice a day (with oral yeast in HIV patients twice a day is recommended, but that’s the mouth and HIV patients, so not a fair comparison). If you have any irritation using gentian violet you should stop using it and be seen by your doctor.

What you need:

  • Disposable gloves
  • Gentian violet 1%
  • A disposable Tupperware type plastic container for mixing the gentian violet and soaking the tampon
  • Tampons with a plastic applicator (a cardboard applicator will fall apart in the liquid)
  • A tablespoon (and possibly teaspoon) that you won’t mind throwing away
  • Dark towels
  • Vaseline to coat your skin (if you choose)
  • Pads
  • Underwear that you won’t mind throwing away
  • Plastic baggies (for throwing away the tampon applicator, you don’t want to risk stains as you chuck the tampon in the trash, but obviously you can avoid this step if you like)

 

Step One: Wash your hands. Apply Vaseline to protect the skin of your vulva if you decide on that option. Have your pad secure in the underwear that you are going to put on and close at hand. Wash your hands again and dry them well. Put on the disposable gloves. (you can also apply the Vaseline while the tampon is soaking up the gentian violet if mixing up the stuff with your bottoms off bothers you and you think you can be quick about it).

Step Two: Add one tablespoon of gentian violet 1% to the Tupperware container. If you plan on diluting it add another tablespoon of water and you will have a 0.5% solution (based on the oral studies for thrush 0.5% is probably fine and likely to be less irritating). You don’t need much liquid. If you want to make a 0.1% solution use one teaspoon of gentian violet and three tablespoons of water.

Step Three: Take the tampon out of the wrapper and put the tip in the gentian violet. The liquid will soak up into the tampon through the opening at the tip. Let it soak about ¾ of the way up. This will not take very long (a few minutes at most).

Step Four: Insert the tampon as you normally would and put the applicator in the baggie to throw away. Remove the tampon after 3-4 hours and discard, remove sooner if you have irritation.

Repeat this for 5 to 12 days depending on your symptoms. Starting at once a day seems reasonable.

If you fail this or any other treatment for yeast you should get a yeast (mycology) culture before retreating. Many women and their health care providers incorrectly diagnose chronic yeast based on symptoms or the and what they see (or think they see) under the microscope. A mycology culture is the gold standard. You don’t want to use any treatment repeatedly for a problem that you may not have.

THIS POST IS NOT DIRECT MEDICAL ADVICE.

 

 

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Discussion

20 thoughts on “How to use gentian violet for a vaginal yeast infection

  1. It seems like a lot of trouble to go through just to avoid Monistat or whatever!

    Very interesting stuff, though.

    Posted by Anna | October 17, 2013, 8:44 pm
  2. I remember seeing it used in the 1970’s for stubborn trichomonas infections too. One painting seemed to do it.

    Posted by lancelotgobbo | October 18, 2013, 5:06 am
  3. I usually mix 1 tbsp into a 2 liter douche and use it while I’m in the shower or bath. 2 times a day (morning and night) for 3 – 7 days, usually that gets rid of anything that’s itching, if I’m unbalanced or irritated.

    Loads of pediatricians recommended it for oral thrush in babies, if it’s safe enough for my newborn’s mouth undiluted, I think my lady bits will be fine.

    Posted by Oubli | October 18, 2013, 12:12 pm
  4. Huh, wow. I’ve never used Gentian Violet, but based on the sorts of people who write about it, I always assumed it was some sort of plant extract. There’s a family of plants called Gentians.

    Posted by Miriam | October 18, 2013, 3:57 pm
    • It’s named Gentian Violet because it is supposed to be the color of the plant. It is by no means a plant based product.

      Posted by Dr. Jen Gunter | October 18, 2013, 5:55 pm
      • I am so amused by this. Especially because of how people tout it as a ‘natural’ remedy. I. Yep.

        That said, I am very curious about things that might help recurrent yi. They’re horrible.

        Posted by whatpalebluedot | October 19, 2013, 1:33 pm
  5. A midwife I trained under had used this method before OTC miconazole was available for some ladies, and would retreat them every 3 days for about a week, sometimes less if one dose did the trick.

    I used gentian violet on my daughter’s very stubborn thrush when she was an infant after many unsuccessful rounds of nystatin. Wish I had used it sooner, but it’s hard to find.

    Posted by Jamie Bourgeois | October 18, 2013, 5:52 pm
  6. The gentian violet I found at drugstore.com says it’s 9% alcohol. Is that the stuff I should be using? Wouldn’t it sting and or burn my vaginal tissue with that much alcohol?

    Posted by Tracy Howell | October 18, 2013, 8:34 pm
    • Mine has 10% alcohol in it as a preservative. I’ve used it on my own mouth thrush and it didn’t burn at all, I’ve never used it undiluted on vaginal tissue because of the staining power it has but I’d imagine if it doesn’t burn my or my newborns mouth (she never reacted to it) then your vagina will be fine but if it still freaks you out see my previous comment on how I dilute it for vaginal use.

      Posted by Oubli | October 22, 2013, 2:09 pm
    • Wow almost jumped through the roof.. But its my last resort.. Burns like hell.. All purple now..

      Posted by purple plum | August 3, 2014, 9:13 am
  7. Thanks for this blog. My dad, a retired Ob/Gyn, said this was their standard back in the day- the 1960’s- and I use it as a last resort in my Ob/Gyn practice. Recently I had a very stubborn athlete’s foot- the kind I wanted to cut of my foot- and stole some from my office. Yes I ruined a pair of shoes but it worked like a dream!

    Posted by lee mccain (@leemccainmd) | October 21, 2013, 5:26 pm
  8. Yikes! Seems to me that boric acid would be a preferable home remedy.

    Posted by AbrashTX | October 23, 2013, 5:30 pm
  9. http://vaginapagina.livejournal.com/9326026.html?page=1#comments – hello – I wanted to post this link because it is extremely relevant – several personal accounts on how women today have used Gentian Violet for vaginal yeast infection (average is 3-4 hours for 3 days). Using a 1% solution with 10% alcohol.

    Posted by 1whitehorse1 | November 7, 2013, 8:41 pm
  10. So I have severe bacterial vaginitis since giving birth to my son. I had tried everything under the sun until my gyno told me about this. she had me come in and she painted my vagina with this stuff and then asked me to come back for the second application in 4 weeks. it worked for me for about a month and now i am trying it on my own at home. so messy but worth the relief!

    Posted by sophie | January 11, 2014, 9:15 pm
  11. great post

    Posted by Sco Levi | April 24, 2014, 9:35 am
  12. When all else failed I went to my gyno, he used it on me one time and that did it. He said it was the treatment of choice. He said use non diluted one time on a tampon for 6 hrs.if I did it myself. You may order for under $3 on walgreens website.

    Posted by Paula Schmidt | July 1, 2014, 4:15 am
  13. Thank you so Much for this article! I have been dealing with chronic yeast infections and BV for several years and can’t seems to get rid of it for long. I have used it once and it went away. But came back after only a few weeks. Due to intercourse or menstral cycle.Yeast can be a plaguing thing to deal with and you feel there should be some 1,2,3 step solution to get rid of it for good. Please keep researching.. We really need more experts who know more about this! Instead of dr. Who cont. To try treating with a Rx that doesn’t work..

    Posted by nicmathess | August 12, 2014, 7:15 pm
  14. After self-administering 1% gentian on a push up tampon. (didn’t dawn on me an applicator would be easier) never had the problem again. Single application. Well I have made some lifestyle changes, by going off cane sugar, eat meat once per year, and rinsing undies in a baking soda solution and hanging them outside in the sunshine. Also add vinegar to my wash water and wash the vagina separately after bath no rags or washcloths.

    Posted by nana makeda | August 18, 2014, 6:32 pm

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