Comparing the Effect of Dill Seed Vaginal Cream, with a Persian Traditional Base, and 1% Clotrimazole Vaginal Cream on Vulvovaginal Candidiasis: A Double-Blind, Randomized Clinical Trial

Background: Vulvovaginal candidiasis (VVC) is a very common debility in gynecology clinics. Despite access to several antifungal agents, VVC is still a challenge; therefore, presenting a novel antifungal agent, especially with a traditional origin, is of interest and demand. Objectives: The current study aimed at comparing the efficacy of Anethum graveolens L. (dill) vaginal cream with that of 1% Clotrimazole vaginal cream to treat VVC. Methods: A prospective, single-center, randomized, double-blind clinical trial was performed. In the current study, married females aged 18 - 65 years, with probable vulvovaginal candidiasis were enrolled for primary evaluation. After VVC confirmation by the sniff test, the patients were allocated into three groups with regard to blocked randomization, and inclusion and exclusion criteria. The first group (n = 59) was treated with 1% Clotrimazole vaginal cream; the second (n = 60) with a combination of dill seed essential oil and dried aqueous extract vaginal cream (TEE); and the last (n = 56) with dill seed essential oil vaginal cream (EO) for seven nights. After 10 days, the therapeutic effects were assessed. Results: After the intervention, itching decreased to 30.5%, 3.3%, and 12.5% in the Clotrimazole, TEE, and EO groups, respectively; the sniff test also decreased to 33.9%, 13.3%, and 12.5%, respectively. Although a statistically significant difference, according to itching and sniff test, was observed among the three groups (P < 0.001, P = 0.005), there was no significant difference between TEE and EO (P = 0.06). Conclusions: The current study showed that the herbal preparation could be used as an alternative antifungal agent for vulvovaginal Candidiasis.