Cream for BV: Which Vaginal Cream Treats Bacterial Vaginosis?
▶ In short — creams for BV
Two prescription vaginal treatments are used for bacterial vaginosis: Dalacin cream (clindamycin), applied for 7 nights, and Zidoval gel (metronidazole), applied for 5 nights. Both work directly inside the vagina and are effective alternatives to oral tablets. There's no antibiotic BV cream available over the counter — both need a prescription, which you can get online after a short consultation.
Part of the Access Doctor Bacterial Vaginosis guide. For the full three-way comparison including tablets, see BV treatment options.
Which Creams Treat BV?
Bacterial vaginosis is treated with an antibiotic, and two of those antibiotics come as vaginal preparations you apply yourself rather than swallow:
- Dalacin 2% Cream — contains clindamycin. A cream inserted with an applicator each night for 7 nights. See the full Dalacin cream guide.
- Zidoval Vaginal Gel — contains metronidazole (the same drug as the tablets). A gel applied once nightly for 5 nights. See the full Zidoval gel guide.
Both act directly at the site of infection, which means less of the drug is absorbed into the rest of your body than with tablets. Both are recommended, effective treatments — the choice comes down to your history and preference.
Dalacin Cream vs Zidoval Gel
| Dalacin 2% Cream | Zidoval Gel | |
|---|---|---|
| Active drug | Clindamycin | Metronidazole |
| Course | 1 applicator nightly, 7 nights | 1 applicator nightly, 5 nights |
| Alcohol | No interaction | Avoid alcohol during use & 48h after |
| Condoms | Weakens latex (up to 72h) | Weakens latex |
| Often chosen when | You can't tolerate metronidazole, or want to avoid the alcohol rule | You want the shorter course, or prefer metronidazole |
Get the Right BV Cream Online
Complete a free confidential consultation reviewed by GPhC-registered pharmacist independent prescribers. They'll confirm the right treatment and dispatch it discreetly, usually next working day.
Start a BV Consultation →How to Choose — Cream, Gel or Tablets
All three formats clear BV in most women, so it's rarely about effectiveness. A cream or gel is often preferred if you:
- get nausea or a metallic taste from oral metronidazole tablets;
- want to avoid the metronidazole–alcohol interaction (choose clindamycin cream specifically for this);
- prefer a local, once-daily bedtime routine over remembering tablets twice a day.
Oral metronidazole tablets remain the NICE first-line option and may be simpler if you're happy taking tablets and can avoid alcohol for the course. Your prescriber will weigh your history and recommend the best fit.
Is There an Over-the-Counter BV Cream?
No — there is no antibiotic cream for BV sold over the counter in the UK. Both Dalacin (clindamycin) and Zidoval (metronidazole) are prescription-only. You can still get them without a GP appointment by completing an online consultation. Some pharmacy shelves carry BV "gels" that only adjust vaginal pH; these may ease symptoms briefly but do not reliably clear an established infection, so an antibiotic is usually needed for a proper cure.
How Fast Creams Work & the Condom Warning
Most women notice the discharge and fishy odour settling within 2–3 days, but you should finish the whole course — 7 nights for Dalacin, 5 nights for Zidoval — because stopping early makes BV more likely to return.
Both creams weaken latex. Clindamycin and metronidazole vaginal products can damage latex condoms and diaphragms during treatment and for a few days after. Avoid intercourse during the course, or use a non-latex method.
How to Get a BV Cream Online
BV creams and gels are prescription-only, but you don't need a GP appointment. Complete a short confidential online consultation with Access Doctor; a GPhC-registered pharmacist independent prescriber reviews it and, if treatment is appropriate, issues a prescription dispatched in discreet packaging — usually next working day.
Get assessed if symptoms don't fit BV. A cream won't help thrush or an STI. If you have itching, soreness, pelvic pain or fever — or you're pregnant — get a clinical assessment first, as these point away from simple BV.
Frequently Asked Questions
Which cream is best for bacterial vaginosis?
The two vaginal options are Dalacin 2% Cream (clindamycin) and Zidoval gel (metronidazole). Both are effective and recommended — the "best" depends on your history and preference. Clindamycin cream suits women who want to avoid oral antibiotics or the metronidazole alcohol rule; Zidoval is a shorter 5-night course. A prescriber will help you choose.
Can you treat BV with a cream instead of tablets?
Yes. A vaginal cream or gel is a recognised alternative to tablets and works just as well for most women. Dalacin clindamycin cream (7 nights) and Zidoval metronidazole gel (5 nights) act directly at the site of infection, with less whole-body exposure than tablets.
Is there an over-the-counter cream for BV?
No antibiotic BV cream is available over the counter in the UK — both Dalacin and Zidoval are prescription-only, though you can buy them online after a short consultation. Some over-the-counter "BV gels" only adjust vaginal pH and don't clear an established infection.
How long does a BV cream take to work?
Most women notice improvement within 2 to 3 days. Still complete the full course — 7 nights for Dalacin cream, 5 nights for Zidoval gel — as stopping early makes recurrence more likely.
Do BV creams affect condoms?
Yes — both clindamycin (Dalacin) cream and metronidazole (Zidoval) gel can weaken latex condoms and diaphragms during use and for a few days after. Avoid intercourse during treatment, or use a non-latex alternative.
References
- BASHH. UK National Guideline for the Management of Bacterial Vaginosis. 2023. bashh.org/guidelines
- NICE. Bacterial vaginosis: Clinical Knowledge Summary. 2023. cks.nice.org.uk/topics/bacterial-vaginosis
- Electronic Medicines Compendium. Dalacin Cream 2% w/w: SmPC. 2024. medicines.org.uk/emc/product/4063
- Electronic Medicines Compendium. Zidoval 7.5mg/g vaginal gel: SmPC. 2023. medicines.org.uk/emc/product/6148
Medical disclaimer: This article is for informational purposes only and does not constitute medical advice. Always consult a qualified healthcare professional for diagnosis and treatment. Dalacin Cream and Zidoval gel are prescription-only medicines — a medical consultation is required before they can be dispensed. If you are pregnant, or have itching, soreness, pelvic pain or fever, seek in-person assessment. In a medical emergency, call 999.