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Gentian violet used when breastfeeding: irritant and carcinogenic

Gentian violet has no place in the treatment of nipple thrush while breastfeeding, nor of oral thrush in the newborn baby.

Despite a name suggestive of a health-promoting plant, gentian violet is a synthetic colouring agent, produced industrially.

In France and other countries, a solution of gentian violet is recommended by some organisations for treating nipple candidiasis (nipple thrush) in breastfeeding women, and for treating oral thrush in newborn babies.

In 2019, the Canadian agency Health Canada drew attention to the carcinogenic effects of gentian violet.

Several dozen notifications of adverse effects recorded in the Canadian and World Health Organization (WHO) pharmacovigilance databases have reported skin and mouth irritation, mouth ulcers, inflammation of the oesophagus, pharynx, and larynx as well as facial swelling in newborn babies exposed to gentian violet.

Furthermore, there are data showing that gentian violet can alter genetic material and cause cancer. Its use in cosmetic products has been banned by the French medicines agency.

Nipple thrush is often over-diagnosed. In one study, in at least one-third of cases of supposed nipple thrush, Candida (the yeast responsible for thrush) could not be identified in the mother’s milk. 

For proven cases of nipple thrush, or oral thrush in the newborn baby, antifungal drugs have been better studied than gentian violet, and can be used either as oral suspensions of nystatin or amphotericin B from birth, or from the age of 4 months, as a miconazole-based oral gel.

©Prescrire 1 October 2020

Source: "Gentian violet when breastfeeding: irritant and carcinogenic" Prescrire International 2020; 29 (219): 243. Subscribers only.

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