Candidiasis is a fungal infection due to a yeast (a type of fungus) known as candida. Certain species of candida cause the most common infection – Candida Albicans. Typically, Candida lives on the skin and inside the body, and in places such as the mouth, throat, gut, and vagina, without causing any problems. However, it may lead to infections when it grows out of control or enters deep into the body (for instance, in the bloodstream or internal organs such as the kidney, heart, or brain).
What are the types of candidiasis?
The various types of candidiasis are as follows:
- Athlete’s foot – also called tinea pedis, is a fungal infection that affects the skin on the feet. It may also spread to the hands and toenails. The fungal infection is known as athlete’s foot because it generally affects athletes. It is not severe and, sometimes, difficult to cure.
- Oral thrush occurs when a yeast infection develops inside the mouth. Oral thrush is also called oral candidiasis, oropharyngeal candidiasis, or thrush. It is common in infants and children.
- Vaginal yeast infection – a healthy vagina contains certain bacteria and yeast cells. However, when the balance of bacteria and yeast changes, the yeast cells can increase, causing itching, swelling, and irritation.
- Fungal infections – they may affect any part of the body. Fungi usually are present in and on the body with various bacteria. However, people can get an infection when a fungus starts to overgrow.
- Tinea cruris – also called jock itch, tinea cruris is a fungal infection of the skin that belongs to a group of fungal skin infections known as tinea. As in other tinea infections, fungi called dermatophytes cause jock itch. These microscopic fungi live on the skin, nails and hair.
- Diaper rash – Infants and toddlers experience diaper rashes. It causes red spots and scales in the genital area and buttocks. However, in some instances, it can spread to the legs and stomach.
What are the causes and risk factors?
Candida skin infections may occur anywhere in the body, but they are generally found in intertriginous (areas where two skin areas may touch or rub together) regions. Such sites include the groin, armpits, skin folds, and the space between the fingers and toes. The fungus grows in warm, moist, and sweaty conditions.
Generally, the skin acts as an important barrier against infection. Any incisions or breakdown in the superficial layers of the skin may cause fungal infection. Candida is capable of causing disease when conditions are favourable for it to grow. These conditions can include hot and humid weather and poor hygiene.
It is also prevalent in people working in wet conditions and pregnant women. Certain medications can increase the risk for candidiasis. Topical corticosteroid medications are the ones that lead to problems. However, birth control pills and antibiotics are other probable causes. People taking these medications should monitor their skin frequently for candida infection symptoms.
What are the symptoms of candidiasis?
The symptoms are different depending on the body, and location, but common symptoms are:
- Red or purple patches
- Cracks in the skin
- Erythema, which leads to areas of redness
- Maceration, or the emergence of soft white skin
- Red and white lesions in the mouth
How is candidiasis diagnosed?
The diagnosis of candidiasis initially relies on appearance and skin sampling. The doctor may take skin scrapings, nail clippings, or pluck hair from the affected area for examination. Once the candida infection is diagnosed, the primary step is to address the underlying cause of the infection. It may include lifestyle changes such as being hygienic, weight loss if people are overweight or managing diabetes.
It usually is advisable for people to see the doctor the first time they experience an infection so that the doctor can diagnose it properly and offer the best treatment options. Candida is often recurring; therefore, patients require follow-up visits.
How is candidiasis treated?
The treatment is simple as candidiasis does not require hospitalisation unless the patient is immunocompromised or experiences sepsis. The doctor may prescribe drying agents with antifungal creams, ointments, or lotions applied to the skin.
In some cases, oral medications can also be prescribed to patients. People may also need over-the-counter drugs, such as ketoconazole or clotrimazole, and antifungal drugs called azoles. These medicines are available in various forms, such as ointments, tablets, and creams. They don’t have the same serious side effects as other antifungal agents such as nystatin or amphotericin B, an intravenous medication used in hospitals.
The doctor may prescribe different kinds of drugs based on the type of infection and the part of the body that is affected. They include:
- Vaginal gels or creams, such as miconazole, for vaginal yeast infections.
- Different oral medications of lozenges, tablets, or liquid mouth to treat oral thrush.
- Sprays, ointments, and powders to treat athlete’s foot.
- Oral or even intravenous medications for severe infections.
Certain medications like miconazole and clotrimazole can be safely used to treat candidiasis in any trimester of pregnancy. Women must ask the doctor about the medicines that are safe for them to use.
All medications may have side effects. Side effects for antifungals typically include:
- Redness, mild burning or itching at the site where it is applied
- Indigestion or stomach upset
- Skin rashes
Intravenous antifungals are more to cause adverse side effects, including:
In rare cases, antifungals can lead to severe allergic or skin reactions, including peeling or blistered skin. Patients with liver damage should not use antifungal medicine without the doctor’s permission because it’s more likely to be severe in those with liver damage. However, antifungals can lead to liver damage in healthy patients.
Medications that a patient can mix with antifungals include:
- An antibiotic called rifampin
- Benzodiazepines used to induce sleep and minimise anxiety
- Estrogens and progestogens, found in contraceptives and hormone replacement therapy
- Phenytoin that is used to treat epilepsy
How is candidiasis prevented?
Candidiasis can be prevented when the patient:
- Wears ‘dry-fit’ clothing that helps absorb moisture from the skin.
- Keeps the armpits, groin area, and other areas vulnerable to infection clean and dry.
- Wear sandals or other forms of open-toe footwear when it is warm.
- Regularly changes the socks and underwear.
It is essential to keep in mind an obese patient must properly dry their skin folds to prevent infection.
In healthy adults, candidiasis can be treated easily. The infection can be more problematic in older adults, young children, and people with weaker immune systems. It may spread the infection to other parts of the body, mostly in cases of oral thrush. Preventive measures can help prevent candida growth. When candidiasis is treated early, the outcomes are better.