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A normal resident that overgrows in damp warmth or when defences shift — and which differs from the dermatophyte in place and shape.
Also known as: candidiasis · thrush · yeast · gut fungus
Open in the tool — with search and all the links →This compilation is for information and replaces neither medical diagnosis nor treatment. If you have symptoms, see a doctor.
A yeast that lives normally on the skin and mucous membranes of almost everyone. It only becomes a problem when conditions change: damp and warm, after a course of antibiotics, with a raised blood sugar, in pregnancy, on steroids or when defences are weakened. It then overgrows, and the familiar pictures follow — white, wipeable coating in the mouth, itchy crumbly discharge, split corners of the mouth, glossy red weeping skin in the folds under the breasts, in the groins, on the abdomen or between the buttocks. The difference from a dermatophyte matters because the two are treated differently: the yeast likes it damp, sits in the depth of the fold, is red in sheets with small satellite spots at the edge. The dermatophyte prefers it dry, grows outwards in a ring and is more active at the border than in the centre. A swab separates them in one appointment. On the common question of "gut candida": almost everyone carries it, and it can nearly always be found in stool. A positive result alone therefore says little — it describes the normal state.
Yeast and dermatophyte look alike in a fold and need different products. A swab or skin scraping settles it in one appointment.
Air dry or use a cool hairdryer, lay a strip of linen or cotton in the fold, nothing tight, nothing airtight. Without this it comes back whatever the cream.
Gone from sight is not gone. Treatment continues for another week or two beyond that as the doctor directs — stopping too early is the commonest reason it returns.
For oral thrush during asthma treatment this is the simplest and most effective step: rinse and spit after every puff, and use a spacer.
A yeast infection that keeps coming back is one of the commonest occasions on which diabetes is first noticed in adults.
The other family — ring-shaped, edge-dominant, often carried from the foot. Once you know it you no longer confuse it.
Starting a strict elimination diet for tiredness or bloating costs time and variety, for a question the stool result does not answer. Those symptoms deserve an assessment of their own.
Real, localised infections — well treated with antifungals.
Serious and treatment-needing — affects the severely ill, not otherwise-healthy people.
Antifungals attack the wall of the fungus. Applied locally they work where they reach — in the mouth as a suspension held in the mouth, in the vagina as a pessary; swallowed tablets act through the blood and reach deeper sites too. What they do not do: remove the fungus from the gut. Candida belongs to the normal flora; it becomes a problem when sugar, antibiotics, cortisone or weakened defences shift the balance.
Candida belongs to the normal mouth flora in about half of people and to the gut flora in many. It becomes a problem when the balance shifts — on antibiotics, a cortisone spray without rinsing, sugar, a dry mouth or weakened defences. Oral thrush improves within a week on treatment and is continued for two weeks. A finding in the stool alone does not mean illness — it is found in healthy people too.
The yeast sits where skin lies on skin and stays damp: under the breasts, in the groins, in the fold of the abdomen, between the buttocks.
Glossy red, often weeping, with small separate spots just beyond the border. Those satellites are the giveaway.
It grows outwards in a ring, more active at the border than in the middle, prefers it drier and often travels from the foot to the groin. Different product, different duration.
In oral thrush the coating can be wiped off and the lining beneath is red. A white patch that does not wipe off is something else and needs looking at.
Antibiotics, steroids — including asthma inhalers when the mouth is not rinsed afterwards — raised blood sugar, pregnancy, damp clothing, weakened defences.
Almost everyone carries it in the gut. A positive stool result is therefore not in itself a finding — it does not answer the question that was asked.
The yeast likes moist folds — including the anus. Typical is a broad redness with small satellite spots at the edge, unlike the sharply bordered dermatophyte.
The most important value here. Recurring yeast infection is a common occasion on which a previously unknown diabetes is found in adults.
Split corners of the mouth and recurring oral thrush often go together with an empty iron store.
Zinc keeps skin and mucosa resilient; a deficiency likes to show first at the junctions between skin and mucous membrane.
Worth doing if a yeast infection is unusually extensive or keeps returning — the question is then about the defences, not the fungus.
Fever, sweating and faster breathing clearly raise the need. Drinking enough keeps the mucus thin and the circulation steady — in children and older people it is the most important point of all.
With low levels airway infections occur somewhat more often; correcting a deficiency makes sense, a high single dose during the infection does not act on it.
Needed by the defence cells. For lozenges at the start of a cold there are hints of a slightly shortened duration; at a high dose over months zinc lowers copper.
Antibodies and defence cells are protein. After several days with little appetite it is worth at least keeping the protein up — soup with egg, quark, yoghurt, lentils.
Clearly worthwhile and well studied when deficient; fewer data for the wider uses. Fat-soluble — check blood levels at high doses.
Recurrent fungal infections with no other reason are one of the classic first pointers to sugar that is too high. With certain diabetes medicines that excrete sugar through the urine they are also more common.
Oestrogen makes the vaginal lining store sugar, which the fungus lives on. This is why thrush is rare before puberty and after menopause, and common in pregnancy.
Cortisone — including as an asthma inhaler — encourages oral thrush. Rinsing the mouth after inhaling is the simplest prevention there is, and it is rarely said.
Strict months-long avoidance of sugar and yeast is not established and narrows the diet. Established: in poorly controlled diabetes and after antibiotics fungal infections are more common — that is where to start.
Much used externally; undiluted it strongly irritates skin and mucous membrane.
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