Candida albicans is a yeast that occurs naturally in and on the body. The Candida does not cause problems under normal circumstances, but if circumstances change then the Candida can grow and cause a Candida infection. Most Candida infections are innocent and will pass by themselves. However, when a Candida infection does not pass or keeps coming back, a Candida infection is treated.
What is Candida?
Candida is a fungal infection caused by yeasty fungi. The most common yeast in humans is Candida albicans. This yeast feels most comfortable in a warm and humid environment. Candida albicans can be found on the skin, in the skin folds and on the mucous membranes of the mouth, oesophagus, intestines and genitals. In healthy people, this fungus does not normally cause any symptoms. Due to various factors, however, this yeast can form threads. From that moment on, one speaks of a fungus.
What are the causes of Candida?
There are causes that apply to all forms of Candida and there are local causes.
The general causes are:
- Medication, like antibiotics that kill bacteria, but not the Candida yeasts. The pill causes fluctuations in the hormone balance and this seems to affect the growth of Candida. Chemotherapy can reduce resistance.
Serious diseases that reduce resistance, such as cancer, in someone who is HIV positive, or someone who has undergone a transplant.
- A lack of vitamin B or iron
The reason why people with diabetes are more likely to have Candida is not yet entirely clear. A reduced resistance could be a cause or, with Candida of the skin, the thought is that the small blood vessels deteriorate and the skin becomes more vulnerable as a result. The local causes can differ per Candida and can be read about under 'What forms of Candida are there?'.
What forms of Candida are there?
Candida can develop on several parts of the body. These places are:
- In the mouth: in addition to the general causes, the Candida can be caused by inhalation of medication, intubation during surgery, abrasion of poorly fitting dentures, smoking and dry mouth by medication.
- The oesophagus: a Candida infection of the oesophagus can be caused by inhalation of medication (corticosteroids in case of asthma), intubation during surgery and smoking.
- The vagina: in addition to the general causes, hormone fluctuations during pregnancy and due to the pill can cause a Candida infection. An incorrect PH value due to soap can also cause Candida.
- The penis: a Candida infection of the penis is not common, but can be caused by a tight foreskin or by a transfer from a partner who has Candida. Candida is not an STD (sexually transmitted diseases), but it can be transmitted.
- The skin and skin folds: Candida of the skin and skin folds can occur when the skin becomes irritated or damaged by, for example, too much soap use or sanding of the clothing. Candida loves warm and moist spots such as the skin folds, people who are overweight are more likely to suffer because of the larger skin folds.
- The nipples: during breastfeeding, the nipple is a warm and humid place where Candida can easily develop. Breastfeeding is likely to damage your nipple during feeding, while your baby's moist mouth is also a risk factor in itself. Your baby can also have Candida (thrush). Hormonal fluctuations during pregnancy and after childbirth can also play a role in the development of Candida.
- The nails and the edges of the nails: it is likely that Candida's nails and nail edge will first contaminate the skin with Candida. Public spaces such as swimming pools are a risk factor in the case of lime nails. The cuticle can be damaged by a lot of water (softening), nail biting, picking on sheets. The Candida can get into the damage and cause an infection.
- The corners of the mouth: in addition to the general causes of Candida, cracks in the corners of the mouth can also be caused by poorly seated prostheses or artificial teeth that are not at the right height.
- Generalised Candida: in rare cases, Candida ends up in the blood. This form occurs in people with a strongly reduced resistance.
How do you recognise Candida?
You can recognise Candida by the complaints that depend on where Candida is located. These are:
- In the mouth (thrush)
- White dots, which together can form larger areas (plaques) that can be coloured grey or yellowish
- Swollen spots if the dentures are the cause
- Pain when swallowed
Of the oesophagus:
- Difficulty swallowing (the main complaint) of both solid food and liquid also of water or saliva
- Pain near the sternum that can radiate to the back or shoulder blades
- Frequently white-yellow deposits in the oral cavity and on the tongue
Of the vagina:
- Vaginal itching, sometimes on the labia
- White, not smelling strong, sometimes crumbly discharge
- Sometimes red, swollen and painful mucous membrane of the vagina
- Sometimes burning or painful sensation when urinating or having intercourse
On the penis:
- Itches on the penis
- Redness of the foreskin, perhaps swollen on the inside
- Red jerk
- Pain when urinating
- Pain during intercourse
Of the skin:
- Red spots with flakes on the edges
- Itching, burning sensation
- Any pimples and blisters
Of the nails:
- Thick nails crumbly and yellow
Of the nail tip (paronychia):
- The skin is red, painful and swollen on both sides of the nail.
Of the corners of the mouth (called angular cheilitis):
- Cracks, which are painful and can itch
Of the nipples during breastfeeding:
- Red and/or sore nipples with a burning sensation
- Damage or fissures to the nipple
- White dots in the skin folds of the nipple
- Serious itching of the nipples
- The skin of the nipple and areola becomes smooth and tense
- Severe stabbing pain in the breast during and after breastfeeding, this can be accompanied by radiation to the shoulders and back.
- Your baby can also have Candida (thrush). With symptoms such as white cervical spots on the oral mucosa and tongue, a white deposit in the mouth and tongue and often a shine on the lips.
- Severe illness and high fever.
Is there anything I can do myself against Candida?
Good hygiene can help you fight Candida. Do not use soap. Dab the places where you have Candida skin dry. Keep the spots as dry as possible. Ensure good oral hygiene in Candida's mouth, corners of the mouth and oesophagus. Avoid very hot drinks or food, acidic products, sharp herbs and alcohol in the case of Candida of the oesophagus. For all Candida: try to increase your resistance by living healthily with a varied diet, by not smoking and consuming little or no alcohol. Drink plenty of water. Avoid stress, ensure a good night's sleep, exercise regularly and ensure sufficient relaxation.
What are the forms of treatment?
A Candida infection can pass by itself. The doctor may use your current medication such as antibiotics, corticosteroids, the pill, and medications that have the side effect of reducing, adjusting, stopping or changing saliva production. Never do this on your own if you suspect that a medicine is the (co-)cause of Candida. Discuss your suspicions with a doctor. When inhaling medicines (corticosteroids) you can rinse the mouth and throat cavity with water after inhalation. Regularly clean any dental prostheses. If the Candida infection does not go away or if it comes back, the doctor will usually prescribe anti-fungal medicines.
The choice of medication depends on the location. An anti-fungal medicine such as gel, ointment, suspension, cream, powder, pessary or pill can be chosen. An anti-fungal medicine kills the fungal cells, or prevents the fungal cells from growing and reproducing. If the anti-fungal medicines do not work, antibiotics may be prescribed. Sometimes a combination of medicines is given. Always read the package leaflet before use. Complete medication cures as prescribed, even if the symptoms have disappeared. Only when you have an allergic reaction should you stop. In any case, contact a doctor immediately.
Anti-fungal medicines used in Candida are in different forms:
Miconazole increases the use of anticoagulants. This is strongest in vaginal applications. This medicine should preferably not be used when using anticoagulants.
Antibiotics that can be used for Candida are:
- Amphotericin B
- Griseofulvin suspension FNA
Sometimes hydrocortisone is added to a cream or ointment. It has an anti-inflammatory effect and helps against itching. Benzoic acid /salicylic acid cream or ointment can also be used on the skin.
- For vaginal Candida, an antifungal vaginal cream, vaginal tablets or vaginal suppositories (pessaries) can be chosen. The creams can also be lubricated on the labia if the labia are itchy.
- For Candida of the skin folds, penis and nipples, a cream or ointment is usually chosen.
- For Candida of the nails, the use of cream does not make much sense because the product does not attract well in the often thick nails. Medicines via the mouth are more likely to be chosen. There are fungicidal nail polishes of which the treatment takes at least 7 to 12 months.
- A fungicidal ointment or cream can be applied to the edges of the nails. However, in case of persistent fungal infections, it is sometimes necessary to take antifungal or antibiotics for a long period of time.
- For Candida of the corners of the mouth a zinc oxide smear can be given first to dry and protect the corners of the mouth. Or a zinc oxide spread in combination with another agent.
- Methylrosaniline can be applied to thrush and nail edges with a cotton swab if nothing helps. As it can cause dark purple discolouration of the skin and can affect clothing, there is some reluctance to use it.
If a Candida infection continues despite medication or if it comes back regularly, then the doctor can examine the Candida to see what the Candida does react to.
A light form of Candida can also pass by itself. For your baby's thrush, you can clean the mouth with a cloth soaked in orange juice.
When you have Candida it is important to have good hygiene. Do not use soap in places where you have Candida. With vaginal Candida, vaginal intercourse can be painful so you can use a neutral lubricant. Avoid vaginal intercourse when the mucosa is still very dry and painful. With Candida, try not to keep hands in water for too long (particularly fingers or cuticles), put on gloves when cleaning, but do not keep them on too long because they can make the skin moist and soft again due to perspiration. With Candida of the feet, it is advisable to wear flip-flops in swimming pools. Wear well ventilated shoes and clean socks every day. Dry your sports shoes well after exercise. With Candida, wear the clothing that is airy for the skin, preferably made of cotton.
Additional risks and side effects
Candida is not contagious, but we do see that in a vaginal Candida sometimes the partner also has a Candida. With a genital Candida, feelings of shame can also occur. Talk to your doctor about this. A baby can get thrush from the Candida to the nipple of the mother - this can also be the other way around. The mother can also give Candida to her baby during childbirth.
How can you prevent Candida?
A healthy lifestyle can help prevent Candida. A food that contains sufficient iron and vitamin B. Ensure good hygiene of the body as well as of the mouth. Also see 'Can I do something myself against Candida' for a healthy lifestyle.
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