Candida Treatment (candidiasis) – Candida is a family of yeast or fungi that can naturally occur on the skin, mucous membranes and intestines. This is also called commensals. The most common Candida species is Candida albicans. Almost everybody naturally experiences Candida albicans on the skin, mucous membranes (vagina, mouth, etc.), the intestines, etc. at birth.
- Candida infection (candidiasis): how and where can you get them?
- Risk factors
- Is Candida contagious?
- Where can a Candida infection occur?
- What can you do to prevent a (new) Candida infection?
- Treatment of Candida Vaginitis
The yeasts live in balance with the bacteria that are also naturally occurring. These bacteria ensure that there is enough food for the yeast so that their number remains small. Normally, therefore, we do not notice anything and do not hurt them either.
Sometimes, however, the Candida yeast can expand greatly, resulting in a candida infection or candidiasis. This usually occurs when our natural resistance is reduced for some reason or when the balance between bacteria and yeasts is disturbed (eg by an antibiotic cure).
A Candida infection is usually quite innocent and can usually also be treated fairly well. In exceptional cases, it may be dangerous when Candida enters the blood and causes a generalized infection or “systemic candidiasis”. This form of a Candida infection occurs only in severely ill people with greatly reduced resistance. For example, in people who have undergone organ transplantation, in cancer patients after chemotherapy or in AIDS patients.
|Other Candida yeasts|
Candida albicans are not the only Candida yeast in humans. Candida tropicalis and Candida glabrata sometimes also occur. People who have been treated with a drug for Candida albicans several times may be more easily bothered by those other yeasts that are insensitive to those drugs and which take the place of the sensitive Candida albicans. This is similar to the resistance that can be caused by frequent antibiotic use. There are indications of an increasing occurrence of these yeasts. The non-albicans yeasts give similar symptoms, although they are often less severe.
Several factors may play a role in the emergence of a Candida infection.
• A moist environment stimulates the multiplication and spread of all yeasts and fungi.
• Antibiotics also destroy the useful bacteria in and on the body. When these bacteria are thawed, Candida gets more chance to multiply and spread.
• People with a weak or weakened immune system are more sensitive. This is especially true for premature and very young babies, HIV patients, elderly people, people who follow a chemotherapy course and people who have had organ transplants and should take immunosuppressive drugs.
• Sugar sickness that is not well controlled.
• Chronic diseases, through a combination of risk factors.
• There may also be genetic factors that make someone more sensitive to a Candida infection.
• Hormonal factors: A vaginal candidase is handled by pregnancy, contraception, and estrogen treatment. Some women often get a fungal infection around the menstrual period, others during pregnancy.
• Multiple or frequent fluctuating sexual contacts and oral sex may potentially reduce the risk of vaginal Candida infection.
• Spruw (Candida infection in the mouth) can be handled by the use of medicines to be inhaled (for example in asthma).
• Many carbohydrates or sugars eat could promote candidiasis in theory because yeast sugar lives. But the precise (causative) connection between a sugar-rich diet and a Candida infection still has a lot of ambiguity.
Is Candida contagious?
Candida yeasts naturally occur on the skin, on mucous membranes of the mouth and vagina. Although the yeast can be transferred from one person to another (eg from mother to child or vice versa, between sexual partners), it is not really a contamination in the traditional sense of the word.
Candida is therefore not considered an infectious disease and not at all as a sexually transmitted disease.
Therefore, the partner of a person with vaginal candidiasis should not be treated with me unless he or she is infected and has complaints.
In babies with sprouts or when a breastfeeding mother has a candida infection of the nipples, both mother and child must be treated because they can pass the infection together.
Where can a Candida infection occur?
A candida infection can occur in different body parts.
• On the skin
Candida albicans survive well on a moist, softened skin, and especially in skin wrinkles (eg in the loops, under the breasts or armpits). Babies can get Candida infection on top of a regular diaper rash.
Nails can also be infected with candida. This is especially true for people who work a lot with sugars (eg bakers, chefs) or who often have wet hands.
• On the nipples
In breastfeeding women, a Candida infection may occur on the nipples.
• In the mouth
Almost half of the population would naturally (commensal) have Candida in the mouth without any hassles. But sometimes it can give rise to an infection.
Oral candidiasis or spraw occurs in patients with an impaired immunity (eg cancer or AIDS patients), after treatment with antibiotics or chemotherapy, in prematurity, inhalation of corticosteroids (eg in asthma), intubation (during surgery or if you stay intensive care for a long time). Even if you produce too little saliva and have too dry a mouth, it may occur. For example, when you are irradiated there. Saliva helps to maintain the balance in the mouth.
Spraw can also be the result of a poorly done dental denture. The prosthesis locally softens the gums and closes the air.
Babies can become infected with Candida in the birth canal, but also through the hands of other caregivers.
|Perlèche or rupture mouth|
Perlèche or rupture mouth is a usually stubborn eczema-like inflammation of the mouth angles caused by salivary irritation. Often there is an infection with Candida albicans on top. Typical features are redness and a flaky, wet skin. In a Candida infection, there is usually a white peeling. Young children can get perlèche by drooling and sabbling. In children with a large tongue (such as Down’s syndrome) this occurs frequently. In elderly people, it may be a result of a badly dented denture or the incidence of the cheeks.
• In the vagina (vulvovaginal candidiasis) Candida is the major cause of vaginal infections. Most women make at least one vaginal Candida infection during their life, eg during pregnancy. In some women, this may occur repeatedly.
A vaginal candida infection can occur when the balance between bacteria and Candida in the vagina is disturbed. Especially in the second half of the menstrual cycle, during pregnancy, in pill and in diabetes, the vagina contains a higher sugar content of which the candida yeast benefits. Also, the vagina can be infected from outside (eg via toilet paper or a washcloth that was previously used for the anus).
Genital Candidiasis or Vaginitis no sexually transmitted disease (SOA). Therefore, your partner must not be treated with me unless he himself has complaints.
|Repeated vaginal infections|
Approximately 5% of all women are expected to receive a vaginal Candida infection. When occurring more than 4 times a year, recurrent vulvovaginal candidiasis is mentioned. Why this happens in some women is still not entirely clear.
Possible factors that may help you to do this include:
• Bad therapy faith from previous treatments (not treated long enough).
• Oral contraception pills with more than 30 mg estradiol
• Sexual activity (especially oral sex: the mouth is an important candida reservoir)
• Excessive vaginal hygiene
• Immune disorders (corticoids, chemotherapy, AIDS)
• An infection with a form other than Candida albicans (Candida tropicalis and Candida glabrata).
In case of repeated vaginitis, the doctor will always check if it is a candida infection. Vaginitis can also be a consequence of, for example, contact dermatitis (for soap, deodorant, undergarment, etc.).
• Penis (Balanitis)
In the men, the penis may be infected with Candida yeasts.
• In the intestines?
Candida albicans live in the intestine where he is harmless. Whether this may give rise to complaints such as diarrhea after antibiotic abuse, and whether or not to be treated is controversial.
After a medical procedure, a Candida infection may occur in different organs. For example, if the intestinal tract is damaged by repeated intestinal surgery, or if you have a catheter for sincere days. These systemic infections occur mainly in kidney, heart, liver, central nervous system, lungs, spleen and deeper tissues of the digestive system.
That’s serious and needs to be treated with powerful drugs.
• Contaminated skin looks reddish. Small volatile vesicles may develop.
The nail bed is affected when the nails (Candida paronychia) are attacked. The nail bed can be red and painful, the nails can become white or yellow and blemishes.
• In case of infection of the oral mucosa (spraw) a witty, sometimes painful rash on the tongue and mucous membranes of the cheeks and palate occurs. The mucous membranes themselves are red inflamed.
Spraw can expand to the throat and esophagus where it causes an annoying pain and ulceration.
Babies who drink restlessly, repeatedly release the chest or refuse the chest may have a sprout.
• Perlèche or tear mouth causes gaps in the corners of the mouth.
• In a candida infection of the nipples, they look shiny pink to red, with sometimes white dots or flakes. Sometimes gaps arise. It is usually accompanied by a stinging pain that radiates from the nipple to the chest, nd can last long after breastfeeding.
• In case of candida vaginitis or vaginal candidiasis, the skin around the sheath can become red and often it causes severe itching and burning sensation. Also, the pubic lips may be red and swollen. There may be an increase in vaginal secretion (fluorine vaginalis). The secretion is often grainy and white, such as crispy cheese but odorless. Pissing and freeing can be painful.
• In a candida infection of the penis, the acne may look red and flaky, severe itching and pain when touched or released.
• The complaints of generalized candidiasis are not always very clear because these people are often very ill and already have a high fever.
How is the diagnosis made?
The appearance of the affected skin or mucous membranes sometimes makes the doctor aware of what it is all about. In case of doubt, a sample will be examined under the microscope or in the lab.
If a generalized Candida infection is suspected, a specialized blood test will usually be performed.
What can you do to prevent a (new) Candida infection?
Infections in the mouth (spraw)
• In infants, good hygiene is extra important. If you are breastfeeding, it is wise to wash hands and nipples for each diet with lukewarm water.
• It is best to cook teaspoons (from bottles) daily and keep them in a dry and clean place.
Infections of the nipples
• Use as few soaps as possible or use only sour soap (soap with a pH of less than 7).
• Replace suction compressors at least after each power supply. Cotton suction compresses must be boiled out for 5 minutes after use.
• Carefully wash your bra at 60 ° C and clean a well-washed brass daily.
• Keep your nipples dry after the powder. In the event of a fungal infection, moisten a drop of breast milk on the nipple.
• Wash your vagina out with soap, because it disturbed the natural acidity of the vagina. Use lukewarm water preferably.
• Do not use disinfectants such as Isobethadine soap, even during infections. Do not use vaginal showers and the like.
• Make sure that the vagina’s mucous membrane is not damaged when exposed. Use a lubricant if necessary.
• Oral sex may increase the risk of vaginal infection.
• Keep your skin clean and dry. Pour the skin gently dry, instead of rubbing hard.
• Use as little as possible soap.
• Use any talcum powder in skin creases and in babies to absorb moisture.
A candida infection is usually quite innocent and rather annoying than dangerous. The infection often disappears spontaneously after a few weeks. But in some cases, they may be stubborn or repeatedly come back.
Treatment is only required when complaints are annoying or recurring. In case of severe or repeated Candida infection, the physician will always check the exact Candida type and check any previous treatments to correct the appropriate treatment.
Always follow the prescribed dose and route of administration – ask your doctor for advice – and complete the prescribed cure.
• Skin infection
For a superficial infection of the skin, treatment with a local dehydrating product such as Eosine is usually sufficient. Talking powder can also help. That does nothing against the yeast itself, but on a dry skin, the yeast can not expand.
In more severe complaints, the doctor may prescribe a skin cream or ointment for fungi and yeasts such as nystatin (magistral prepared by the pharmacist), Miconazole (brand name: Daktarin) or clotrimazole (brand name: Canesten). In case of severe infection and damage to the nails, an oral medication may also be required.
In diaper dermatitis, the doctor may prescribe a combination product of miconazole with zinc oxide (Daktozin).
• Mouth infection
Candida of the mouth can be well combated with drugs. Usually, local treatment with an oral rinse or oral gel based on miconazole (Daktarin gel) or nystatin will suffice. In young children (from 4 months) miconazole is preferred.
The product is given after diet. The gel is spread into the mouth with the finger or a cotton swab. The product must be kept in the mouth for as long as possible (at least a few minutes).
The treatment should be continued until 2 days after the rash has disappeared.
In severe or stubborn infection, the physician may receive a systemic treatment with fluconazole (Candizole, Diflucan, Fluconazole generic product) or itraconazole (Sporanox, Spozole, Itraconazole generic product)
prescribe. The treatment will need to be continued for 7 to 14 days.
• Gentian violet is no longer recommended due to discoloration of the mucous membranes.
• Obviously, the causes must also be addressed (eg a bad seat, dentures at night, good oral hygiene etc.).
• Tummy infection
Usually, local treatment with an antifungal ointment based on miconazole (Daktarin) or nystatin will be prescribed. These products can also be used during breastfeeding.
Treatment of Candida Vaginitis
The treatment depends on the severity of the infection and whether or not it is a recurrent infection.
• Acute infection
In case of acute infection, for the sake of safety, a locally-based antifungal product based on clotrimazole (Canesten) or miconazole (Gyno-Daktarin) is usually preferred. Local treatment also allows for a slightly faster relief of complaints than oral pills.
These products consist of ovules, cream or vaginal tablets. Bring the product into the vagina before going to bed. The vagina cream contains a special disposable applicator.
This allows you to bring the cream deep into the vagina. For this, you are best placed on your back with bent, spread legs. Then bring the cream-filled applicator deep into the vagina. Then you empty the applicator and throw it away. You can break the ovules with your finger.
Usually, a single-dose treatment with a high dose ovule is sufficient. In case of severe infection, longer treatment (one to two weeks) may be required.
During pregnancy and breastfeeding, only local imidazole derivatives are preferred, preferably miconazole (Gyno-Dactarin), for one week.
• Oral treatment with itraconazole pills (brand name Sporanox or generic product Itraconazole) or fluconazole (brand name: Diflucan, Candizole or Fluconazole generic product) is recommended when local treatment has failed. Because a pill is easier than an ointment, some women also prefer such treatment.
During pregnancy, these products are better not given, although there are no direct indications that they are harmful. During breastfeeding Fluconazole may be given, intraconazole better because it can pass into breast milk.
• A combination of local and oral medicines is not recommended.
• Repeated infections
Repeated infections (four or more times a year) are more difficult to treat. Usually, a long-term treatment (10 to 14 days or more) is required. Preferred is a drug that is taken by mouth.
It is important that treatment is maintained until all complaints have disappeared. If you stop early, the infection will return, and other candida types may also occur.
We will also look at factors that facilitate the infection and, if possible, take the necessary measures (eg better control of diabetes, another contraceptive pill, other anti-fungal drugs, etc.).
• The doctor may prescribe a preventive treatment for a period of three to six months once a week or monthly (just before or at the end of menstruation) a tablet of fluconazole or itraconazole or a vaginal cream with clotrimazole or miconazole.
• The use of ketoconazole tablets (Nizoral) in regularly recurring Candida infections is not recommended due to high risk of liver damage.
• Treatment of the partner (s) is only necessary if it also has complaints.
• During treatment, it is better not to use tampons and not have sex.
• Baking soda (NaCO3) (1 soup spoon per centimeter water) and (cooled) wet teaspoons or olive oil can help with itching and burning.
• Rubbing the sheath and shampoo with gentian violet solution to the itch is not recommended. It causes a purple discoloration of body parts, clothing and bedding.
• Polyvidic iodine and hydrogen peroxide do not help and may irritate and are therefore not recommended.
• Flush with a lactic acid solution (Lactic acid solution 2%, Lactacyd) or the introduction of lactic acidovulas to acidify the vagina has hardly any effect.
Also, the insertion of yogurt tampons is not recommended.
Because certain (fatty) ingredients in the creams and vaginal tablets can affect the condoms and pessaries rubber, these contraceptives are not safe for up to three days after discontinuation.
As with vaginal infection, the doctor may prescribe an anti-fungal ointment or cream (imidazole) to apply to the penis. Twice a day for one to two weeks is usually enough.
Because certain (fatty) ingredients in the creams can affect the rubber of condoms and pessaries, these contraceptives are not safe for up to three days after the discontinuation of treatment.
There are several diets that are wrongly claimed to be able to fight or prevent an infection with Candida.
According to the scientific literature, diets do not affect an infection with Candida albicans. So-called ‘anti-candida diets’ can cause or aggravate complaints, because they contain, for example, no or few fruit and milk products. As a result, shortages of fiber, vitamins, and minerals can eventually occur.
Probiotics may be useful in helping to protect good bowel bacteria during an antibiotic cure. But that they can counteract the development of Candida has not been demonstrated.
Probiotics would also increase the effectiveness of oral antifungal products (such as fluconazole) for vaginal candida infections.