Candida Overgrowth: Gut, Mouth, Skin Elimination

Candida is a group of fungi that exists (usually harmlessly) in areas such as the skin, the mouth, the vagina, and the gastrointestinal tract.

Candidiasis is an infection caused by Candida fungus, usually Candida Albicans. Candida infection, also known as a yeast infection, is rarely serious in people with healthy immune systems but can sometimes spread to other parts of the body in immunocompromised people.

Symptoms depend on the area of infection. On the skin, an overgrowth may cause a rash, while a vaginal yeast infection can cause itching, burning, and abnormal discharge. An oral yeast infection can cause white patches on the tongue, while an overgrowth of Candida in the gut can cause gastrointestinal complaints such as bloating.

This article will discuss symptoms of Candida overgrowth, how to stop Candida overgrowth, the role diet plays in Candidiasis, causes of persistent Candida overgrowth, and how to prevent Candidiasis when immunocompromised.

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Candida Overgrowth Symptoms by Body Part

Candidiasis can cause a range of symptoms depending on the location and severity. It is usually mild. Although rare, it can become serious enough to affect the heart or brain.

The symptoms of Candida overgrowth can be similar to those of other health conditions. Always see your healthcare provider to get an accurate diagnosis.

Here is how Candida overgrowth can affect different areas of the body.

Skin

Candidiasis of the skin (cutaneous Candidiasis or cutaneous Moniliasis) often develops in the skinfolds of areas such as:

It may also occur on the scalp (which could lead to hair loss), face, fingertips, trunk, or anus (called perianal Candidiasis).

Reproduced with permission from ©DermNet NZ and ©Waikato District Health Board www.dermnetnz.org 2022

Symptoms of Candidiasis of the skin include:

Rash with redness and skin breakdown
Clearly defined red lesions/patches that are typically rimmed with small, red-based pustules
Oozing clear fluid from patches
Pimples
Itching or burning

Vagina

Symptoms of vaginal Candidiasis (commonly called a vaginal yeast infection) include:

Abnormal discharge (may be white, yellow, clumpy/curd-like, and/or watery)
Reddened and/or swollen tissues of the vulva and vagina
Vaginal/vulva itching, irritation, and/or soreness
Pain or discomfort during sexual intercourse and/or during urination

Symptoms can vary by person. For instance, not everyone with a vaginal yeast infection experiences abnormal discharge.

Penis

Symptoms of Candidiasis of the penis include:

Painful rash on the underside of the penis
Redness on the underside of the penis
Scaling on the underside of the penis

Candidiasis of the penis is more common in those whose female sexual partners have vaginal Candidiasis, and in those who have diabetes mellitus.

Mouth

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Candidiasis in the mouth (thrush) has two main forms, which are:

Pseudomembranous: More common form; affects mouth, tongue, or back of the throat
Atrophic form. Less common form, usually found in older adults; typically appears underneath upper dentures

Symptoms of thrush include:

White patches on the tongue. inner cheeks, roof of the mouth, and/or throat
Redness
Soreness
Pain while eating or swallowing (difficulty swallowing may indicate thrush in the esophagus)
A cottony feeling in the mouth
Redness and cracking of the corners of the mouth
Loss of taste
Sensitivity to spicy foods

In the Gut

Yeast in the gastrointestinal tract is normal, but an overgrowth has the potential to cause problems. Broad-spectrum antibiotics have been linked to increased colonization of Candida species in the gut.

Gastrointestinal symptoms of Candidiasis may include:

Bloating
Constipation
Diarrhea
Gas
Abdominal pain

Nails

Candidiasis can occur under the fingernails or toenails.

Symptoms of Candida infection around the nails (Candidal paronichia) may include:

Swelling
Pus
Pain
White or yellow coloring of the nail
Separation of the nail from the nail bed

Systemic

Systemic Candidiasis and invasive Candidiasis can affect many parts of the body. This infection is serious.

Systemic/invasive Candidiasis can affect the:

Blood
Heart
Brain
Eyes
Bones
Joints
Other areas

The most common symptoms are fever and chills that don't improve after being treated with antibiotics for suspected bacterial infections, but other symptoms more specific to the area of infection can occur.

Systemic/invasive Candidiasis tends to occur in people who are hospitalized, immunocompromised, or who have other medical conditions.

How to Stop Candida Overgrowth 

Candida overgrowth is usually treated with antifungal medications such as:

Clotrimazole
Miconazole
Nystatin
Fluconazole

Oral thrush is typically treated with antifungal medicine applied to the inside of the mouth for seven to 14 days.

Oral thrush may also be treated with a medicated mouthwash or lozenges that dissolve in the mouth. Candidiasis of the esophagus is usually treated with oral or intravenous antifungal medications.

Yeast infections of the vagina or penis may be treated with antifungal creams, medicated suppositories, or oral medications.

Candidiasis of the skin may be treated with antifungal powders or creams.

Candida infections of the nails are often treated with oral antifungal medications.

Severe Candidiasis may require oral antifungal medications, especially for people with weakened immune systems.

If the Candida infection stems from or is worsened by medication use, such as antibiotics, corticosteroids, or immunosuppressants, your healthcare provider may look for alternative medications or treatments for you to use.

Measures that may help prevent Candidiasis include:

Practice good oral hygiene (especially for people who wear dentures), including regular brushing and flossing, and using mouthwash as needed.
Keep skin dry and try to reduce friction in areas where skin rubs against skin.
Wear cotton underwear.
Change diapers frequently and keep the skin dry (avoid petroleum jelly and talcum powder).

What Are "Good" and "Bad" Bacteria?

Most types of bacteria don't make people sick, and many types are beneficial. Certain types of bacteria help to:

Digest food
Destroy disease-causing cells
Give the body vitamins it needs
Make foods like yogurt and cheese

The gut is colonized by 10 times more microbes (including bacteria) than human cells. Gut bacteria are important for keeping people healthy.

Infectious bacteria can reproduce quickly in the body and cause illness. Types of infectious bacteria that cause infections include:

Streptococcus
Staphylococcus
Escherichia coli (E. coli)

Some bacteria help keep Candida from overgrowing. Taking antibiotics can kill these bacteria and cause a buildup of Candida. Taking probiotics of bacteria such as lactobacillus acidophilus or bifidobacterium when taking antibiotics may help restore a balance of bacteria, but the evidence is mixed. If you need to take antibiotics, talk to your healthcare provider about how to ensure you take them correctly, and whether probiotics may be useful for you.

Using Diet to Cleanse Candida Overgrowth

While there isn't a consensus on a "Candida diet", some studies and/or practitioners suggest it may help prevent yeast infections by reducing or avoiding foods such as:

Sugar
Dairy products and foods with high concentrations of yeast (like cheese, peanuts, and alcohol)
Processed foods

Eating certain foods may help prevent yeast infections, including:

Garlic
Nuts
Yogurt with live probiotic cultures
Whole grains
Oregano
Sage
Cinnamon
Cloves

While some people feel better following the "Candida diet," that effect may be due to eating healthier foods, which benefits overall health.

Causes of Persistent (Chronic) Candida Overgrowth

Chronic Candidiasis more commonly affects people who:

Have predisposing health conditions (such as diabetes mellitus)
Have immune deficiencies
Are pregnant

Between 5% and 9% of people with vaginas experience recurrent vaginal yeast infections (three or more confirmed infections annually). Most vaginal yeast infections are caused by a type of fungus called Candida albicans. Still, recurrent or persistent yeast infections may be caused by a less common type of Candida, such as Candida glabrata or Candida krusei.

Vaginal cultures (samples of vaginal discharge tested in a lab) should be done to look for these less common species in people with recurrent or persistent yeast infection symptoms.

Factors that may increase a person's chances of developing recurrent vaginal yeast infections include:

Blood sugar levels
Insulin resistance
Overall immune risk
Presence of vaginal inflammation
Chronic stress
Microbiota (microbes in a specific environment, such as the vagina)

Chronic or recurrent Candida infections may be due to familial Candidiasis. This is an inherited tendency to develop Candida infections, caused by mutations in any of several genes identified with the condition.

A rare and severe form of Candidiasis called chronic mucocutaneous Candidiasis, usually developed in infancy, can cause chronic infection of the:

Talk to your primary healthcare provider if you are experiencing recurrent or persistent Candida infections. If this is not an option, you can try services such as Zocdoc or Minute Clinic.

Preventing Candida Overgrowth When Immunocompromised

For an existing, severe Candida infection that could be life-threatening to someone who is immunocompromised, an intravenous (IV) medication called amphotericin B may be used.

Antifungal prophylaxis (antifungal medication given to prevent the infection) may be recommended for people at high risk for developing invasive Candidiasis.

Summary

Candidiasis is an overgrowth of the Candida fungus. It usually occurs on the skin, in the mouth, in the vagina or on or around the penis, in the gut, or under the nails. Rarely, it can be systemic, affecting areas such as the blood, brain, or heart.

Candida infections are usually treated with antifungal medications such as creams, powders, rinses, lozenges, oral or IV medicines.

While not proven, avoiding or reducing sugar, food and drinks high in yeast and processed foods may help prevent yeast infections. It may also help to eat foods and spices such as garlic, yogurt with probiotic cultures, whole grains, nuts, cinnamon, sage, oregano, and cloves.

Chronic Candida overgrowth may result from compromised immune systems, infection with less common forms of Candida, familial Candidiasis, and Chronic Mucocutaneous Candidiasis.

Antifungal medication may be given as a preventative measure against Candida infection for people at risk for developing invasive Candidiasis.

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