Candida is the name of a genus of some twenty species of microscopic yeasts, a type of fungus. About half these species can opportunistically infect human beings, with consequences ranging from (most commonly) discomfort to death (usually among already vulnerable populations). The most common of these yeasts is Candida albicans, the culprit in the majority of yeast infections.
There’s no avoiding the Candida organisms; they pervade the environment, and commonly live, invisibly and trouble-free, on and in human beings. Problems can arise with any upset in the complex balance of microorganisms to which our bodies play host: excess moisture held in skin folds, a course of antibiotics, the residue of sexual intercourse, or hormonal changes such as those brought on by birth control pills.
A candida infection can appear early in life when it is known as diaper rash: flat, red, patches on the skin. Their sharp, scalloped edges, often surrounded by “satellite lesions,” are accompanied by itching or pain. Usually, these can be treated with powder, lotion or cream containing nystatin, which kills the invading organism by breaking down its cell walls. Sometimes another “occlusive agent” is used to keep the warmth, moistness, and skin folds that invading candida loves from further finding opportunities to break down the skin. Treatment, including frequent changes to help keep the skin dry, should stop the spread of the infection, and clear it in a week or two.
These same superficial infections can appear in older adults, for example in skin folds under the breasts, on the belly, or at the corners of the mouth. Older people should be vigilant about oral hygiene and regularly inspect any place where sagging flesh creases over itself. As always, antibacterial soaps are a threat to both general and individual health. In this case, they both dry out the skin and upset the balance of its microbial flora. As always, do your research, read labels and check with your doctor about the proper use of soaps, moisturizers, and skin disinfectants, over and above any topical antifungals that might be prescribed.
At any age, rash or other damage spreading despite treatment requires a doctor’s attention. Other danger signals include chills, fever, nausea and vomiting.
Candida likes mucosal tissue, and can often cause irritating infections of the vagina. Symptoms of vaginal and/or vulvar infection can include burning during urination or pain during vaginal intercourse, and most characteristically, a clumpy white discharge. This is known medically as candidiasis, or more commonly as a yeast infection, or simply candida. These infections can be treated topically with over-the-counter topical antifungals or with plain yogurt with live bacteria.
One thing to be aware of in topical self-treatment is that there is considerable overlap in symptoms between various kinds of vaginal infections. Non-menstrual vaginal discharge can be caused by any number of conditions, including bacterial vaginosis, Chlamydia, gonorrhea, and trichomoniasis. A 2002 study from Obstetrics and Gynecology found that at least among women who opted first for a commercial antifungal, barely over a third had correctly diagnosed themselves with a yeast infection; four out of ten had bacterial vaginosis or mixed vaginitis, and the remaining quarter or so had other diagnoses or no clinically verifiable condition. These results were not affected by whether the women had had a prior clinical diagnosis, or whether they read the directions on the antifungal package. Women readers who have gone through the clinical diagnosis of a yeast infection may have wondered why the diagnostic procedure is so intrusive—if your doctor didn’t explain it to you, now you know.
Recurrent infections may signal an underlying problem such as AIDS, leukemia or diabetes. A discharge that does not resolve within a week requires medical advice. Non-menstrual bloody discharge, more frequent urination, abdominal pain, overall sickness, and fever also require medical attention.
A yeast infection may also recur from being passed back and forth between a penetrative and receptive partner in unprotected sex. Candida can infect the penis months before it shows itself in the form of red, scaly patches and (relatively rarely) unusual discharge.
Hygiene, including sexual hygiene, provides some measure of protection. Douches, however, can precipitate an infection if they upset the normal vaginal flora.
Candidiasis of the mouth, called thrush, erupts in white patches over a red base. The white patches cannot be wiped away easily; scraping with a scalpel, brush or cotton swab typically provokes bleeding of the underlying tissue and is best left to your dentist or doctor. An infection can also redden the tongue. Thrush can be painful enough to interfere with eating and even drinking, to the extent that its sufferers can be subject to dehydration. A child who refuses to drink for longer than twelve hours may need intravenous fluid support. Fever or prolonged feeding problems also require medical consultation.
A doctor or dentist can usually diagnose thrush and provide a prescription for oral antifungals: a tablet, lozenge or liquid administered for up to two weeks. If the infection spreads into the esophagus, both diagnosis and treatment become more complicated. Candidal esophagitis, particularly in people with AIDS or otherwise weakened immune systems, can spread further into the gastrointestinal tract and cause painful ulcers, interfering further with nutrition and hydration.