Tuesday 25 August 2015

Have we gone beyond Candidal skin infection not being serious, we need to stop treating the symptom and kill the cause

A rash caused by candida is usually not serious and is usually easily treated with an antifungal cream.
Candida is a type of yeast (fungus). Small numbers of candida normally live on your skin and do no harm. Sometimes, under certain conditions, they can multiply and cause infection. The common sites for candida to cause infection are your vagina (vaginal thrush), your mouth (oral thrush) and your skin. This leaflet just deals with candidal skin infections. See separate leaflets called Vaginal Thrush and Oral Thrush for further details.
Usually not. Most infections occur in people who are otherwise healthy (although they are more common if you are overweight). Treatment usually works extremely well. In some people, the candidal skin infection may be the first indication of another condition such as diabetes.
The chance of a candidal skin infection developing is more likely in the following situations:
  • Areas of skin that are moist or sweaty are ideal for candida to thrive. Therefore, the common sites affected are in the folds of skin in your groin, armpits and under large breasts. (Another name for inflammation within a fold of skin or under a breast is 'intertrigo'. Candidal infection is a common cause of intertrigo.) Nappy rash is sometimes due to candida. Obese people may develop candidal infection between folds of skin. It can also affect skin between your fingers and toes and at the corners of your mouth.
  • If you have diabetes.
  • If you take a long course of antibiotics or steroid medication.
  • If you have a poor immune system. For example, if you have AIDS, or have chemotherapy, or have certain types of serious blood disorder.
In affected folds of the skin (under breasts, groin, etc) a typical red rash develops. The rash is usually sore and itchy. Small blister-like swellings may develop on the rash. Skin scale can accumulate on the rash to produce a white-yellow, curd-like substance over the affected area. If the areas between toes or fingers are involved, the affected skin may become thick and macerated (where your skin softens and becomes a whitish colour).
  • An antifungal cream usually clears the infection within a week or so.
  • Sometimes a mild steroid cream is added to reduce inflammation whilst the antifungal cream is working. There are creams available which contain a combination of antifungal and steroid which are easier to use. (However, a steroid cream alone will make the condition worse as soon as the steroid is stopped.)
  • Occasionally, if your rash is widespread, antifungal tablets are prescribed.
  • Your doctor may recommend that you wash your skin with a moisturising cream or ointment (emollient) which is more sensitive on your skin than soap products.
  • Some people with a candidal skin infection can develop a secondary infection caused by a germ (bacterium).  It is important to see your doctor if your skin infection does not improve or if it worsens, as you may need an alternative treatment for a bacterial infection. This is usually a different cream or antibiotics.
To minimise the risk of a candidal skin infection:
  • Keep areas likely to be affected as clean and dry as possible.
  • Always dry well after washing, particularly in your groin, armpits and under large breasts. Some people use a hairdryer to dry these areas after washing to ensure they are dry before putting clothes on.
  • Wear light, loose, absorbent clothing and avoid wool and synthetic fibres. This helps to keep your skin from becoming too moist.
  • Losing weight may help if obesity is contributing to this problem.
  • If you are troubled with repeated infections at the angle of your mouth and you wear dentures:
    • Remove the dentures each night to clean them.
    • Sterilise the dentures overnight.
If the infection keeps recurring for no apparent reason, a test to check for sugar (diabetes) may be advised by a doctor.

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