Dr. Charles "Pat" Davis, MD, PhD, is a board certified Emergency Medicine doctor who currently practices as a consultant and staff member for hospitals. He has a PhD in Microbiology (UT at Austin), and the MD (Univ. Texas Medical Branch, Galveston). He is a Clinical Professor (retired) in the Division of Emergency Medicine, UT Health Science Center at San Antonio, and has been the Chief of Emergency Medicine at UT Medical Branch and at UTHSCSA with over 250 publications.
A Candida skin infection can come from the upper gastrointestinal tract, the lower gastrointestinal tract, or exposure from a care provider. A Candida diaper rash can be accompanied by Candida infection of the mouth (thrush). A breastfeeding infant with a thrush infection may inadvertently infect the mother's nipple/areola area. If such an infection is suspected, simple topical medications may be prescribed by her doctor.
Vicariotto, F., Del Piano, M., Mogna, L., & Mogna, G. (2012, October). Effectiveness of the association of 2 probiotic strains formulated in a slow release vaginal product, in women affected by vulvovaginal candidiasis: A pilot study [Abstract]. Journal of Clinical Gastroenterology, 46 supp, S73-80. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/22955364
For vaginal yeast infection in pregnancy, topical imidazole or triazole antifungals are considered the therapy of choice owing to available safety data. Systemic absorption of these topical formulations is minimal, posing little risk of transplacental transfer. In vaginal yeast infection in pregnancy, treatment with topical azole antifungals is recommended for 7 days instead of a shorter duration.
Taking steps to reduce moisture in the genital area can reduce the chances of developing a yeast infection. Wearing cotton underwear or underwear with a cotton crotch, wearing loose-fitting pants, and avoiding prolonged wearing of wet workout gear or bathing suits are all measures that can help control moisture, and may help reduce the chance of getting a yeast infection.
To treat vaginal yeast infections and thrush, a mother has several options. Dr. William Sears says the nursing mother can safely treat her yeast infection in the traditional manner by using over-the-counter yeast infection creams or the prescription drug Diflucan. Sears says it's important, though, to treat the nipples if it appears that the yeast has spread to the nipples. Over-the-counter treatments such as clotrimazole (Lotrimin or Mycelex) or miconazole (Mycatin or Monistat-Derm) can be applied to the nipples after feedings two to four times a day. Use until the symptoms have cleared up for two days. These medications are safe to take while nursing and don't affect a woman's ability to breastfeed.
This is because vaginal infections caused by bacteria, as well as some sexually transmitted infections (STI), may have symptoms very similar to those caused by yeast, but they require different treatments. Since yeast infection treatments have become available over the counter (OTC), many women simply visit the closest drugstore and buy an antifungal cream.
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That said, you can still see a doctor for confirmation of your yeast infection even if you’ve had one diagnosed in the past. In general, people don’t seem to be particularly good at self-diagnosing their vaginal health issues. A 2010 study of 546 people published in Nursing Research found that study participants with yeast infections misdiagnosed themselves around 30 percent of the time, and those with bacterial vaginosis or the sexually transmitted infection trichomoniasis misdiagnosed themselves around 44 percent of the time. A lot of these conditions can share the same symptoms, so it’s not your fault if you can’t always tell them apart. So, if you’re at all unsure, see a doctor.
The most common treatment for yeast infections is a one-, three-, or seven-day course of antifungal medicines called azoles, which are in medications such as Monistat. “The over-the-counter treatments work well for the most common yeast [that causes infections], Candida albicans,” Linda Eckert, M.D., professor in the Women's Health Division of the department of obstetrics and gynecology at the University of Washington, tells SELF. However, she notes that other strains of yeast can also cause yeast infections, and Candida albicans has developed some resistance to azoles. As such, sometimes longer treatment is necessary, like a course of treatment that lasts 14 days.
For infrequent recurrences, the simplest and most cost-effective management is self-diagnosis and early initiation of topical therapy. However, women whose condition has previously been diagnosed with candidal vulvovaginitis are not necessarily more likely to be able to diagnose themselves; therefore, any woman whose symptoms persist after using an over the counter preparation, or who has a recurrence of symptoms within 2 months, should be evaluated with office-based testing. Unnecessary or inappropriate use of topical preparations is common and can lead to a delay in the treatment of other causes of vulvovaginitis, which can result in worse outcomes.
A: It sounds like your baby may have a yeast infection diaper rash, which can happen if a mild diaper rash gets infected with yeast. This is especially likely if your baby recently took antibiotics. If your baby's had the rash for more than a few days and go-to diaper rash treatments (like Desitin or A+D ointment) haven't helped clear it, call your pediatrician. You'll probably need an anti-fungal cream (there are over-the-counter and prescription versions, but you shouldn't use them without your doctor's approval), which usually helps beat the rash quickly. Your baby should also be evaluated to make sure it isn't something more aggressive than diaper rash.
It's not clear whether vaginal yeast infections can be transferred during sexual intercourse. However, if your sexual partner has the symptoms of candida—redness, irritation and/or itching at the tip of the penis in a male—he may need to be treated. In rare cases, treatment of partners of women with recurrent yeast infection is recommended. Additionally, recurrent yeast infections may be representative of a different problem. Thus, it is important to see your health care provider for an evaluation.
There are plenty of reasons why having a vagina can be great. It can lead to some pretty pleasurable experiences (hey, hey, G-spot orgasms, if that’s a thing your body can do). And, obviously, it often comes with that whole miracle-of-life potential. But there are downsides, too. Enter the dreaded yeast infection: You’re going about your business and suddenly your underwear is covered in a sticky, white residue, or you’re having sex and realize it’s not so much hot as it is burning.
Many girls find that yeast infections tend to show up right before they get their periods because of the hormonal changes that come with the menstrual cycle. Clothing (especially underwear) that's tight or made of materials like nylon that trap heat and moisture might make yeast infections more likely. Using scented sanitary products and douching can upset the healthy balance of bacteria in the vagina and make yeast infections more likely.
Some dermatologists and pediatric infectious disease specialists point out that the effectiveness of these topical creams has been waning over the last few years. An alternative oral medication (fluconazole [Diflucan]) taken once a day for two weeks can be very effective. Many pediatricians will initially recommend one of the topical medications for ease and simplicity and use fluconazole if topical treatment is not effective.
Take antibiotics only when prescribed by your health care professional and never take them for more or less time than directed. In addition to destroying bacteria that cause illness, antibiotics kill off the "good" bacteria that normally live in the vagina. Stopping treatment early, even when symptoms have improved, can cause infections to return and make them resistant to the medication.
Vaginal candidiasis is common. In the United States, it is the second most common type of vaginal infection after bacterial vaginal infections.2 More research is needed to determine the number of women who are affected and how many have vaginal candidiasis that keeps coming back after getting better (more than three times per year). The number of cases of vaginal candidiasis in the United States is difficult to determine because there is no national surveillance for this infection. Vaginal candidiasis can be more frequent in people with weakened immune systems.
Yeast infections are caused by an imbalance in the vaginal flora (the natural bacteria in the vagina), and things that can cause that imbalance are changes in diet, medications you may be taking that wipe out natural bacteria in the vagina (like antibiotics), or other illnesses like diabetes and autoimmune disorders that raise your risk for infection. The most common antibiotics that tend to lead to a yeast infection are those used to treat urinary tract infections, though McHugh said that's likely because doctors just prescribe those antibiotics to women more often.
References: 1. ISSVD. (2016). Vulvovaginal Candidiasis (Candida, Yeast): Tips for Diagnosis and Treatment (Version 1.0) [Mobile application software]. Retrieved from http://itunes.apple.com. 2. Richter SS, et al. Antifungal susceptibilities of Candida species causing vulvovaginitis and epidemiology of recurrent cases. J Clin Microbiol. 2005;43(5):2155-2162. 3. Mølgaard-Nielsen D, Svanström H, Melbye M, Hviid A, Pasternak B. Association between use of oral fluconazole during pregnancy and risk of spontaneous abortion and stillbirth. JAMA. 2016;315(1):58-67. 4. Lowes R. Low-dose fluconazole in pregnancy worries FDA. Available at: http://www.medscape.com/viewarticle/862447. Published April 26, 2016. Accessed August 26, 2017. 5. Centers for Disease Control and Prevention. Vulvovaginal candidiasis. Available at: http://www.cdc.gov/std/tg2015/candidiasis.htm. Updated June 4, 2015. Accessed August 26, 2017. 6. May M, Schindler C. Clinically and pharmacologically relevant interactions of antidiabetic drugs. Ther Adv Endocrinol Metab. 2016;7(2):69-83. 7. Diflucan [prescribing information]. New York, NY: Roerig; 2013. 8. Goswami D, Goswami R, Banerjee U, et al. Pattern of Candida species isolated from patients with diabetes mellitus and vulvovaginal candidiasis and their response to single dose oral fluconazole therapy. J Infect. 2006;52(2):111-117. 9. Nyirjesy P, Sobel JD. Genital mycotic infections in patients with diabetes. Postgrad Med. 2015;125(3):33-46.