Brief overview
- Diagnosis:Preparation of a fungal culture, microscopic detection.
- Treatment:Antifungal agents (antimycotics) for application or ingestion.
- Symptoms:On the outer skin, reddish scaly papules and itching; on mucous membranes, itching, whitish strippable coatings
- Prevention: Depends on the localization.
- Causes and risk factors: Damp, poorly ventilated skin areas, lowered immune defenses, diseases such as diabetes mellitus, HIV infection, pregnancy, prolonged use of antibiotics or cortisone
- Prognosis and progression: Usually thrush disappears with appropriate treatment. Rarely, namely in the case of a severely weakened immune system, complications are also possible.
What is thrush?
Thrush is an infection caused by certain yeast fungi. The most common thrush pathogen is Candida albicans. Doctors therefore also refer to thrush as candidiasis. Thrush usually occurs on the outer skin or mucous membrane.
In particular, candidiasis occurs in skin folds, in the diaper area of babies (diaper thrush) or on the mucous membrane of the mouth, esophagus, gastrointestinal tract and in the genital area of women and men.
Infestation of other organs (e.g. brain, eyes, bones) as well as the blood with the yeast fungi is possible, but rare. Doctors then speak of systemic candidiasis.
How do you recognize thrush?
If thrush appears on the outer skin, in the mouth or in the genital area, doctors usually suspect candidiasis based on the typical appearance and symptoms. The red skin with small pustules in the diaper area is also a typical indication of thrush in babies for the pediatrician.
To confirm the diagnosis, the doctor usually takes a swab from the changed area and examines it under the microscope.
If an internal infection with Candida albicans is suspected, the laboratory uses the swab to prepare a fungal culture. This allows yeast fungi to be precisely identified and their sensitivity to medication to be tested.
How can thrush be treated?
The treatment of thrush depends on the location and extent of the infestation. For internal infections with the yeast fungus, doctors usually use oral medications. These include antimycotics such as amphotericin B, active substances from the group of so-called triazoles (for example, fluconazole or itraconazole), and nystatin.
In the case of superficial candidiasis of the skin and mucous membrane, antifungal agents for application, for example as a cream, are usually sufficient for thrush treatment. Sometimes medications for the external treatment of fungal infections also contain an anti-itching agent (e.g., cortisone).
Thrush: symptoms and typical locations
- Mouth and throat (oral thrush)
- Skin and skin folds, in babies often diaper area (diaper thrush), in breastfeeding mothers in particular the breast (breast thrush)
- Esophagus (thrush esophagitis)
- gastrointestinal tract
- external genital organs (vaginal mycosis, acorn inflammation/penile mycosis)
- finger and toenails
- internal organs, including blood
Depending on its manifestation, thrush causes symptoms such as skin redness, pustules, scales, whitish coating on mucous membranes, and a burning, painful, or itchy sensation.
In most healthy people, Candida albicans can be detected in the oral or intestinal flora. The fungus does not cause any symptoms. The body’s own defense system ensures that it remains at low germ counts – the fungus is thus a “colonizer” without health consequences.
However, if the immune system is suppressed (especially by medication or disease), the fungi multiply almost unchecked – this is how thrush occurs. Also, if the skin and mucous membranes are sore and injured, the pH value changes or certain metabolic values are derailed (for example in diabetes mellitus), this favors the development of thrush.
Thrush prophylaxis is especially important for babies and very old and sick people, as they are particularly susceptible to fungal infections.
Is there a thrush prophylaxis?
To reduce the risk of infection of the skin and mucous membrane with Candida albicans, the following is useful:
- Dry skin folds (for example, groin area, under the breast, between toe area, diaper area) very carefully after washing, frequent diapering of babies and toddlers
- Wear airy, breathable clothing
- Reduce weight if overweight
- Get treatment for diseases such as diabetes mellitus
- Wear breathable underwear, for example, made of cotton
- Do not use drying washing substances with a high pH value for the intimate area
Especially with Candida infections of the genitals, thrush is contagious. It makes sense to treat both partners to prevent reinfection of each other.
In many cases, a Candida albicans infection is associated with a weakened immune system. A healthy lifestyle with a varied diet, sufficient physical exercise and little stress supports a functioning immune system.
What are the causes of thrush?
The cause of thrush is yeast fungi of the Candida genus. Therefore, doctors refer to the infection with these fungi as candidiasis. A total of about 150 Candida species are known. The most important pathogen is Candida albicans.
The following risk factors are associated with candidiasis:
- Factors that reduce the natural protective mechanisms of the skin (e.g. unfavorable pH, warm and humid environment)
- Diseases such as diabetes mellitus
- HIV infection
- Hormonal changes, e.g. during pregnancy
- Medication, e.g. long-term use of antibiotics or glucocorticoids (so-called cortisone)
- Long-term use of catheters
What is the course of thrush?
The course of thrush depends on the location and extent of the fungal infection. Superficial candidiasis of the skin or mucous membrane as well as genital infections (for example, vaginal thrush) usually heal completely with therapy.
In the case of internal infestation of organs or infection of the blood with Candida yeasts (so-called candidemia), the course is sometimes more complicated and in severe cases life-threatening. In such cases, however, there are often debilitating underlying diseases that favor the Candida infection.
