Cure skin yeast infection. Comprehensive Guide to Yeast Infections: Causes, Symptoms, and Treatment Options
What are the common causes of yeast infections. How can you recognize the symptoms of a yeast infection. What are the most effective treatment options for yeast infections. How can you prevent recurring yeast infections. What are the potential complications of untreated yeast infections.
Understanding Yeast Infections: Causes and Risk Factors
Yeast infections occur when the fungus Candida albicans grows excessively on various parts of the body. While Candida is naturally present on the skin and in mucous membranes, certain conditions can disrupt the balance of microorganisms, leading to overgrowth and infection.
What causes yeast infections? Several factors can contribute to their development:
- Compromised immune system due to diseases like HIV/AIDS or cancer treatments
- Prolonged use of antibiotics, which can eliminate beneficial bacteria
- Hormonal changes from birth control pills or hormone replacement therapy
- Diabetes, which can create an environment conducive to yeast growth
- Warm, moist environments that promote fungal growth
- Contact with infected individuals or contaminated surfaces
Are certain individuals more susceptible to yeast infections? Yes, those with weakened immune systems, frequent antibiotic use, or underlying health conditions like diabetes face a higher risk. Additionally, individuals who spend time in humid environments or wear tight-fitting clothing may be more prone to developing yeast infections.
Recognizing the Symptoms of Yeast Infections
Identifying a yeast infection early is crucial for prompt treatment and relief. The symptoms can vary depending on the affected area of the body.
Common Signs of Yeast Infections
- Itchy, red rash on the skin
- White, cottage cheese-like discharge (in vaginal infections)
- Burning sensation during urination or intercourse
- Swelling and irritation in the affected area
- Cracking or peeling skin, especially between toes or in skin folds
How do symptoms differ in various types of yeast infections? Oral thrush presents as white lesions on the tongue and inner cheeks, while nail infections may cause discoloration and thickening of the nail. Skin yeast infections often appear as red, itchy rashes with distinct borders.
Diagnosing Yeast Infections: When to Seek Medical Attention
While mild yeast infections can often be treated at home, persistent or severe symptoms warrant professional medical evaluation. Healthcare providers can accurately diagnose yeast infections through physical examination and laboratory tests.
What diagnostic methods are used for yeast infections? Doctors may employ the following techniques:
- Visual inspection of the affected area
- Microscopic examination of skin scrapings or discharge
- Culture tests to identify the specific strain of yeast
- Blood tests to check for systemic infections
When should you consult a doctor for a yeast infection? Seek medical attention if you experience recurrent infections, severe symptoms, or if over-the-counter treatments prove ineffective. Individuals with compromised immune systems or diabetes should always consult a healthcare provider for yeast infection symptoms.
Conventional Treatment Options for Yeast Infections
The treatment approach for yeast infections depends on the severity and location of the infection. Both over-the-counter and prescription medications are available to combat fungal overgrowth.
Over-the-Counter Treatments
For mild to moderate yeast infections, several over-the-counter options are effective:
- Antifungal creams and ointments containing miconazole or clotrimazole
- Suppositories for vaginal yeast infections
- Antifungal powders for skin infections
- Oral thrush treatments like nystatin drops
Prescription Medications
In cases of severe or recurrent infections, healthcare providers may prescribe stronger treatments:
- Oral antifungal drugs such as fluconazole or itraconazole
- Prescription-strength topical medications
- Intravenous antifungal therapy for systemic infections
How long does it take for yeast infection treatments to work? Most topical treatments show improvement within a few days, while oral medications may take 1-2 weeks for full effectiveness. It’s crucial to complete the entire course of treatment as prescribed, even if symptoms improve, to prevent recurrence.
Natural Remedies and Alternative Treatments for Yeast Infections
In addition to conventional treatments, some individuals seek natural alternatives to manage yeast infections. While scientific evidence varies, certain remedies may offer relief for some people.
Potential Natural Remedies
- Probiotics to restore balance to the microbiome
- Tea tree oil as a topical antifungal agent
- Garlic, known for its antifungal properties
- Coconut oil as a natural moisturizer with antifungal effects
- Apple cider vinegar baths or diluted applications
Can dietary changes help prevent or treat yeast infections? Some evidence suggests that reducing sugar intake and consuming probiotic-rich foods may support overall microbial balance. However, dietary modifications should complement, not replace, medical treatments for active infections.
Preventing Recurrent Yeast Infections: Lifestyle and Hygiene Tips
While not all yeast infections are preventable, certain lifestyle changes and hygiene practices can reduce the risk of recurrence.
Preventive Measures
- Wear breathable, loose-fitting clothing
- Change out of wet or sweaty clothes promptly
- Practice good hygiene, especially in warm, moist areas of the body
- Avoid douching or using scented feminine products
- Manage underlying health conditions like diabetes effectively
- Use antibiotics only when necessary and as prescribed
How can you maintain a healthy balance of microorganisms in your body? Supporting your immune system through a balanced diet, regular exercise, stress management, and adequate sleep can help maintain the natural balance of microorganisms and reduce the risk of yeast overgrowth.
Complications of Untreated Yeast Infections
While many yeast infections are uncomfortable but harmless, leaving them untreated can lead to more serious complications, especially in individuals with compromised immune systems.
Potential Complications
- Spread of infection to other parts of the body
- Systemic candidiasis, affecting internal organs
- Increased risk of other infections due to skin barrier disruption
- Chronic, recurring infections that become resistant to treatment
Can yeast infections become life-threatening? In rare cases, particularly in immunocompromised individuals, yeast infections can spread to the bloodstream or lungs, leading to severe systemic infections that require immediate medical attention.
Yeast Infections in Special Populations: Pregnancy, Diabetes, and Immunocompromised Individuals
Certain groups face unique challenges when it comes to yeast infections, requiring specialized care and treatment approaches.
Yeast Infections During Pregnancy
Pregnant women are more susceptible to yeast infections due to hormonal changes. How are yeast infections treated during pregnancy? While some over-the-counter treatments are safe, it’s essential to consult with a healthcare provider before using any medication during pregnancy.
Managing Yeast Infections with Diabetes
Individuals with diabetes are at higher risk for yeast infections due to elevated blood sugar levels. Effective diabetes management, including blood sugar control and proper hygiene, is crucial in preventing and treating yeast infections in this population.
Yeast Infections in Immunocompromised Patients
Those with weakened immune systems, such as HIV/AIDS patients or individuals undergoing chemotherapy, may experience more severe and frequent yeast infections. These cases often require aggressive treatment and close medical monitoring to prevent complications.
How does the approach to treating yeast infections differ in these special populations? Treatment plans are typically tailored to address the underlying condition while safely managing the yeast infection, often involving longer courses of treatment or alternative medications to avoid potential drug interactions.
The Future of Yeast Infection Treatment: Research and Emerging Therapies
As our understanding of fungal infections grows, researchers continue to explore new treatment options and preventive strategies for yeast infections.
Promising Areas of Research
- Development of new antifungal drugs with fewer side effects
- Investigation of probiotics as a preventive measure
- Exploration of natural compounds with antifungal properties
- Advancements in rapid diagnostic techniques
What potential breakthroughs are on the horizon for yeast infection treatment? Scientists are investigating targeted therapies that disrupt fungal growth mechanisms without harming beneficial bacteria. Additionally, research into the human microbiome may lead to novel approaches for maintaining microbial balance and preventing fungal overgrowth.
As we continue to advance our understanding of yeast infections, it’s clear that a multifaceted approach combining conventional treatments, lifestyle modifications, and emerging therapies offers the best hope for effective management and prevention of these common yet troublesome infections. By staying informed about the latest developments and working closely with healthcare providers, individuals can take proactive steps to maintain their health and well-being in the face of fungal challenges.
Yeast Infections – Dr. Weil’s Condition Care Guide
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What are yeast infections?
Yeast infections occur when the fungus Candida albicans grows rapidly anywhere on the body from the mucus membranes of the oral cavity, under the nails, on the scalp, in the pelvic area or any other areas of the skin, especially where it can be moist. Candida is found normally on the body, but bacteria and other normal inhabitants usually keep fungal growth in check. However, if the balance of these organisms is altered, Candida can multiply, resulting in overgrowth and potentially severe medical concerns, especially when yeast gets into the blood or lungs.
What are the symptoms of yeast infections?
The first sign of yeast overgrowth is typically an itchy rash. In the case of thrush, white lesions on a red base are seen on the tongue, inner cheeks and occasionally, the roof of the mouth, gums and tonsils. This can cause pain when swallowing as well as a feeling of tightness in the throat, as if food were “sticking” there. Fever can occur if the infection spreads past the esophagus.
Nail fungus typically begins with a white or yellow spot appearing underneath the tip of the nail, which then thickens and distorts as the infection progresses. As yeast grows under and into the nail, crusting, discoloration and darkening begin. Moreover, infected nails can oftentimes separate from the nail bed, which can cause pain in the tips of fingers and toes, as well as a slightly foul-smelling odor.
Yeast likes warm, wet places to grow and prefers to nestle into folds of redundant skin. Fungal overgrowth on skin can appear as ringworm, a ring-shaped, red rash, with a wavy, wormlike border on the scalp, extremities, chest and back. Besides ringworm, the same fungus is also responsible for athlete’s foot, jock itch, diaper rash and vaginal infections. This rash can cause itching, burning, small blisters, inflammation and cracked, scaly skin especially between fingers and toes and within skin folds. Itching and burning may worsen as the infection spreads. Yeast can also spread if you scratch the infection and then touch yourself elsewhere, especially moist areas like the feet, groin and underarms. The fungus can also be transmitted to other parts of the body from contaminated bedding, towels or clothing.
Yeast infections can become life-threatening when they invade the circulatory system and lungs. This is most often seen in people with compromised immune systems. There is also some question whether yeast overgrowth within the digestive tract contributes to chronic gastrointestinal symptoms like gas, bloating, and either diarrhea or constipation.
What are the causes of yeast infections?
Candida infections can occur when the immune system is compromised by disease or suppressed by medications, like antibiotics, which change the normal balance of microorganisms in the body. Prolonged or frequent use of antibiotics can wipe out the “friendly” bacteria that normally keep yeast in check, resulting in overgrowth. Medical conditions related to the incidence of recurrent yeast infections include diabetes, HIV/AIDS, immune suppression in bone marrow transplant patients and those with cancer taking chemotherapy, as well as those who take immunosuppressive drugs. Other medicines besides antibiotics that can wipe out intestinal flora or encourage overgrowth of yeast are steroids and estrogen, either in the form of birth control pills or hormone replacement therapy.
Moreover, yeast skin infections can be picked up by touching a person who already is infected or from walking on damp floors in public showers or locker rooms. It’s also possible to catch a fungal infection from dogs and cats, or from farm animals. A sign that animals are infected is a patch of skin with missing fur.
What is the conventional treatment of yeast infections?
Over-the-counter antifungal medications are often recommended for skin infections. Patients are advised to use drying powders, creams or lotions containing miconazole or clotrimazole, and there are also liquid drops of nystatin available for thrush. Oral antifungal drugs such as itraconazole (Sporanox) or griseofulvin (Grisactin) are most often prescribed for stubborn infections, although these drugs are not without side effects and need monitoring by a physician if prolonged therapy is required. For those with HIV/AIDS, prescription antifungal medications such as amphotericin B may be used when other medications do not prove helpful. Intravenous antifungal therapy is often used for severe systemic infections. Because these drugs can cause serious and possibly life-threatening liver damage, patients who take them should have their liver function monitored regularly.
What therapies does Dr. Weil recommend for yeast infections?
Diet: A diet high in sugar may predispose some people, especially women, to yeast infections. Experiment with cutting back on refined sugars. You may even want to lower carbohydrates as a group for a time. Over a four to six week period, avoid fruits and fruit juices (except green apples, berries, grapefruit, lemons and limes), dairy other than plain yogurt and sour cream, breads and grains, alcohol, peanuts, potatoes and beans. Also stay away from sugary condiments like ketchup, salad dressings, horseradish, and barbecue sauces.
Be sure to eat plenty of fresh vegetables of various colors, as long as they are not starchy or root vegetables like carrots, parsnips, or rutabaga. Eat one to two cloves (not the entire bulb) of garlic per day, preferably raw. Garlic has a long history of use as an effective antifungal agent. You may also want to use thyme in your cooking, which is approved in Europe for use in upper respiratory infections and is effective against oral thrush.
Topical herbal preparations: Dr. Weil recommends tea tree oil, extracted from the leaves of Melaleuca alternifolia. This is a natural disinfectant that works as well or better than pharmaceutical antifungal products. Apply a light coating to the affected area two or three times a day, and continue to apply it for two weeks after signs of the infection have disappeared to make sure the fungus is eradicated. You’ll find tea tree oil products at health food stores – be sure to select brands that are 100 percent tea tree oil. An alternative remedy is grapefruit seed extract used the same way as tea tree oil – twice a day for at least two months.
You can also use topical calendula cream or lotion made from petals of the ornamental “pot marigold” (Calendula officinalis) to soothe the affected areas of skin irritated by yeast. Look for products with at least 10 percent extract of this plant, and you might also try washing the irritated skin with a diluted solution of calendula tincture.
Probiotics: A proven probiotic product such as Lactobacillus GG or Bacillus coagulans (BC-30) may help to help restore normal gut flora. This is also a good preventive strategy whenever you have taken a dose of antibiotics. The dose is one tablespoon of the liquid culture or one to two capsules with meals unless the label directs otherwise.
Other supplements: For yeast infections of the skin, Dr. Weil also recommends taking a good multivitamin plus a supplement of gamma-linolenic acid (GLA) in the form of black currant oil or evening primrose oil. The correct dosage for adults is 500 mg twice daily; half the dose in children.
Healing My Confidence and My Skin From Chronic Yeast Infection
“Yeast? Like, in bread? How is that stuff, you know … down there?“
I had my first yeast infection when I was a preteen. I waited at least a week to tell the school nurse about the severe, itchy, burning pain.
I regretted telling her at all.
That nurse took one look at me and said, “Yeast infections are common for girls like you. Chubby girls.” I felt offended but realized asking about bread probably hadn’t helped my case.
She continued: “You probably didn’t clean yourself well enough. Skin irritation is part of growing up, and if you take care of yourself properly, the infections will go away.”
They never did.
Over the years, I carefully washed myself multiple times a day, changed my underwear and even regulated my sugar intake. When these precautions inevitably did not prevent another rash or infection, I felt like I had failed. I’d always been taught that clean people don’t contract these genital skin conditions. Since I had frequent vaginal yeast infections despite my best efforts, I believed there must be something innately dirty about my plus-sized, female body.
I felt this adolescent shame rush back last year when I was sitting in the bathroom at work. That summer, I had secured my first professional paid internship with my dream organization. I styled my hair and purchased business attire that would keep me comfortable in the swampy Washington, D.C., heat: biking shorts with flowy black dresses, tailored gray suit jackets and cropped trousers. I felt healthier and, well, cleaner than ever. But my new-found confidence flickered when I developed two skin infections that summer.
In the cramped bathroom stall, I struggled to apply a dose of a medicated cream that I’d purchased from the pharmacy on my lunch break. After I’d stepped out of the store, my stomach growling, I saw my supervisors across the street, eating at a cafe. I shoved the transparent shopping bag under my arm and picked up my pace.
All of my skin — including the skin on my genitals — was supposed to help me navigate the world and keep me healthy. Now, my vagina was making my world feel smaller and more isolated than ever. With my burning pain, I had trouble focusing on my work or — even worse — sitting on the hard Metro train seats on the long, bumpy commute home.
While I knew that yeast infections were common in puberty, I never expected them to follow me into adulthood. I lingered in that bathroom stall as long as I could, lonely and embarrassed. My self-esteem stung almost as badly as my skin.
I didn’t realize then that I was not alone in my struggle with chronic yeast infections. Three in four women experience some sort of yeast infection in their lifetimes, and most women report having multiple yeast infections. Plus-size people like me are especially vulnerable to yeast infections — not because we are less hygienic, but because our bodies tend to sweat and hold heat more than thinner bodies do.
When I began talking with other chronic yeast infection sufferers, I recognized that the embarrassment and social stigma about women’s bodies often prevent us from learning from one another and advocating for our wellness. Nearly every woman I spoke with, especially plus-sized women, shared a similar story. How many of us had swallowed our pain like a horse pill, afraid to talk about “TMI” experiences when we were struggling with the same symptoms?I finally understood that yeast, or candida, isn’t a moral condition. It’s simply an organism that lives on the ecosystem of the human body. And like any other ecosystem, human skin sometimes needs extra help to stay balanced.
During one of the hottest summers in D.C.’s history, the odds of contracting a skin infection were stacked against me in 2019. Many dermatologists have correlated hotter weather with more frequent yeast infections and jock itch rashes. Why? Candida flourishes in hot, moist environments. Think of sweltering public transport, walking in the heat and sitting at a desk for long stretches of time. Like other working women, these elements made up my daily routine. It wasn’t that my body was wrong or dirty.
With this realization, I was able to heal from my shame. But how could I heal my irritated skin and do my best to prevent this pain in the future?
I still cope with yeast infections, especially since I’ve moved to an even hotter location: Florida. My previous doctors had suggested I wear linen or other loose-legged pants to allow my groin to breathe, but this thin material doesn’t work with “chub rub. ” The pants wore down and quickly showed holes from the friction of my thighs. Fortunately, breaking my silence about yeast infections helped me find a new health care provider. My provider encouraged me to embrace breathable cotton granny panties, carry a spare pair of underwear and use thigh-protecting balms instead of leggings to avoid chub rub. This doctor treats me with dignity, and she suggests the best preventive strategies for my skin in all of its resilient, plus-sized beauty.
So months later, I no longer felt alone or ashamed when I began to feel the telltale burn between my legs while traveling to a conference in Chicago. Instead of being angry at my body for the infection, I silently thanked it for allowing me to experience a new city. Since my body takes care of me 24/7, I couldn’t hold a grudge against it for needing me to return the favor once in a while.
And this time, after a quick underwear change and some soothing ointment, my skin and I were both ready to leave the bathroom stall and tackle the world together.
Laken Brooks is a current PhD student at the University of Florida where she studies disability, gender and digital humanities. When she’s not studying and teaching, she is a freelance writer for CNN, Inside Higher Ed, Good Housekeeping and other national publications.
Frontiers | Malassezia-Associated Skin Diseases, the Use of Diagnostics and Treatment
Introduction
Yeasts of the genus, Malassezia, formerly known as Pityrosporum, are lipophilic yeasts, which are a part of the normal skin flora (microbiome). The genus Malassezia belongs to the phylum Basidiomycota (class Malasseziomycetes) and the genus consists at present of 17 species (Grice and Dawson, 2017; Theelen et al., 2018). It is the most prevalent fungal genus of the healthy skin, but these yeasts also demonstrate a pathogenic potential where they can, under appropriate conditions, invade the stratum corneum. They interact with almost all the cellular constituents of normal epidermis, including keratinocytes, Langerhans cells, melanocytes as well as the host immune system, both directly but also through chemical mediators (Glatz et al. , 2015; Grice and Dawson, 2017). Malassezia colonize the human skin after birth and must therefore, as a commensal, be normally tolerated by the human immune system. Depending on sampling technique and diagnostic methods they have been isolated from 30 to 100% of newborns (Ayhan et al., 2007; Nagata et al., 2012).
Malassezia species are dependent on exogenous lipids because they lack fatty acid synthase genes, except M. pachydermatis (Glatz et al., 2015). This explains their distribution on seborrheic skin areas (face, scalp and thorax), but they have been detected from most body sites except the feet (Grice and Dawson, 2017). There is also a correlation between species diversity and anatomical sampling site (Grice and Dawson, 2017; Theelen et al., 2018).
The species distribution on the skin varies between different Malassezia related diseases, but their worldwide distribution may also differ (Grice and Dawson, 2017). For example, M. sympodialis considered the most prevalent species in Europe and M. restricta and M. globosa the most predominant species in Asia. The difference in the species distribution may not only be revealed by differences in geographic specificity but may also be due to a difference in diagnostic methods used. Most of the European studies used culture-based methods whereas Asian countries generally have applied molecular based methods and as some Malassezia species are slow-growing and more fastidious in culture, such as M. restricta, this particular species in culture may be overgrown by a more rapid-growing Malassezia species as e.g., M. sympodialis (Kohsaka et al., 2018).
Skin diseases caused by Malassezia are usually treated with antifungal therapy and if there are associated inflammatory skin mechanisms this is often supplemented by anti-inflammatory therapy. Different Malassezia species have shown various antifungal susceptibility patterns (Prohic et al., 2016; Theelen et al., 2018). It may therefore occasionally be important to identify the Malassezia species in order to choose the most sensitive antifungal drug although this poses immense practical problems in resource poor settings.
The aim of this paper is to provide an overview of the Malassezia related skin diseases Head and neck dermatitis, seborrheic dermatitis, pityriasis versicolor, and Malassezia folliculitis, their diagnostic methods and treatment options.
Diagnostics
Different sampling methods have been used to confirm the presence of Malassezia yeasts in skin conditions and these include tape stripping, skin scraping, swabs, and contact plates (Darabi et al., 2009). Direct microcopy is used frequently in clinical settings (Saunte et al., 2018) as it can be used to detect fungal elements after application of potassium hydroxide and adding a dye such as e.g., Parker ink, methylene blue, lactophenol blue, May-Grunwald-Giemsa, Gram staining or a fluorescence dye such as Calcofluor white and Blancophor (Rubenstein and Malerich, 2014; Tu et al., 2018). Malassezia is recognized by the detection of characteristic unipolar budding yeasts and in the case of pityriasis versicolor these are accompanied by short hyphae (the so-called spaghetti and meatballs appearance). Hyphae are not detected in head and neck dermatitis and rarely seen in Malassezia folliculitis or seborrheic dermatitis/dandruff. Even though it is possible to see differences in the shape of the Malassezia yeasts cells as e.g., the globose cells of M. globosa or the sympodial budding of M. sympodialis, accurate species identification is not possible by direct microscopy. For this, different in vitro methods have been applied.
The initial isolation usually employs Dixon’s or Leeming-Notman agar and growth at 32–35°C under aerobic conditions. Daily evaluation of the cultures is required to observe the presence of mixed species colonies, which are needed to be separated using needle sampling of the colonies and/or multiple dilutions before subculturing. Identification to species level is achieved by evaluation of the different lipid assimilation profile of the Malassezia species (Guého et al., 1996; Mayser et al., 1997) in combination with microscopic morphological features. However, the variations revealed by this conventional mycology approach are not sufficiently specific for the identification of the current expanded Malassezia species, as there is a common lipid profile overlap between species (Cafarchia et al., 2011; Theelen et al., 2018). Although these culture-based methods are time-consuming and it is difficult to separate closely related species characteristics of each strain.
For this reason during the last five decades molecular based methods (Arendrup et al., 2013) as well as methods that identify the chemical imprint of the different species e.g., different Polymerase Chain Reaction (PCR) techniques, Matrix Assisted Laser Desorption/Ionization—Time Of Flight (MALDI-TOF) mass spectrometry (Kolecka et al., 2014; Diongue et al., 2018; Honnavar et al., 2018; Saunte et al., 2018) and or Raman spectroscopy (Petrokilidou et al., 2019) have been applied to achieve fast and accurate fungal identification.
Discrepancies in the epidemiological data generated by culture and molecular based Malassezia identification methods are well-known and probably reflect differences in growth rate, where the fast growing species may overgrowth slower ones in culture based methods and because molecular based methods are considered to be more accurate (Soares et al. , 2015; Prohic et al., 2016). Additionally, species identification using molecular based methods is dependent on reliable “databases” for sequence comparison.
Antifungal susceptibility of Malassezia species using agar and broth dilution methods (Clinical & Laboratory Standards Institute and European Committee of Antimicrobial Susceptibility Testing assays) with lipid supplementation has been studied (Cafarchia et al., 2012; Leong et al., 2017; Peano et al., 2017; Rojas et al., 2017). In vitro antifungal resistance have been demonstrated in different strains, but as there is no reference procedure for antifungal susceptibility testing the strains may appear susceptible under other test conditions (Peano et al., 2017; Rojas et al., 2017).
Despite the current knowledge of Malassezia species’ association and contribution to skin disorders, the mechanisms underlying their change from a commensal to pathogen are still to be further elucidated. Furthermore, there is a need for standardization of species diagnostic methods and antifungal susceptibility testing.
Malassezia-Associated Skin Diseases
Even though Malassezia is a part of the human microbiome it is also involved in the pathogenesis of head and neck dermatitis, seborrheic dermatitis, pityriasis versicolor, and Malassezia folliculitis. It interacts with both the innate and acquired skin immune systems and thereby causes immune reactions under certain conditions. It is possible to detect IgG and IgM antibodies against Malassezia in most individuals, but healthy persons are usually not sensitized as is the cases with atopic dermatitis patients. The sensitization can in atopic dermatitis (AD) patients cause a type I hypersensitivity reaction contributing to redness, itching and further scaling in the seborrheic areas of the head and neck, the so-called head and neck dermatitis (Glatz et al., 2015; Kohsaka et al., 2018). In seborrheic dermatitis (Faergemann et al., 2001) the inflammatory reaction that leads to the development of seborrheic dermatitis seems to be an irritant non-immunogenic stimulation of the immune system that leads to complement activation and local increase in NK1+ and CD16+ cells. Pityriasis versicolor is an infection which involves proliferation of the organisms and activation of the formation of hyphae to cause superficial invasion of the stratum corneum.
In Malassezia folliculitis the yeasts invade the pilo-sebaceous unit leading to a dilatation of the follicles with large number of Malassezia cells. If the follicular walls rupture this results in a mixed inflammatory infiltrate and clinical inflammation.
Head and Neck Dermatitis
Epidemiology and Pathogenesis
Head and neck dermatitis is a subtype and difficult to treat form of atopic dermatitis, which is generally seen in post-pubertal atopic dermatitis patients. The prevalence of atopic dermatitis among adults in industrialized countries is 1–3% and it affects 10–20% of children (Brodská et al., 2014). It is thought to be due to a type I hypersensitivity reaction to Malassezia antigens (Table 1). The antigens e.g., M. globosa protein (MGL_1304) and its homologs from M. sympodialis (Mala s 8) and M. restricta (Mala r 8) have all been implicated in the pathogenesis of head and neck dermatitis and show different histamine releasing activity (Kohsaka et al., 2018). The Malassezia (antigen) proteins are found in sweat and the disease is therefore triggered by sweating (sometimes referred to as sweat allergy) (Hiragun et al., 2013; Maarouf et al., 2018). IgE antibodies against Malassezia is found in up to 27% of children and 65% of adults with atopic dermatitis (Glatz et al., 2015).
Table 1. Malassezia associated diseases and their possible pathogenesis, main diagnostics and differential diagnosis.
Malassezia’s interaction with the skin immune system is thought to be both humoral and cell-mediated and it contributes to and accentuates the pre-existing skin inflammation in AD (Brodská et al., 2014). It is suggested that an increased pH, which is higher in AD patients, may contribute to allergen release by Malassezia. The disturbed skin barrier in AD allows both Malassezia allergens as well as cells to penetrate the epidermis and hereby introducing them to toll-like receptor 2 on dendritic cells and keratinocytes. A release of pro-inflammatory cytokines and Malassezia spp.- specific IgE antibodies is produced through T cell mediated activation of B cells and through dendritic cells and mast cells and this contributes to the skin inflammation. Furthermore, autoreactive T cells may cross react and sustain skin inflammation (Glatz et al., 2015).
Clinical Presentation
The clinical manifestations of head and neck dermatitis are typically erythematous involvement of the eyelids, forehead and neck; sometimes the changes are wheal-like (urticarial) (Maarouf et al., 2018). Affected areas are itchy and there is often scaling giving the appearances of an eczema flare (Figures 1A,B).
Figure 1. (A,B) Head and neck dermatitis. (A) Neck with erythema and discrete skin scales. Arrows indicate the area. (B) Skin scales, erythema (arrows) and excoriation (square) of neck and cheek.
Diagnosis
The diagnosis is based upon the clinical picture and may be supported a positive type I allergic reaction to Malassezia and a positive skin prick test with Malassezia spp. –specific extract is found in 30–80% of adult atopic dermatitis (Glatz et al., 2015). A study by Devos and van der Valk found that all AD patients with head and neck dermatitis had increased Malassezia-spp. specific IgE as compared with only 13.6% of AD patients without head and neck dermatitis (Devos and van der Valk, 2000). A commercial and standardized kit (ImmunoCAP® m70, Phadia) is available for measuring Malassezia spp.-specific serum IgE (Glatz et al., 2015). The use of atopy patch test shows diverse results (Brodská et al., 2014). In two different studies (Ramirez De Knott et al., 2006; Johansson et al., 2009) there was no correlation between IgE and atopy patch test for Malassezia, whereas Johansson et al. (Johansson et al., 2003) found that atopic patch test was positive in 30% of AD patients without head and neck dermatitis and in 41% of patients with head and neck dermatitis.
Treatment
Head and neck dermatitis can be treated using anti-inflammatory medications, antifungals or a combination.
The main purpose of the antifungal treatment is to reduce the skin colonization thereby reducing the amount of allergen causing the type I hypersensivity. It has been shown that AD patients with head and neck dermatitis treated with anti-fungals (itraconazole) show decreases in the total Malassezia specific IgE, eosinophil count as well as improving clinical severity scores (Ikezawa et al., 2004).
The clinical improvement is usually seen within the first week(s) and the daily regimen is often continued for 1–2 months followed by a twice weekly regimen to prevent relapse (Darabi et al., 2009). Systemic antifungals are useful in severe cases or when treatment failure after topical therapy.
Furthermore, in AD patients repair of the impaired skin barrier and a reduction of the inflammation with e.g., calcineurin inhibitors or topical steroids are very useful (Nowicka and Nawrot, 2019). It is not clear if the reduction of the inflammation is more important than reducing skin colonization of Malassezia for two reasons. First of all the treatment responses to hydrocortisone combined with placebo shampoo compared with miconazole-hydrocortisone cream and ketoconazole shampoo are not significantly different (Broberg and Faergemann, 1995). Secondly, some antifungals have anti-inflammatory properties (inhibit IL-4 and IL-5 production) (Kanda et al., 2001).
Seborrheic Dermatitis
Epidemiology and Pathogenesis
Seborrheic dermatitis is an inflammatory dermatosis with a predilection for anatomical areas with high sebaceous gland concentration such as the midface, chest, back, and scalp. Seborrheic dermatitis located on the scalp and dandruff should be considered as representing different ends of a disease severity spectrum (Grimalt, 2007). Therefore, for scalp disease the term seborrheic dermatitis/dandruff complex is suggested to encompass the scaling both with inflammation (seborrheic dermatitis) and without inflammatory component (dandruff). As dandruff is extremely common and practically all adults are affected at some point in their life, we will note only relevant data in the pathogenesis section that help us to understand seborrheic dermatitis.
Seborrheic dermatitis is a relative common dermatosis and few recent meticulous studies have addressed the point prevalence of this disease. Thus the point prevalence of seborrheic dermatitis in 161,269 working individuals in Germany (Zander et al., 2019) was recorded to be 3.2% with seborrheic dermatitis being three times more common in men than in women. Also, seborrheic dermatitis prevalence increased with age (2.0% in <35 years; 3.6% in 35–64 years; 4.4% ≥65 years) and there was an association with other fungal diseases such as tinea pedis, onychomycosis and pityriasis versicolor. The age dependence of seborrheic dermatitis is probably responsible for the increased prevalence (14.3%) recorded in the Rotterdam study (Sanders et al., 2018a) as the median age of patients was 67.9 years. These robustly acquired data confirm the association of seborrheic dermatitis with gender (two-fold increase in men), season (increased in winter) and generalized xerosis cutis. A darker skin phenotype was a protective factor for seborrheic dermatitis. Whether this was due to difficulty in recording erythema in darker skin types or the fact that it represents a different barrier function in these skin phenotypes is a matter of debate. Nevertheless seborrheic dermatitis was also commonly diagnosed in 2.1% of young Korean male army recruits (Bae et al., 2012) (93.3% of cohort between 19 and 24 years of age), supporting the generally suggested prevalence of seborrheic dermatitis between 2 and 8% (Palamaras et al., 2012).
It well established that seborrheic dermatitis prevalence is significantly increased in subgroups of patients such as those with Human Immunodeficiency Virus (HIV) infection, where it is associated with low CD4 counts (Lifson et al., 1991) as well as neurological patients. These include those with Parkinson’s disease (Skorvanek and Bhatia, 2017) patients as well as patients with spinal cord injury on which seborrheic dermatitis appears above the level of injury (Han et al., 2015), pointing toward brain-skin axis involvement. In the light of the recent implication of Malassezia yeasts in pancreatic ductal carcinoma development (Aykut et al., 2019), these epidemiological observations point to future research areas (Laurence et al., 2019). The understanding of the pathogenesis of seborrheic dermatitis is limited by the overlap with other conditions such as psoriasis (sebopsoriasis), the indistinct borders between seborrheic dermatitis and dandruff and the absence of a robust severity scoring system. Thus, findings in dandruff pathophysiological changes that are generated from scalp are not necessarily applicable to facial seborrheic dermatitis. Likewise only recently markers to differentiate the overlapping cases of psoriasis and seborrheic dermatitis (sebopsoriasis) have been developed. These include immunohistochemistry markers that address clinical and pathological indistinct cases of sebopsoriasis (Cohen et al., 2019). Additionally, seborrheic dermatitis patients do not share susceptibility loci with psoriasis patients (Sanders et al., 2018b). Regarding the implication of Malassezia yeasts in the pathogenesis of seborrheic dermatitis and dandruff there are characteristic and persistent findings that link seborrheic dermatitis or dandruff associated Malassezia strains with the respective conditions. Thus M. furfur strains isolated from seborrheic dermatitis lesions produce, in vitro, significantly more bioactive indolic substances as compared to strains isolated from healthy skin (Gaitanis et al., 2008). These substances [i.e., indirubin, 6-formylindolo[3,2-b]carbazole (FICZ), indolo[3,2-b]carbazole (ICZ), malassezin, and pityriacitrin] are also found on seborrheic dermatitis skin and correspond to the most active aryl-hydrocarbon receptor ligands known (Magiatis et al., 2013). As a marker of their clinical significance, indirubin is used as a potent local treatment for psoriasis (Lin et al., 2018), while there are ongoing clinical trials that evaluate aryl hydrocarbon receptor ligands applied locally for this disease (https://clinicaltrials.gov/ct2/show/NCT04053387). Likewise, the irritating effect on the skin through a compromised permeability barrier function (Turner et al., 2012) of free fatty acids (DeAngelis et al., 2005) and squalene peroxides (Jourdain et al., 2016) produced by Malassezia lipases as a result of its nutritional needs, are key players, at least, in the pathogenesis of dandruff. Accordingly, the skepticism expressed (Wikramanayake et al., 2019) on the implication of Malassezia yeasts in seborrheic dermatitis can be a useful starting point for future research toward the better understanding of seborrheic dermatitis pathogenesis.
Clinical Presentation
Seborrheic dermatitis presents with erythema, small papules and sometime pustules overlayed with greasy, white to yellow scales. The areas of predilection include the nasolabial folds and the upper lip close to the nostrils (Figure 2A), the eyebrows and the root of the nose, the pre- and retro auricular areas, the sternum (Figure 2B) and less often the back. Scalp seborrheic dermatitis/Dandruff does not involve the whole scalp, rather it appears as patchy areas of erythema and scaling. Involvement of the eye presents as seborrheic dermatitis blepharitis.
Figure 2. (A,B) Seborrheic dermatitis. (A) Peri-nasal skin and upper lip with erythema and greasy skin scales. (B) Erythema and greasy skin scales of the chest and a close-up (square) of an area with erythematous lesions.
Diagnosis
The diagnosis of seborrheic dermatitis is mostly clinical. The typical cases are straightforward in their recognition while some confusion can be created when there is co-existence with rosacea or late-onset acne. In rosacea the involvement of “convex” anatomical areas (nose, cheeks) and the evaluation of precipitating factors is of help. In acne the lesions are located in the hair follicles, scaling unless receiving therapy is not prominent and the prevailing lesions are comedones, papules and pustules.
Biopsy should be restricted to difficult to diagnose cases and the appearances are mostly described as a psoriasiform, spongiotic dermatitis without intraepidermal pustules (Table 1). Routine cultures for identification and characterization of Malassezia species involved to a case of seborrheic dermatitis are not currently suggested. Hopefully in the future, our understanding of seborrheic dermatitis pathogenesis could be associated with identification of virulence factors of Malassezia yeasts. This could possibly lead to the development of therapy guided by the pathogenetic mechanisms (tryptophan metabolism, enzyme production) of the case related Malassezia strain.
Treatment
The patient should be informed that seborrheic dermatitis can be a chronic, recurring condition and side-effects of long-term treatment should be weighed against the potential gain. This mostly pertains to topical steroids that are used in clinical practice to rapidly reduce erythema (Gupta and Versteeg, 2017). When long-term control of the inflammatory response in seborrheic dermatitis is required topical use of the calcineurin inhibitors tacrolimus and pimecrolimus is advised (Ang-Tiu et al., 2012). Safety regarding carcinogenicity of these substances is extrapolated from data in atopic dermatitis and does not seem a reason of concern (Cook and Warshaw, 2009). The use of topical antifungals (ketoconazole, ciclopirox) is supported by recent systematic reviews (Okokon et al., 2015) and given their high efficacy and improved safety they should be included in relevant therapeutic schemes. Also it should be stressed that both pimecrolimus and tacrolimus have antifungal action against Malassezia yeasts (Sugita et al., 2006) so at least part of their activity in seborrheic dermatitis can be attributed to this. A variety of alternative or natural product treatments are also suggested for seborrheic dermatitis (Gupta and Versteeg, 2017) while a recent suggestion is the use of formulations that restore the barrier function of the skin (Purnamawati et al., 2017) and definitely formulations that restore the barrier function of the skin will be a useful addition to treatment (Wikramanayake et al., 2019). Furthermore various salts are also efficient, like lithium succinate, which seems to interfere with the availability of the prerequisite lipids for Malassezia growth (Mayser and Schulz, 2016). Systemic antifungals are suggested for resistant or rapidly relapsing cases of seborrheic dermatitis (Gupta et al., 2014).
Pityriasis Versicolor
Epidemiology and Pathogenesis
Pityriasis versicolor is a mild, chronic infection of the skin caused by Malassezia yeasts, characterized by discrete or confluent, scaly, dark or depigmented patches, mainly on the upper trunk but this can extend to the neck, abdomen and other sites, although the peripheries are usually spared.
Pityriasis versicolor occurs in both tropical, where it may be very common, and temperate climates and affects both genders equally. However, lesions in temperate areas are often noticed after a visit to a warmer environment. It is commonest in teen-agers and young adults but can occur at any age. Data on global prevalence is not available, however in tropical climates, the condition is more common than in temperate zones, and in one study from Bahia, Brazil 40% of the population of some areas was affected (Santana et al., 2013). Although there are reports of an association between pityriasis versicolor and a number of other underlying conditions, it generally occurs in otherwise healthy individual although patients with idiopathic and iatrogenic Cushing’s syndrome are more susceptible (Finding et al., 1981). It does not appear to be more common in the acquired immune deficiency syndrome (AIDS) (Mathes and Douglass, 1985).
A striking feature of most cases of pityriasis versicolor is the presence of hyphae in lesions. But the reasons for hyphal growth are still unknown. The activation of the MGL_3741 gene which encodes the enzyme Dihydroxy acid dehydratase (DHAD) in M. globosa has been implicated as it is present in lesional but not non-lesional skin (Aghaei Gharehbolagh et al., 2018) Lack of inflammation in lesions of pityriasis versicolor is noticeable although there is evidence of interaction between Malassezia species in this condition and innate and acquired immunity (Brasch et al., 2014) T-cell inhibition by a lipid component associated with the yeast cell wall has also been reported (Kesavan et al., 1998) which may partially explain the lack of clinically significant inflammation.
The mechanism for the typical pigmentary changes seen in pityriasis versicolor is still not understood, although electron microscopy shows abnormally large melanosomes in hyperpigmented lesions (Figure 3A), and smaller-than-normal melanosomes in hypopigmented ones (Figure 3B). Depigmentation has been explained on the production of dicarboxylic acids produced by Malassezia species (e.g., azaleic acid) causing competitive inhibition of tyrosinase and perhaps a direct cytotoxic effect on hyperactive melanocytes (Nazzaro-Porro and Passi, 1978). M. furfur produces pigments and fluorochromes with tryptophan as sole nitrogen source. They (i.e., malassezin, pityriacitrin, pityrialacton, pityriarubins) may explain some clinical phenomena of pityriasis versicolor (depigmentation. fluorescence, lack of sunburn in pityriasis versicolor alba) (de Hoog et al., 2017).
Figure 3. (A,B) Pityriasis versicolor. (A) Hyperpigmented maculae on the back and a close-up of the lesion (square). (B) Hypopigmented maculae and a close-up of the lesion (square).
The Malassezia species mainly identified in pityriasis versicolor lesions are M. globosa and also M. sympodialis and M. furfur.
Clinical Presentation
The primary lesions are well demarcated macules, which may be slightly erythematous and covered by fine scales which may only be noticeable after scratching the lesional surface. These co-alesce to form scattered patches of hypo- or hyperpigmentation (Figures 3A,B). Itching is very mild. The sites most commonly affected are the upper trunk, but there is often spread to the upper arms, the neck and the abdomen. Lesions in the axillae and groins, and on the thighs and genitalia occur, and extension down the forearms on to the backs of the hands; these atypical forms of pityriasis versicolor may be associated with oval yeast forms seen in direct microscopy. Another rare but well documented variant is one where there is marked atrophy or anetoderma-like change in the skin that follow infection (Tellechea et al., 2012). Pityriasis versicolor is a chronic infection if left untreated. In some patients, lesions recur rapidly and may not respond well to treatment. Such cases, while not common, are seen regularly. Some have been associated with the presence of the organism, M. japonica, and raised IgE levels (Romero-Sandoval et al., 2017).
Vitiligo and chloasma are normally distinguishable from pityriasis versicolor by their complete absence of scaling.
Diagnosis
Under filtered ultraviolet (Wood’s) light, the scaly lesions may show pale yellow fluorescence. Direct microscopy shows coarse mycelium, fragmented into short filaments, together with spherical, thick-walled yeasts. Occasionally, only oval yeasts may be seen (see above). The characteristic appearance on microscopy has been described as “spaghetti and meatballs” (Table 1). Detection of Malassezia species by culture or molecular methods from skin scrapings is of no diagnostic value, and does not form part of the diagnostic investigation of pityriasis versicolor. Dermoscopy, although useful in confirming the scaling, does not identify specific diagnostic features (Mathur et al., 2019).
Treatment
The first line treatment is topical antifungal therapy. The topical azole antifungals work well in pityriasis versicolor, and there is no significant difference in results achieved by different azoles. The usual time to recovery is 2–3 weeks. A practical problem with the use of topical antifungals is the difficulty of applying creams to a wide body surface area. An alternative solution to this is ketoconazole shampoo which is lathered into the skin in a shower and then washed off after 3–4 min, and although it has not been fully evaluated in pityriasis versicolor, two or three applications of the shampoo appear to clear most infections. Terbinafine 1% cream, but not oral terbinafine, is also effective. Another approach is the application of 2.5% selenium sulfide in a detergent base (Selsun® shampoo). It is applied to all the affected areas and left overnight. Alternatives include 50: 50 propylene glycol in water. The latter has also been used intermittently as long-term suppressive therapy to prevent relapse (Faergemann and Fredriksson, 1980).
Oral itraconazole is also very effective in cases of pityriasis versicolor 100 mg daily for 10 days (Delescluse, 1990) although it is usually given in extensive or recalcitrant cases. Fluconazole has also been used.
Whatever medication is given patients should be warned that normalization of pigmentation may take several months after the end of treatment.
Malassezia Folliculitis
Epidemiology and Pathogenesis
Malassezia folliculitis is an inflammatory condition caused by Malassezia yeasts involving the pilo-sebaceous unit.
Predisposing factors includes immunosuppression (e.g., immunosuppressive medication, broad spectrum antibiotics, diabetes, HIV, hematological malignancies), occlusion and sweating (Tragiannidis et al., 2010; Prohic et al., 2016). It is more frequent in, or after visiting, tropical areas or hotter climates because of humidity and high temperatures (Tragiannidis et al., 2010).
The most prevalent species associated with Malassezia folliculitis are M. globosa, M. restricta and M. sympodialis (Akaza et al., 2009; Ko et al., 2011; Durdu et al., 2013; Prohic et al., 2016).
Clinical Presentation
The typical presentation is monomorphic, approximately 2–4 mm, erythematous itchy papules or papulopustules on the chest (Figures 4A,B), back, upper arms, neck and face; some patients have concomitant pityriasis versicolor or seborrheic dermatitis (Hald et al., 2014). Malassezia folliculitis, especially in adolescent, may be misdiagnosed as acne or bacterial folliculitis, but comedones are absent and itching is a common symptom (Hald et al., 2014; Tsai et al., 2019). The itching may be less pronounced in immunosuppressed patients (Hald et al., 2014).
Figure 4. (A,B) Malassezia folliculitis. (A) Erythematous paplues and pustules on the chest of a male and a close-up of a papule (square). (B) On the chest of a woman and a close-up of a papule (square).
Diagnosis
The diagnosis is based upon the clinical picture and symptoms supported by mycological detection and response to antifungal therapy (Prohic et al., 2016). Histopathology can be used to differentiate Malassezia folliculitis from other types of folliculitis such as e.g., bacterial, eosinophilic or pustular drug eruptions. In Malassezia folliculitis invasion and dilatation of follicles with large number of Malassezia conidia (and rarely hyphae) is seen and inside the follicle there is a reticular pattern of keratin plugging in the majority of patients (An et al., 2019). The follicular walls may rupture resulting in a mixed inflammatory infiltrate of neutrophils, lymphocytes and histiocytes in the dermis. Direct microscopy on skin scraping and the content of pustules treated with KOH (and a dye) will detect unipolar budding yeast, rarely hyphae (Table 1). In a study by Tu et al. Gram staining has been shown to have a sensitivity and specificity of 84.6 and 100% as compared with a final diagnosis of Malassezia folliculitis when two of three criteria was met: 1. Typical clinical presentation, 2. Biopsy with Malassezia in inflamed hair follicle, 3. Treatment response to antifungal therapy (Tu et al., 2018). This suggests that direct microscopy which is both rapid, simple and non-invasive is an alternative to histology. Nevertheless, direct microscopy is not species specific as are culture- or molecular-based methods and it does not reveal location of the fungus in relation to the follicle.
Other diagnostic methods includes Wood’s lamp which fluorescence yellow-green when the lesions is illuminated, reflectance confocal microscopy and optical coherence tomography (Rubenstein and Malerich, 2014; Andersen et al., 2018).
In clinical settings initial diagnosis based upon the combination of symptoms such as itch, clinical picture with monomorphic papulopustules without comedones supported by direct mycological detection by microscopy is sufficient to initiate therapy while awaiting histopathology results. The direct microscopy is important to differentiate Malassezia folliculitis from bacterial folliculitis.
Treatment
Systemic itraconazole 100–200 mg daily has been used for 1–4 weeks with a clinical treatment effect of 69–100% (Parsad et al., 1998; Durdu et al., 2013; Suzuki et al., 2016; Tsai et al., 2019) and fluconazole 100−200 mg daily for 1–4 weeks with a clinical effect of 80% (Rhie et al., 2000). Combination of systemic antifungals and topical antifungals (Abdel-Razek et al., 1995; Prindaville et al., 2018) or tretinoin/bensylperoxide (Ayers et al., 2005) is also useful. Topical therapies which have proven useful for the treatment of Malassezia folliculitis include azoles (Back et al., 1985; Rhie et al., 2000; Suzuki et al., 2016; Prindaville et al., 2018; Tsai et al., 2019), selenium sulfide once daily for 3 days then weekly (Back et al., 1985) and propylene glycol 50 % twice daily (Back et al., 1985). Systemic antifungal monotherapy is thought to be more efficient than topical monotherapy, but in a small study (N = 44) comparing ketoconazole cream twice daily with oral itraconazole 100 mg daily an improvement and treatment respond was noted in both groups although the topical treatment required a longer treatment course (Suzuki et al., 2016). Topical therapy may therefore be useful and considered in patients as a prevention measure or in patients with contraindication for systemic therapy.
Recurrence is common after treatment is completed, and maintenance therapies such as weekly topical or monthly oral antifungals have been used as prevention measures (Levy et al., 2007; Rubenstein and Malerich, 2014).
Alternative treatment options include photodynamic therapy (Lee et al., 2010, 2011).
Currently, there is no internationally approved treatment guideline for the management of Malassezia folliculitis.
Conclusion
The Malassezia yeasts are complex fungi which are part of the normal skin microbiome. They have pathogenic potential and are able to cause skin related diseases through different mechanisms: an activation of the immune system as in head and neck dermatitis, an eczematous/inflammatory reaction as in seborrheic dermatitis, an infection of stratum corneum as in pityriasis versicolor or a colonization (invasion) with a large number of Malassezia yeasts of the pilo-sebaceous unit as in Malassezia folliculitis. To support the clinical suspicion of the association between Malassezia and disease, a broad spectrum of techniques is used for the confirmation of the presence of Malassezia yeasts or for the detection of pathogenetic mechanisms such as Malassezia related type I allergy. Traditional direct microscopy, culture on lipid enriched media, biochemical tests and histopathology but also newer molecular based methods can be used for the detection of Malassezia yeast. For confirmation of type I allergy to Malassezia a specific IgE testing or prick testing is useful. A positive treatment response to antifungals, backed by reduction or temporary elimination of the organisms is highly suggestive, if not confirmatory, of a Malassezia etiology, but there are other variables such as the host’s general condition and the species involved. Further investigative work that helps to delineate the disease mechanisms and the role, if any, of other members of the skin microbiome in the process is needed.
Ethics Statement
For patients providing clinical photos a written consent was obtained.
Author Contributions
DS, GG, and RH planned, wrote, and contributed to the critical review of the manuscript.
Funding
This publication was made possible by a grant from the Department of Dermatology, Zealand University Hospital, Roskilde, Denmark.
Conflict of Interest
DS was paid as a consultant for advisory board meeting by AbbVie, Janssen, Sanofi, and Leo Pharma. Leo Pharma and received speaker’s honoraria and/or received grants from the following companies: Abbvie, Galderma, Astellas, Novartis and Leo Pharma during the last 3 years.
The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.
Abbreviations
AD, atopic dermatitis; M, Malassezia; HND, Head and neck dermatitis; PCR, Polymerase Chain Reaction; PV, pityriasis versicolor; SD, seborrheic dermatitis.
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How to Treat Yeast (Fungal) Infections in Pets
Yeast dermatitis is a fairly common inflammatory skin condition in pets. The condition is caused by overgrowth of the Malassezia species of yeast, which are normal inhabitants of the skin, ears, and mucocutaneous areas. Yeast infections are particularly common in hot, humid environments. The infections occur when the yeast reproduces uncontrollably, overpopulating and invading the areas where it normally resides. Usually this will occur when your pet’s immune system becomes compromised and/or strong immunosuppressive drugs are being used. There are other yeast-like organisms or fungi that may invade into the blood and circulation and cause problems in the lungs, liver, spleen, bones, eyes, brain, and other organs. Examples of these other more serious fungi include aspergillosis, blastomycosis, cryptococcus, histoplasmosis, and Valley Fever. These other fungi are found in various areas across the country where soil conditions favor the development of fungal spores amenable to infection in many cases.
Causes & symptoms of yeast infections in pets
Malassezia is a normal inhabitant of your dog’s or cat’s skin, but it becomes problematic only when it changes from a harmless to a pathogenic form. The precise causes of this transformation is unknown, although factors that suppress or imbalance the immune system are often involved. Some factors that may contribute to yeast infections include allergies to fleas, inhalant/contact allergies, food allergies, prolonged use of steroids or antibiotics, hormonal disorders like hypothyroidism or Cushing’s Disease, cancer, chemotherapeutic drugs, and external skin parasites. Pets with excessive skin folds such as the brachycephalic breeds of dogs (Bulldogs, Pugs) are also at increased risk.
Concurrent bacterial skin infection also may cause an increased risk for yeast overgrowth. Yeast overgrowth will often result in increased oil production by the skin, causing increased itching that can create secondary sores, and providing an even more supportive environment for the yeast to thrive.
Symptoms of yeast infection may include intense itchiness, skin irritation, and inflammation, especially around the ears, between the paw pads and digits, and on the nasal folds, anal area, armpits, and neck. Skin redness, sores, and sticky discharge are often secondary to yeast overgrowth. Greasy coat and/or hair loss is also frequently seen, as well as foul-smelling, rancid skin. When occuring in the ears, yeast infections may lead to yellowish green, musty smelling discharge. Some breeds of dogs predisposed to yeast include West Highland White Terriers, Poodles, Basset Hounds, Cocker Spaniels, and German Shepherds.
Remedies for skin and ear yeast infections in pets
Zymox Otic Enzymatic Solution with Hydrocortisone is recommended for yeast of the ears, which often results in dramatic response of clinical symptoms. This product works through the action of antifungal enzymes that literally break up wax and discharge from the ears. For pets with yeast infection on the skin, some excellent products include Be Soothed Tea Tree Oil Skin Relief topical spray (for dogs), Be Super Clean Shampoo, and Medicated Shampoo. The spray works through natural tea tree oil, while the shampoos work with the use of antifungal medicines. In severe cases of yeast overgrowth, oral Ketaconazole or Fluconazole is recommended to help alleviate the infection.
Yeast infections of your pet’s internal organs
Symptoms of internal fungal infections of the lungs and other organs are quite varied. With respiratory involvement, lethargy, fever, coughing, and difficulty breathing, as well as purulent and/or bloody nasal discharge may be seen. Vomiting and loss of appetite also may be seen. Other symptoms vary depending on the organs involved and may include visual symptoms like corneal ulcers and blindness, as well as lameness and neurological symptoms like seizures. Diagnosis can be difficult and may involve X-rays and blood testing. Systemic antifungal medications are often needed for these infections, including Ketoconazole, Itraconazole, or Fluconazole.
Tips to Cure a Yeast Infection
Published: 2017-12-19 – Updated: 2020-06-05
Author: Disabled World | Contact: www.disabled-world.com
Synopsis: Information regarding mouth, rectum and vagina yeast infections including home remedies and relief to help treat persistent Candidiasis. Recurring yeast infections, or chronic yeast infections, are not only annoying but it can also put you at risk of other illnesses like diabetes and chronic urinary tract infection. If you’re treating a yeast infection, you should abstain from sex during the course of the treatment and cure (about seven days).
Main Digest
NOTE: A proper diagnosis from your doctor is very important to ensure you receive the most appropriate and effective treatment to cure your yeast infection.
Yeast Infections Are Also Known as Candida
Candidiasis is an infection caused by a group of microscopic fungi or yeast and there are more than 20 species of Candida. Candidiasis is the common name for a condition that results in the overproduction of a form of yeast normally found in the body at low levels.
Candida, or Candida albicans, is a type of yeast that is generally found in the regular flora of the skin, intestinal track and the mouth, rectum, and vagina. Although Candida is naturally present in the body, it can cause problems if there is an overgrowth, resulting in Candidiasis.
You can develop yeast infections around dentures, under the breast, vagina and lower abdomen, nailbeds, and beneath skin folds. Yeast infections tend to become more common with increased age, but can occur at any age and are known to cause vagina odors.
While yeast infections are thought to be mainly a problem among women, did you know that men can also get them? This is especially true for a man whose wife is suffering from one, since having sex will pass the infection back and forth.
Many women (and men) suffering from yeast infections resort to the remedies found in a drug store: creams, suppositories, and other “medical” remedies. The problem with these is that they tend to help for only a short period of time and then the yeast comes back with a vengeance. In my experience, there are other, more effective ways to combat this evil menace.
Yeast Infection Home Remedies that Worked for Me
Plain yogurt
The good bacteria in plain yogurt helps fight yeast and yogurt can be used both internally and externally. BUT, be sure you buy plain, unsweetened yogurt. Since sugar feeds yeast, this is a crucial point. You can also make your own, using a yogurt starter. I have done this myself and it is simple and the results are quite good. The advantage is that you can use other types of milk, such as soy or almond. While I made mine directly on the stovetop, you can also purchase a yogurt maker, if you want to take the thinking out of the process. Whether purchased or homemade, yogurt is a great thing to eat before meals because it provides “good bacteria” for your stomach to aid in digestion.
For a topical treatment, you can also dip a tampon in plain yogurt and insert it into your vagina or simply rub some on the outside. I have found, however, that leaving it on for a prolonged period tends to have the opposite effect. It seems that once it has done its job, it is best to wipe it off or you will feel itchier due to the moisture.
Garlic
Garlic is a big enemy of yeast! This is one of the most effective home remedies I have found for instant relief. Inserting one garlic tab (such as Shaklee’s Garlic Tabs) or a garlic clove into the vagina every few hours or as needed provides soothing relief. If you use garlic tabs, be sure the ingredients are natural and pure. I highly recommend the Shaklee garlic tabs. They are what I have always used with great results.
Of course, garlic can be taken internally, as well. Again, the Shaklee garlic tabs work great. I have also used Kyolic garlic tabs and liquid in the past with good results. Or, if you don’t mind the smell, you can press a whole garlic clove and drink it down quickly with water. I have found this to be very effective. Do it as often as necessary.
Garlic is one of nature’s amazing “drugs” that has a number of other health benefits, including lowering blood pressure and reducing bad cholesterol. It is a natural antibiotic. In fact, my Greek father-in-law eats raw garlic everyday and, in his mid-sixties, is very rarely sick.
Apple Cider Vinegar (with the mother)
Apple-cider vinegar has many health benefits (including aiding in weight loss) and can be used both internally and externally, as well. However, it is very strong, so it is not recommended that you apply it directly on the skin. It will kill the yeast, but it will burn like nothing you’ve ever felt! The best external application is to add about a cup of it into your bathwater and take a nice hot bath. This will feel very relaxing and soothing and will help temporarily. I don’t find it as effective long-term, however, as the garlic suppositories. They provide full-day relief.
The type of vinegar I recommend is Bragg’s Apple Cider Vinegar, with the Mother. It is important that it have the mother, as this is more natural and less processed. Never use plain, white vinegar! This actually feeds the yeast instead of killing it.
Water
In my opinion, this is one of the world’s most powerful, secret remedies for any illness! I strongly believe that if we all drank the amount of water our bodies need, we would see a great reduction in all types of sicknesses.
Most doctors say that we should drink at least eight 8-oz. glasses of water daily, but many people need even more than that. I have found that simply drinking enough water greatly reduces my likelihood for getting a yeast infection. Because I am drinking more water, and subsequently urinating more frequently, my body is able to flush out the sugars that feed the yeast.
Be sure to drink water that is pure and free from toxins. It is best to purchase some type of water filtration system, such as one made by Shaklee. Other brands that are good are the Brita and PUR brands. Be sure that regardless of what system you purchase, you do your research first to be sure that it will be effective in its performance.
If you do only one thing, drink more water. It’s easy, accessable, natural, and has no side effects!
Oil of Oregano
This is an amazing herb! It is very potent against yeast. Take it internally daily, according to directions. Be sure, also, that the type of oil you choose has a high carvacrol content, as this is the active ingredient. I recommend Oreganol Super Strength P73.
Beneficial Bacteria Supplement
A healthy body contains trillions of microoragnisms, most of which reside in the colon.
Their main function is to provide balance for less-desirable organisms (such as yeast). I use Shaklee Optiflora to help maintain these probiotics and prebiotics in my intestines. I have used other products in the past, but have not found that their level of quality matched this product’s. Other products can only gaurantee a certain amount of organisms at manufacture. However, Shaklee gaurantees that the bacteria will be alive when you ingest it and be delivered to the intestines. So, at this point, I can only suggest their product.
Solutions-4-You
This is a botanical, non-toxic multi-purpose solution that can be sprayed directly onto the skin. It is extremely soothing on a yeast infection and is effective at killing yeast. I use it straight from the bottle, without diluting it. I find it works best that way, but please be aware that this is not how the company recommends using it. It can be purchased at solutions-4-you.com
Things to Avoid When Fighting a Yeast Infection
- Taking birth control pills – Birth control pills weaken the immune system, making you succeptable to yeast.
- Taking antibiotics – Antibiotics also weaken the immune system.
- Douching – Douching can upset the natural balance of bacteria in the vagina.
- Feminine deodorants – These can be very irritating to anyone, especially those with yeast infections.
- Non-cotton underwear – Any underwear made of man-made fibers is not breathable, as cotton is. They trap moisture and heat, creating a perfect environment for yeast.
- Clothing that is tight in the crotch – Tight clothing also creates a warm environment for yeast to grow.
- Sitting in a wet bathing suit for a prolonged period – This creates not only a warm environment, but a moist one, as well. Perfect for yeast growth!
- Pantyhose – Tight, man-made fiber that also allows yeast to flourish.
- Foods that feed yeast – Avoid sugar, yeast, refined foods (such as white flour). See our list of food to eat and avoid when you have candida.
Yeast Infection of the Mouth
Picture of a person with oral candidiasis (thrush), showing their tongue.
A mouth yeast infection can be a scary thing. Technically, the term is thrush and happens mostly in infants and babies. Adults can get a mouth yeast infection though, so it’s important to know how to cure it as fast as possible.
There are many triggers that can cause a mouth yeast infection.
Often people who suffer from asthma and use inhalers will get a mouth yeast infection. The steroids in the inhaler medication can bring about a mouth yeast infection very easily. That’s why it’s so important to rinse after using an inhaler. Symptoms of a mouth yeast infection include white patchy sores on the mouth that may bleed if they are scraped or tongued. They are usually very uncomfortable and can look pretty gross.
A mouth yeast infection in adults can also be a symptom of a weak immune system so watch out for that. For example, people who have HIV have a much higher probability of developing a mouth yeast infection or thrush. Having a dry mouth can lead to thrush as well. The condition opens your mouth tissue up to bacteria and makes it more vulnerable.
Diabetes causes a mouth yeast infection as well. Candida or Yeast thrives off of sugars and a diabetic will have higher sugar levels in their blood so it only follows that they are more vulnerable to the condition.
Antibiotics may cause a mouth yeast infection by killing off too much bacteria at once in your mouth. A result is candida overgrowth or a yeast infection. When a yeast infection occurs, it can occur anywhere – even the mouth.
Pregnancy can also bring on a mouth yeast infection because of changes in hormonal levels.
Treatment for Mouth Yeast Infections
- Drink cool liquids to cool and soothe the mouth yeast infection.
- Rinse your mouth with warm saltwater
- Avoid sugars and complex carbohydrates to “starve” the infection
- Gentian violet is a dye that kills bacteria and fungi. This can help. This solution should only be used on adults. Talk with your doctor on how to apply this remedy.
Recurring Yeast Infections
For the average, relatively healthy woman, a non-recurring yeast infection is a non-imposing, slightly irritating situation that is generally cleared within a week using over-the-counter or homeopathic remedies. However, recurring yeast infections, or chronic yeast infections, are not only annoying but it can also put you at risk of other illnesses like diabetes and chronic urinary tract infection. Recurring yeast infections are a common problem in diabetics and in those who consume a high sugar diet. When you have more than four infections in a year, you have a condition known as recurring yeast infection.
Birth control is one of the most common causes of recurring yeast infection.
Some women have reported that their recurring yeast infection has gotten better after discontinuation of the pill. Another cause of recurring yeast infection is food, especially sugars and sweet treats. If the level of these sugars are not controlled well and allowed to get high, you will likely experience a recurring yeast infection. Moisture trapped around the vagina can also be the cause of recurring yeast infection. One of the last causes of recurring yeast infection is a change in the immune system. Women who have HIV are also at risk for recurring yeast infection.
It is also important for recurring yeast infection sufferers to become familiar with the possible causes of their infections. For those with recurring yeast infections, the simple touch, tingle, or pain in the genital or pubic region can be the earliest alarm that the infection has returned.
While many patients with recurring yeast infections are eventually placed on prescription medications, medical professionals are reluctant to use this course of treatment because of the possibility of becoming immune to the drug. It is often suggested that recurring yeast infections be treated by alternating over-the-counter medication for one course, and a prescription for the next. One of the most common prescriptions for stubborn or recurring yeast infections is Diflucan, in varying strengths as needed.
Yeast Infection Cures
Some products merely relieve the symptoms, and others cure the infection.
When choosing the treatment for your yeast infection, select a cure so you have the best chance to eliminate your yeast infection. If you’re treating a yeast infection, you should abstain from sex during the course of the treatment and cure (about seven days). Prescribed medicines may cure yeast infection but if you experience recurring yeast infections don’t ignore it as it may lead to chronic yeast infections.
Also See:
NOTE: A proper diagnosis from your doctor is very important to ensure you receive the most appropriate and effective treatment to cure your yeast infection.
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Cite This Page (APA): Disabled World. (2017, December 19). Tips to Cure a Yeast Infection. Disabled World. Retrieved November 20, 2021 from www.disabled-world.com/health/dermatology/yeast-infection.php
Yeast Infections in Dogs – Whole Dog Journal
Thirty years ago, even though the systemic yeast infection called candidiasis had already become an epidemic, practically no one knew anything about it. Even now conventional medicine tends to ignore the problem, but word has spread among health-conscious consumers. If you haven’t had a candida yeast infection yourself, you know dozens of people who have and dozens of dogs as well. Candidiasis is an underlying cause of many skin and coat problems, allergies, fungal infections, dog ear infections, digestive problems, food sensitivities, and other symptoms in our canine companions.
Candida albicans, which causes candidiasis, is a single-celled organism classified as both a yeast and a fungus. It occurs naturally in the digestive and genital tracts, and in healthy bodies it is kept in check by beneficial bacteria. In humans whose beneficial bacteria have been damaged or destroyed, the organism causes or contributes to thrush (a fungus infection of the throat and mouth), diaper rash, athlete’s foot, jock itch, vaginal yeast infections, digestive problems, seasonal allergies, ringworm, nail fungus, and environmental sensitivities. It also disrupts the immune system’s response to agents of infection.
In dogs and humans, patients at highest risk are those who have taken antibiotics, which destroy the beneficial bacteria that normally keep Candida albicans from taking over. But the body’s ecology can be disrupted by environmental conditions, diet, stress, chemotherapy drugs, steroids, and other medications as well.
How to Keep Your Dog’s Candida in Check
Like all yeasts, candida thrives on sugars, including those from grains, starches, and other carbohydrates. Beneficial bacteria (such as Lactobacillus acidophilus) metabolize sugars, which keeps candida in check by disrupting its food supply. A shortage of beneficial bacteria results in a sugar-rich environment and an abundance of Candida albicans.
Once a candida overgrowth occurs, it becomes a vicious cycle. Candida cells overwhelm whatever beneficial bacteria survive in the digestive tract or are introduced as supplements, and a diet high in carbohydrates keeps the candida population strong and in control.
In 1983, William G. Crook, MD, published The Yeast Connection, the first of many books linking candidiasis, chronic health problems, and a high-carbohydrate diet. Since then, hundreds of anti-candida diets, drugs, herbal products, and nutritional supplements have become weapons in the war against Candida albicans.
Canine nutritional consultant Linda Arndt of Albany, Indiana, has studied candida for years, and her checklist of conditions linked to the organism’s overgrowth is lengthy.
Candida is a formidable enemy, she explains, because its cells manufacture toxic chemicals that kill beneficial bacteria and harm the body. Candida’s waste products include toxic alcohols, acetone, and the nerve poison hydrogen sulfide, all of which slow the brain, contribute to fatigue, and disrupt the immune system.
Candida symptoms are often misdiagnosed as allergies, says Arndt, manifesting as rashes or skin outbreaks on the feet, face, underarm, underbelly, or genital areas. Recurring hot spots or infections of the ears, eyes, bladder, or urinary tract can be caused by candida overgrowth.
“These conditions can be accompanied by a secondary infection, which is what gets treated,” she says, “but the underlying cause is rarely addressed by conventional medicine. In addition to fatigue, lethargy, immobility, joint pain, and discomfort, all of which can be caused by yeast toxins, the infected patient may experience severe itching, which leads to endless biting, chewing, and hair loss. The dog’s skin can turn black, become dry and flaky, or develop a greasy grit on the surface, and wherever candida takes over, a bad yeasty smell can develop.”
Treatment with antibiotics, steroids, and other conventional drugs may bring temporary relief, but the patient soon returns with another flare-up, and symptoms progress until the veterinarian suggests allergy testing.
“The results tell you the dog is allergic to everything from dust mites to tuna and lima beans,” says Arndt. “But that’s not where the problem lies. Many so-called allergy cases are nothing more than misdiagnosed systemic yeast infections from candida overgrowth.”
According to holistic physician Bruce Fife, ND, the candida organism is especially insidious because it changes form. “If left unchallenged,” he says, “candida converts from a single-celled form into a multi-celled or mycellial fungal form with hairy, root-like projections called rhizoids. These rhizoids penetrate the intestinal wall, which affects the intestines’ ability to absorb vitamins, minerals, amino acids, and fatty acids, leading to nutritional deficiencies and leaky gut syndrome.”
Leaky gut syndrome allows bacteria, toxins, and undigested food to pass through the intestinal wall into the bloodstream, where they cause chronic low-grade infections, inflammation, and allergic responses. “The immune system identifies undigested food proteins as foreign invaders,” says Dr. Fife, “and its attack results in allergy symptoms. Your dog’s food allergies, seasonal allergies, and environmental allergies can all be caused by an imbalance in the microbial environment of his digestive tract. It’s no exaggeration to say that chronic health problems originate in the intestines.”
Even without an overgrowth of Candida albicans, a disruption of the body’s supply of beneficial bacteria poses problems. As described in “Probiotics for Dogs“, beneficial bacteria form a first line of defense against pathogens; help prevent antibiotic-associated diarrhea, traveler’s diarrhea, and leaky gut syndrome; improve lactose tolerance; produce vitamins and enzymes; decrease toxins and mutagenic reactions; improve carbohydrate and protein usage; strengthen innate immunity; create a protective barrier effect in the intestinal tract; and help reduce food sensitivities and skin disorders.
It’s definitely worth helping your dog become a poor host for Candida albicans and, instead, become a nurturing host for beneficial bacteria.
Natural Remedies for Candidiasis in Dogs
In conventional medicine, antifungal medications clear up chronic yeast infections, fungal infections, and related symptoms. But many antifungal drugs have potentially serious side effects and they produce only temporary results. As soon as the prescription ends, surviving candida cells multiply, recolonize, and trigger a return of symptoms.
Alternative therapies, such as medicinal herbs and diet, have fewer side effects and help correct the problem’s underlying causes. It’s important, says Arndt, to work with a holistic veterinarian and avoid vaccinations, steroid drugs, and other conventional treatments that can disrupt the immune system. Because many (if not most) cases of canine candidiasis coincide with hypothyroidism, the patient’s thyroid levels should be checked.
“Probiotics are popular treatments for candida infections, but proper timing is important,” she says. “Feeding large amounts of acidophilus and other probiotics doesn’t help a dog whose system is overwhelmed by candida. In fact, this kind of supplementation can make things worse. The first step in effectively treating candida is reducing its population. Two weeks after that, beneficial bacteria can be effectively added to the system.”
For human patients, menu plans such as the Atkins diet, which is high in protein and fat and very low in carbohydrates, are recommended because they starve yeast cells without harming beneficial bacteria.
Wild wolves are unlikely to suffer from candida overgrowths because, as Dr David Mech explained in “What Wolves Eat“, wolves in the wild consume little or no sugars, grains, starches, fruits, or other carbohydrates and very little vegetable matter. Their diet consists almost entirely of the meat, organs, blood, skin, and bones of prey animals.
Switching a candida-infected dog from grain-based kibble to a grain-free, starch-free, low-carbohydrate diet is an easy way to reduce a dog’s population of Candida albicans.
Coconut Oil for Treating Yeast Infections
One effective anti-candida ingredient that can be added to a dog’s food, whether commercial or home-prepared, is coconut oil. According to Dr. Fife, author of Coconut Cures and a leading expert on coconut’s health benefits, the fatty acids in coconut oil kill candida and other damaging organisms without harming friendly bacteria. “Coconut oil’s fatty acids are absorbed into the cells, which use them as fuel to power the metabolism,” he says. “When applied topically on the skin, coconut oil promotes the healing of damaged tissue. In the same way, it speeds the healing of perforations in the intestinal wall. Coconut oil can help any dog reestablish and maintain a healthy intestinal environment.”
Caprylic acid, a nutritional supplement derived from coconut oil, kills candida cells. “Caprylic acid is sold specifically for this condition,” says Dr. Fife, “but it’s less expensive and just as effective to use the coconut oil it’s derived from. That way you ingest not only caprylic acid but lauric acid, which has also been shown to kill candida cells, along with other essential fatty acids that improve intestinal health.”
The recommended dose is at least 1 teaspoon coconut oil per 10 pounds of body weight, or 1 tablespoon per 30 pounds. Dogs with candidiasis may need more, especially in the early stages of treatment. For best results, feed in divided doses, provide extra fluids and drinking water to help flush toxins from the body, and start with small amounts and build up gradually so the body has time to adjust. The side effects of too much coconut oil too soon can include greasy stools or diarrhea, fatigue, mental exhaustion, and body aches.
Yeast Die-Offs in the Canine Body
Flu-like symptoms such as exhaustion, body aches, diarrhea, and nausea are caused by die-off, also known as the Herxheimer reaction. When large numbers of viruses, bacteria, parasites, yeasts, or fungi die, their physical remains and the toxins they produce overwhelm the body, and it takes days, weeks, and in some cases, months for the organs of elimination to catch up, during which symptoms such as itching or skin breakouts may increase.
Systemic enzyme supplements such as Wobenzym (discussed in “Accelerated Wound Healing,” August 2006) are especially helpful during detoxification. Taken between meals, systemic enzymes circulate in the blood, breaking down inflammation and digesting dead candida cells. Wobenzym contains pancreatin, bromelain, and other digestive enzymes in enteric-coated tablets that survive stomach acid and break apart in the small intestine.
Other enzyme products like Prozyme, which contains amylase, lipase, cellulase, and protease, are taken with meals to improve the assimilation of nutrients and to compensate for the lack of live enzymes in processed food. Double the recommended dose for dogs age eight or older or for dogs switching from a high-carb food.
Seacure (“Securing Seacure,” April 2003) supports anti-candida programs by providing amino acids that are essential to the liver during the second phase of detoxification. Double the recommended dose of Seacure pet powder or chewable pet tabs for the first two weeks of treatment, then follow label directions.
Herbs and Supplements Used for Yeast Infections
Several medicinal plants are used in candida therapy. They are recommended for use by themselves, in combination, or sequentially (one after another), so that highly adaptable candida cells don’t have time to mutate. Any anti-candida supplement designed for humans can be adjusted for canine use according to the dog’s weight. Divide the human label dose by 2 for dogs weighing 50-70 pounds; divide label dose by 4 for dogs weighing 25-35 pounds.
The following and similar supplements are an essential first step in a candida control program.
Black walnut hulls (Juglans nigra), especially those harvested in early fall when the hulls are still green, repel parasites, improve skin conditions, and fight fungal and bacterial infections. Look for “green” black walnut hull extracts and tinctures.
Garlic (Allium sativum) strengthens immunity by aiding white blood cells, and it has shown significant antifungal activity against Candida albicans in animal and test tube studies. But in large amounts, garlic may cause hemolytic or Heinz factor anemia in dogs. Daily doses of up to 1 small garlic clove per 20 pounds of body weight are considered safe, as are garlic extracts given according to label directions adjusted for the dog’s size. For best results, alternate garlic with other antifungal herbs. Although onions are a highly regarded prebiotic (a food that feeds beneficial bacteria), onions are not recommended for dogs in any quantity because of their high hemolytic anemia risk.
Horopito (Pseudowintera colorata), also known as the New Zealand pepper tree, is a traditional Maori treatment for fungal infections. In 1982, New Zealand researchers tested horopito extracts against Candida albicans with excellent results. The New Zealand product Kolorex is now an international best seller. Yeast and mold expert Ingrid Naiman shares Kolorex with her dog.
Olive leaf (Olea europaea) is a popular supplement for candidiasis. Its active ingredient, oleuropein, has antiviral, antifungal, antibacterial, and antioxidant effects in addition to lowering blood sugar and improving blood circulation.
Pau d’arco (Tabebuia impetiginosa, also known as lapacho or taheebo) is an Amazon rainforest tree with astringent, anti-inflammatory, antibacterial, and antifungal properties. Pau d’arco teas and extracts help treat systemic, chronic, or recurrent candidiasis, leaky gut syndrome, and related disorders.
Quebracho (Aspidosperma quebracho-blaco) is a tannin-rich South American tree. Its bark is used in the leading anti-candida product, Tanalbit. Its manufacturer claims quebracho does not contribute to Herxheimer (die-off) reactions. Some veterinarians have used Tanalbit for canine candidiasis for years with excellent results.
As explained in Whole Dog Journal‘s aromatherapy series (“Smell This, You’ll Feel Better,” December 2004; “Essential Information,” January 2005; and “Canines in a Mist,” April 2005), therapeutic-quality essential oils and hydrosols can be diluted for safe, effective canine use.
The essential oil of wild oregano (Origanum vulgare) has become a popular treatment for candidiasis at human doses of 1 drop once or twice per day, building up to a dose of 1 drop 4 times per day, which is considered safe for long-term use.
Dogs dislike the taste and smell of oregano oil. For canine treatment, dilute full-strength oregano oil with olive oil, then place a drop of the diluted oil in an empty 2-part gelatin capsule, which can be hidden in food. For dogs weighing 50-70 pounds, dilute ½ teaspoon oregano essential oil with ½ teaspoon olive oil; for dogs weighing 25-35 pounds, use 1 teaspoon olive oil; and for smaller dogs, use 1½ to 2 teaspoons olive oil. Start with 1 drop of the diluted oil per day and gradually build up to 1 drop 4 times per day.
Tea tree hydrosol, the water produced during steam distillation of tea tree essential oil, is a safe, effective topical treatment for ear infections, hot spots, skin breakouts, and other candida symptoms.
With antifungal, antibacterial, antiyeast, and antiviral properties, coconut oil is an excellent carrier in which to dilute essential oils. It can also be applied by itself to ringworm and other fungal breakouts. Store in a small dropper bottle for convenient application. In cold weather, melt the coconut oil by placing the bottle in hot water.
Probiotics for Treating Yeast Infections
After two weeks of improved diet and treatment with antifungal herbs and supplements, your dog’s system should be ready to support beneficial bacteria.
A few native bacteria survive even lengthy antibiotic treatment, so the odds are that your dog has a small population of beneficial bacteria that could recolonize her system if properly fed with “prebiotics.”
The best prebiotics for the dog’s beneficial bacteria are lactofermented vegetables (see “It’s All in How You Make It,” March 2001) and supplements such as inulin, whey, and fructo-oligosaccharides (FOS). Start with small amounts and gradually increase, adjusting label directions for your dog’s weight. Reduce the dose if flatulence or digestive discomfort develops. Do not feed whey to dogs with an intolerance to foods containing lactose.
Acidophilus is a familiar probiotic, but there are dozens to choose from. Look for live-culture products in health food or pet supply stores, and give frequent doses to help flood the system with beneficial bacteria. Help the bacteria reproduce by combining them with prebiotics, a low-carbohydrate diet, and enzymes.
Yeast Treatment Kits
To help dogs overcome candiasis, Linda Arndt worked with BioPet, Inc., to design a kit containing cleansing and detoxifying products. The goal was to provide a complete kit, with clear instructions that take the mystery out of candida and detoxification. The Nzymes Healthy Skin kits are what resulted.
The kit contains antifungal treats or granules, oxidizing drops that can be taken internally or applied topically, digestive enzymes, probiotics, and a combination of black walnut and olive leaf extracts for internal and topical use.
“We designed the kit for convenience, because it’s hard to know what to do or where to get products that work,” she says. “Candida infections are difficult to treat. They take time to develop, and it takes time as long as a year or more to get them to go away. But by improving the diet, removing candida, detoxifying the body, and flooding the system with beneficial bacteria, anyone can help candida-infected dogs get and stay well.”
CANDIDIASIS IN DOGS: OVERVIEW
1. Avoid feeding your dog grain-based or high-carb pet foods.
2. Starve or destroy candida and detoxify the body with diet and supplements.
3. Resist giving your dog antibiotics for minor infections or anytime they are not absolutely necessary.
4. Re-establish your dog’s gut microbiome with probiotic supplements.
5. Persevere. Candida infections are difficult to eliminate.
90,000 Treatment of yeast (candidiasis) on the legs in Rostov-on-Don
28.10.2017
The causative agent of yeast nail disease are fungi of the genus Candida, from which the second name of the disease originated – candidiasis. More than a dozen Candida species pathogenic for humans have been identified. The most common are C. albicans, C. krusei, C. tropicalis and others.
Reasons for the appearance of
By themselves, they are present on the skin and mucous membranes of a person and, under certain conditions, begin to multiply intensively.
The provoking factors are:
- Diabetes mellitus
- Uncontrolled use of antibacterial drugs.
- Dysbacteriosis and microflora disorders.
- Injury to the nail plate.
- Prolonged contact with water.
- Poor manicure or pedicure.
In most cases, it is difficult to independently determine the cause of this disease and make sure that it is caused by the yeast fungus.Only a specialist can identify the type of parasitic microorganisms and accurately diagnose.
Symptoms
Yeast fungus spreads directly to the nail folds and nail plates, a separate infection of the rollers or nails is very rare. A combination of candidiasis of the nails and mucous membranes or skin is possible.
At the onset of the disease, severe shooting or throbbing pain occurs in the area of the posterior or lateral nail ridges.Then there is redness and swelling of the skin of the posterior ridge, which becomes shiny, tense and thinned. When pressing on the nail roller, pus may be released.
Over time, the process can affect the entire nail. The nail, changed in shape and color, begins to grow. It is thickened, not shiny, gray in color, may have transverse grooves, less often with punctate depressions.
Danger of self-medication
With a fungal infection, self-medication can aggravate the situation, and then the disease will spread to healthy nails.The use of some drugs is addictive, the fungus simply stops responding to them. Illiterate therapy can lead to nail infection in all family members.
Folk remedies can be used only in combination with the main treatment and only with a mild degree of damage. They are more suitable as preventive measures.
Consequences
Yeast is a real threat to the entire body and can cause other health problems:
- decreased immunity;
- introduction of infection through foci of damage;
- destruction of the nail plates;
- an allergic reaction in the form of itching, rash, redness.
Undesirable consequences can be avoided only through professional and timely treatment. Doctors-mycologists of our medical center will help get rid of yeast even at an advanced stage. The drugs and their dosage are prescribed individually, based on the stage of the disease, contraindications and the patient’s state of health. It is not the first year that we have been using safe methods of dealing with mycosis of nails, which have proven their effectiveness.
90,000 How is underarm yeast infection treated?
A yeast infection of the armpit is caused by the fungus Candida albicans and causes inflammation, burning and itching of the sensitive skin of the armpits, as well as a reddish rash.An over-the-counter (OTC) antifungal cream or lotion that contains an active ingredient called clotrimazole or miconazole can be used to treat an armpit yeast infection. If that doesn’t work, you can ask your doctor for an antifungal medication. Alternatively, you can use an antihistamine to relieve discomfort and make hygiene changes to speed healing and prevent relapses.
Antifungal creams are often used to treat underarm yeast infections.These are the same types of creams you could use if you have had a yeast infection of the vagina or genitalia, such as for itchy skin. Typically, these creams contain the active ingredient clotrimazole or miconazole. If you choose to use this type of medication, you may need to apply the cream to clean, dry armpits a couple of times a day. In most cases, however, you cannot expect immediate relief of symptoms, as the fungus can take a week or so depending on the severity of the fungus and the strength of the medication you choose.
If you want to cure an armpit yeast infection, you can not just get rid of the infection, but get rid of the discomfort that may be your top priority. If this is the case, you may want to consider taking antihistamines to relieve itching and irritation. These medicines are available without a prescription and are usually labeled to relieve mild to moderate allergy symptoms, including itching. After all, the antifungal cream you use to treat this type of infection should ease the discomfort, but antihistamines can help at the same time.
You can also make some hygiene changes to treat your underarm yeast infection. This is because the fungus that causes yeast infections thrives in moist, dark areas, including the folds of the skin under the arms. To help heal this infection and prevent future problems, you can clean the area well once a day with a mild cleanser and then blot dry. You can use an antifungal powder to keep the area dry. If you sweat a lot during the day, you may need to wash and dry the area more than once a day to remove the moisture it needs.
OTHER LANGUAGES
90,000 Common skin conditions in dogs: symptoms and treatment
Unfortunately, skin conditions are very common in dogs. Some allergic reactions cause incessant scratching, licking, biting and fidgeting, giving pets a lot of discomfort. Another consequence can be hair loss and painful skin lesions, through which, if untreated, an infection enters the body.According to PetMD, there are five major causes of skin disease in dogs – be sure to read their description.
External factors
Sometimes dogs have a sensitivity to lawn grass – it causes irritation. The accumulation of moisture on the skin can also lead to skin damage – the formation of so-called “hot spots”, which are most affected by dogs with thick or long, prone to rolling hair.
Other environmental factors such as dust, mold, pollen, powdery mildew and other inhalation allergens can also cause itching and discomfort for your pet.This will eventually lead to painful skin lesions and hair loss. Remember that perfume and tobacco smoke can also cause sensitivity in your dog.
Food allergy
Food allergy in dogs is an extremely rare phenomenon, usually caused by proteins found in beef, pork, lamb, chicken, eggs and fish, as well as plant proteins derived from wheat. The biggest health problems in animals are caused by beef, dairy products and wheat.
The main symptoms of food allergies are skin irritation and excessive scratching, but digestive problems such as vomiting and diarrhea can also occur. It doesn’t matter what signs of allergies you notice, it’s best to see your veterinarian right away.
Parasitic allergy
Dogs may have an allergic reaction to flea bites (essentially an immune response to flea saliva) called parasitic dermatitis. It manifests itself in the form of increased itching, inflammation and hair loss.
Although fleas are the most common cause of parasitic dermatitis in dogs, tick bites can also cause an allergic reaction in the animal. It is difficult to determine the exact cause of parasitic dermatitis in dogs, because the skin reaction occurs in them in response to the bites of various pathogens, such as scabies mites. If treating your pet from ectoparasites does not eliminate the problem, contact your veterinarian to rule out tick-borne infestation.
Infectious dermatitis
Dogs can develop infectious dermatitis caused by bacteria, fungi and viruses. One of the most common causes of infectious dermatitis is the fungus dermatophytes, better known as ringworm. Another causative agent of infectious dermatitis is the yeast malassezia (Malassezia pachydermatis), which is activated against the background of other diseases. For the treatment of the fungal form of dermatitis, in addition to the drugs used to treat the underlying disease, antibiotics or antifungal agents are prescribed.
How to help an animal
The easiest way to cure parasitic dermatitis. If you notice that parasites are the cause of the puppy’s itching, treat the house and other animals with a remedy for ectoparasites and then use prophylactic drugs. Other types of allergies and pathogens are not easy to identify on your own. Therefore, if you got rid of fleas, and the animal still suffers from incessant itching, skin irritation and hair loss, you should contact your veterinarian.When you go to the clinic, your dog will likely have a series of blood tests, skin samples, and other laboratory tests to determine the true cause of the disease.
It is possible that narrowing down the range of possible causes of itchy skin in a dog will be a matter of trial and error, but you need to be patient. Your veterinarian will advise you to switch to diet food to reduce your pet’s itchiness. Once an irritant or allergen is identified, it must be removed from the environment or your pet’s food.If this is not possible for health reasons, try topical anti-inflammatories or oral medications recommended by your veterinarian.
Antibiotics should be used for severe skin lesions and signs of infection. Also, your veterinarian will probably advise you to use special shampoos and rinses to help alleviate the pet’s condition a little.
It is impossible to calmly observe the suffering of your pet.The first thing you can do to help your four-legged friend is to identify the causes of the disease and see a veterinarian.
Contributor Bio
Jean-Marie Bauhaus
Jean-Marie Bauhaus is a fiction writer, writer and freelance editor. She writes frequently about pets and pet care while working from her home office in Tulsa, Oklahoma. Jean-Marie’s cats usually sit on her lap and help in writing articles.
90,000 Yeast infection, STDs, or something else
If you suspect you have a vaginal yeast infection, you are most likely in a hurry to get rid of it. Yeast infections are uncomfortable and are usually accompanied by itching, burning, and thick discharge.
However, before you run to the pharmacy, it is important to determine if what you are experiencing is indeed a yeast infection or something else. Other causes of vaginal pain and discomfort include bacterial infections, sexually transmitted diseases (STDs), skin irritation, and more.Although the symptoms are similar, the causes and treatments are very different.
fstop123 / Getty Images
What is a yeast infection?
Yeast infection is common and most women will experience at least one infection in their lives. A fungal infection occurs when Candida yeast overgrows in the vagina and leads to an infection. This usually causes burning and itching in the vagina and in the surrounding area called the vulva. Vaginal yeast infections are common in girls and women, with about 75% of women having at least one of them.Infection is rare before puberty and after menopause.
Yeast infection symptoms
The most common symptoms of a yeast infection include:
- Thick white discharge of a curd consistency.
Other symptoms to be aware of may include redness and swelling, pain when urinating, and pain during intercourse.
Yeast infection treatment
Most yeast infections can be treated at home with over-the-counter medications.The infection requires antifungal treatment, which can be in the form of a cream, ointment, or vaginal suppository.
Although yeast infections are usually easy to treat, it is still helpful to consult a doctor. Other types of infections can be mistaken for a yeast infection, and it is estimated that up to two-thirds of women who buy over-the-counter yeast medications do not have a yeast infection. Plus, using antifungal medications when you don’t have a yeast infection can cause your body to become drug resistant.The antifungal agent may not work the next time you need it for a true yeast infection.
If you seek treatment from your doctor, he or she may prescribe you a single dose of oral Diflucan (fluconazole) to treat your infection. If you notice that you have frequent fungal infections, talk to your doctor about the possible causes and the longer duration of antifungal medication.
To prevent yeast infection, take the following measures: 1
- Choose underwear made from breathable cotton fabric.
- Make sure your clothing and underwear are not too tight.
- Change pads and tampons frequently
- Change into wet clothes or a bathing suit immediately.
- Never douche or use soap in your vagina.
- Avoid scented soaps or soaps that contain artificial colors.
- Wipe from front to back after using the toilet
- Do not spend too much time in hot tubs or very hot water.
Yeast infection or STDs?
Many STDs have the same symptoms as yeast infections and it can be difficult to determine the cause of your symptoms. Although yeast infections are not considered a sexually transmitted disease, they can be contracted from your partner during sex.
Trichomoniasis
Trichomoniasis is a relatively common sexually transmitted disease, but many have never heard of it. This may be due to the fact that 70% of people are asymptomatic.It is caused by a parasite called Trichomonas vaginalis, and the Centers for Disease Control and Prevention (CDC) estimates that there were two million infections in the United States in 20182.
Most people do not experience symptoms, but if they do, they can include vaginal itching, burning, and soreness. Vaginal discharge can be yellow, white, or green with a fishy smell. Trichomoniasis is curable and requires antibiotics.
Herpes
Genital herpes is a sexually transmitted disease caused by herpes simplex virus type 1 (HSV-1) or herpes simplex virus type 2 (HSV-2).Although most people with herpes do not experience symptoms, possible symptoms include painful sores on the genitals. Sores usually start with blisters, then open and leave a sore.3 People with oral herpes may experience cold sores or blisters around the mouth.
Herpes does not cause changes in vaginal discharge. There is no cure for herpes, but it is still important to see a doctor for a diagnosis and treatment for the blisters.
Genital warts
Genital warts are caused by the human papillomavirus (HPV), the most common STD in the United States.Most of the time, HPV clears up on its own, but when it doesn’t, the virus can lead to genital warts or even cancer. Most people with HPV have no symptoms.
HPV is often detected when a doctor performs a routine Pap smear with an HPV test. However, the CDC does not recommend testing for HPV in women with genital warts because the test results will not help determine the appropriate treatment.
Gonorrhea
Gonorrhea is a common STD that usually does not cause any symptoms in women.If you do experience symptoms, you may notice pain or burning when urinating, increased vaginal discharge, and vaginal bleeding or spotting between periods. Vaginal discharge may appear white or green.
Your doctor may test your urine for gonorrhea and prescribe antibiotics to treat it. Left untreated, gonorrhea can lead to serious health problems, including pelvic inflammatory disease and infertility.
Chlamydia
Chlamydia is another common sexually transmitted disease that can lead to changes in vaginal discharge and pain when urinating. The discharge can be white, green, or yellow.
Chlamydia can be diagnosed by urinalysis or vaginal smear. Chlamydia can be treated with prescription drugs. Lack of treatment for chlamydia can lead to pelvic inflammatory disease, infertility and ectopic pregnancy.
- Vaginal pain
Vaginal pain
Combustion
- Thick white cheesy discharge
Thick white cheesy discharge
- Does not cause bleeding
Does not cause bleeding
- May cause pain
May cause pain
- May cause burning when urinating
May cause burning when urinating
- The discharge may be green, white or yellow and may have an unpleasant odor.
The discharge may be green, white or yellow and may have an unpleasant odor.
- May cause abnormal bleeding or spotting
May cause abnormal bleeding or spotting
Other possible causes
In addition to yeast infections and sexually transmitted diseases, there are other infections and conditions that can cause vaginal pain and discomfort.It is important to be able to recognize them in order to get the right treatment as soon as possible.
Bacterial vaginosis
Bacterial vaginosis occurs when normal bacteria in the vagina grows, causing an imbalance in bacteria and yeast. While not considered a sexually transmitted disease, it can increase your risk of infection. Bacterial vaginosis is the most common vaginal health problem in women between the ages of 15 and 44. It causes a thin, gray or white discharge with pain, itching, and burning.You can also smell the strong fish smell. Bacterial vaginosis sometimes clears up on its own, but check with your doctor as you may need antibiotics.
Contact dermatitis
Contact dermatitis on and around the vulva can cause tingling and burning from micro cracks in the skin. Contact dermatitis usually results from skin irritation with an allergen or irritant.9 Examples include soap, laundry detergent, douching, spermicides, perfumes, and deodorants.This condition does not cause changes in vaginal discharge.
Treatment requires careful skin care, as the skin is already irritated. Your doctor may recommend a corticosteroid cream to reduce redness and itching. The urge to itch must be counteracted to heal, so your doctor may recommend taking antihistamines before bed to help relieve itching.
Decreased estrogen levels
With age, estrogen levels drop, which can lead to vaginal dryness and irritation.Other risk factors for low estrogen levels include family history, pituitary problems, extreme dieting, eating disorders, and excessive exercise.11 Symptoms may include vaginal dryness, irritation, and pain during sex.
Low estrogen also has several other symptoms such as hot flashes, night sweats, insomnia, amenorrhea, headaches, fatigue, depression, and more. If you think you may have low estrogen levels, talk to your doctor about possible causes and treatments.
Hemorrhoids
Hemorrhoids are swollen veins in and around the rectum and anus. Symptoms of external hemorrhoids include pain, itching, swelling, and bleeding. Internal hemorrhoids located inside the rectum may cause bleeding during bowel movements. Hemorrhoids can often be treated with lifestyle changes, such as adding more fiber-rich foods to your diet, taking a warm bath, and using over-the-counter pain relievers as needed.12 If symptoms do not improve, see your doctor.
Skin diseases
Skin conditions such as eczema and psoriasis can be present on the skin around the vagina, making you think you have a fungal infection. Psoriasis occurs when your skin cells reproduce too quickly, resulting in thick patches of rough skin made up of old skin cells. When these patches appear on the vulva, they usually appear as pink patches with well-defined edges.10 If the skin opens, it can become infected.To do this, you need to see your doctor for a topical prescription steroid cream that is gentle enough for the vulvar area.
Other skin conditions that can irritate the vagina include lichen planus and lichen sclerosis. Lichen planus is caused by an overactive immune system and causes a burning and sore vulva. It can also lead to thick, yellow vaginal discharge and pain during intercourse. Lichen sclerosis is an inflammatory disease that is more common in postmenopausal women.Symptoms include itching and flaky white patches of skin. It is usually treated with a corticosteroid ointment and needs to be monitored as these spots can turn into skin cancer.
Small cuts
Small cuts or tears in and around the vagina can cause pain, burning, and itching. Larger tears usually occur during childbirth, but small tears can occur due to vaginal dryness, sex without adequate lubrication, and removal of pubic hair.13 The most common symptoms include pain, tingling or burning when urinating, spotting, itching, and burning.Most minor cuts will heal on their own. See your doctor if you develop bleeding, foul-smelling discharge, fever, numbness, or worsening symptoms.
When to see a doctor
It is important to see your doctor whenever you are worried about new vaginal pain or discomfort.