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Steroids yeast infection: Yeast infection. Thrush symptoms and treatment – Patient

Yeast infection. Thrush symptoms and treatment – Patient

What is candida?

Candida is a type of yeast (fungus). Small numbers of candida normally live on your skin and do no harm. Sometimes, under certain conditions, they can multiply and cause infection. The common sites for candida to cause infection are your vagina (vaginal thrush), your mouth (oral thrush) and your skin. This leaflet just deals with candidal skin infections. See the separate leaflets called Vaginal Thrush (Yeast Infection) and Oral Thrush (Yeast Infection) for more details.

Is a candidal skin infection serious?

Usually not. Most infections occur in people who are otherwise healthy (although they are more common if you are overweight). Treatment usually works extremely well. In some people, the candidal skin infection may be the first indication of another condition such as diabetes (diabetes mellitus).

Why does candida sometimes multiply and cause infection on the skin?

The chance of a candidal skin infection developing is more likely in the following situations:

  • Areas of skin that are moist or sweaty are ideal for candida to thrive. Therefore, the common sites affected are in the folds of skin in your groin, armpits and under large breasts. (Another name for inflammation within a fold of skin or under a breast is ‘intertrigo’. Candidal infection is a common cause of intertrigo.) Nappy rash is sometimes due to candida. Obese people may develop candidal infection between folds of skin. It can also affect skin between your fingers and toes and at the corners of your mouth.
  • If you have diabetes (diabetes mellitus).
  • If you take a long course of antibiotics or steroid medication.
  • If you have a poor immune system. For example, if you have AIDS, or have chemotherapy, or have certain types of serious blood disorder.

What are the symptoms of a candidal skin infection?

In affected folds of the skin (under breasts, groin, etc) a typical red rash develops. The rash is usually sore and itchy. Small blister-like swellings may develop on the rash. Skin scale can accumulate on the rash to produce a white-yellow, curd-like substance over the affected area. If the areas between toes or fingers are involved, the affected skin may become thickened, white and soft.

What is the treatment for candidal skin infection?

An antifungal cream usually clears the infection within a week or so. Creams commonly used include:

Sometimes a mild steroid cream is added to reduce inflammation and itch whilst the antifungal cream is working. The most commonly added steroid cream is hydrocortisone. These combination creams are easier to use. A steroid cream should not be used on its own for a fungal skin infection.

Occasionally, if your rash is widespread, antifungal tablets called fluconazole are prescribed. These are usually taken once a day for two weeks.

Your doctor may recommend that you wash your skin with a moisturising cream or ointment (emollient) which is more sensitive on your skin than soap products. Certain emollients are useful as soap substitutes in this situation.

Some people with a candidal skin infection can develop an added infection caused by another type of germ (bacterium). It is important to see your doctor if your skin infection does not improve or if it worsens, as you may need an alternative treatment for a bacterial infection. This is usually a different cream containing an antibiotic, such as fusidic acid. Occasionally antibiotic tablets or medicine may be needed.

Can candidal skin infections be prevented?

To minimise the risk of a candidal skin infection:

  • Keep areas likely to be affected as clean and dry as possible.
  • Always dry well after washing, particularly in your groin, armpits and under large breasts. Some people use a hair dryer to dry these areas after washing to ensure they are dry before putting clothes on.
  • Wear light, loose, absorbent clothing and avoid wool and synthetic fibres. This helps to keep your skin from becoming too moist.
  • Losing weight may help if obesity is contributing to this problem.
  • Avoid anything wet being in contact with the skin for very long. So, change nappies or incontinence pads as soon as they are wet. If you have been exercising and are in wet, sweaty clothes, change into dry clothes as soon as you can.
  • If you are troubled with repeated infections at the angle of your mouth and you wear dentures:
    • Remove the dentures each night to clean them.
    • Sterilise the dentures overnight.

If the infection keeps coming back for no apparent reason, a test to check for diabetes (diabetes mellitus) may be advised by a doctor.

Oral thrush in adults – Illnesses & conditions

Oral thrush is a fungal infection of the mouth. It is not contagious and is usually successfully treated with antifungal medication.

It is also called oral candidosis (or candiasis) because it is caused by a group of yeasts called Candida.

Symptoms of oral thrush can include:

  • white patches (plaques) in the mouth that can often be wiped off, leaving behind red areas that may bleed slightly
  • loss of taste or an unpleasant taste in the mouth
  • redness inside the mouth and throat
  • cracks at the corners of the mouth
  • a painful, burning sensation in the mouth

In some cases, the symptoms of oral thrush can make eating and drinking difficult.

When to seek medical advice

Speak to your GP if you develop symptoms of oral thrush. If left untreated, the symptoms will often persist and your mouth will continue to feel uncomfortable.

In severe cases that are left untreated, there is also a risk of the infection spreading further into your body, which can be serious.

Your GP will usually be able to diagnose oral thrush simply by examining your mouth. Sometimes they may also recommend blood tests to look for certain conditions associated with oral thrush, such as diabetes and nutritional deficiencies.

What causes oral thrush?

Low numbers of the fungus Candida are naturally found in the mouth and digestive system of most people. They don’t usually cause any problems, but can lead to oral thrush if they multiply.

There are a number of reasons why this may happen, including:

Babies, young children and elderly people are at a particularly high risk of developing oral thrush, as are people with certain underlying conditions, including diabetes, an iron deficiency or vitamin B12 deficiency, an underactive thyroid (hypothyroidism) and HIV.

As most people already have Candida fungi living in their mouth, oral thrush is not contagious. This means it cannot be passed to others.

Treating oral thrush

Oral thrush can usually be successfully treated with antifungal medicines. These usually come in the form of gels or liquid that you apply directly inside your mouth (topical medication), although tablets or capsules are sometimes used.

Topical medication will usually need to be used several times a day for around 7 to 14 days. Tablet or capsules are usually taken once daily.

These medications don’t often have side effects, although some can cause nausea (feeling sick), vomiting, bloating, abdominal (tummy) pain and diarrhoea.

If antibiotics or corticosteroids are thought to be causing your oral thrush, the medicine – or the way it is delivered – may need to be changed or the dosage reduced.

Preventing oral thrush

There are a number of things you can do to reduce your chances of developing oral thrush, including:

  • rinsing your mouth after meals
  • brushing your teeth twice a day with a toothpaste that contains fluoride and interdental cleaning (flossing) regularly
  • visiting your dentist regularly for check-ups, even if you wear dentures or have no natural teeth
  • removing your dentures every night, cleaning them with paste or soap and water before soaking them in a solution of water and denture-cleaning tablets
  • brushing your gums, tongue and inside your mouth with a soft brush twice a day if you wear dentures or have no or few natural teeth
  • visiting your dentist if your dentures do not fit properly
  • stopping smoking if you smoke
  • rinsing your mouth with water and spitting it out after using a corticosteroid inhaler, and using a spacer (a plastic cylinder that attaches to the inhaler) when you take your medicine
  • ensuring that any underlying condition you have, such as diabetes, is well controlled

If you have a condition or are receiving treatment that could put you at a high risk of developing oral thrush, your doctor may recommend taking a course of antifungal medication to prevent this happening.

Read more about taking care of your oral health.

Can You Get a Yeast Infection on Your Penis?

If you have any medical questions or concerns, please talk to your healthcare provider. The articles on Health Guide are underpinned by peer-reviewed research and information drawn from medical societies and governmental agencies. However, they are not a substitute for professional medical advice, diagnosis, or treatment.

Your concept of a yeast infection—if you have one—is probably shaped by mainstream commercials for yeast infection-fighting products targeted to women. Unfortunately, men can get yeast infections as well. Here are the symptoms and what you can do about it.  

  • Yes, you can get a yeast infection on your penis.
  • It’s called candida balanitis, and it can cause symptoms, including pain, itching, irritation, and discharge.
  • It’s important to get a penile yeast infection treated to avoid complications and to avoid infecting or reinfecting a sexual partner.
  • Antifungal creams usually clear up a penile yeast infection within a week.

Yeast (specifically one called Candida albicans) is a form of fungus that naturally lives on our skin and inside our bodies in places such as the mouth, throat, digestive system, and vagina (CDC, 2019). Most of the time, we co-exist peacefully, and you have no idea it’s even there.

But an overgrowth of that yeast can cause an infection, including a penile yeast infection (or candida balanitis), which is an infection of the glans, or head of the penis.

Overgrowth of Candida albicans in the mouth or throat results in the formation of white patches called thrush (or oral thrush) on the tongue or the walls of the mouth.

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Common symptoms of a penile yeast infection can include:

  • Redness, itching, or irritation 
  • A thick white discharge that may be present in skin folds (Steckelberg, 2018)
  • A burning sensation during urination
  • Discomfort or itching during or after sexual activity (David, 1997)
  • Small white spots on the penis
  • A dry, peeling rash (Thaler, 2018)

Researchers have found that between 15-20% of men naturally have Candida on their penis. It is even more common in people who are uncircumcised, those with diabetes, and people who have a partner with a yeast infection (David, 1997). A penile yeast infection is often (but not always) caused by having sex with a partner who has a yeast infection. 

Other things that can increase your chance of getting a penile yeast infection can include:

  • Poorly controlled diabetes (high blood sugar, a hallmark of diabetes, can cause yeast to overgrow on and in the body)
  • A weakened immune system (like if you have HIV or are receiving chemotherapy)
  • Frequent or recent use of antibiotics
  • Poor hygiene

You’re more likely to get a penile yeast infection if you’re uncircumcised (Morris, 2017), and a penile yeast infection can be the first sign of diabetes for some people, so it’s important to be evaluated by a healthcare professional. 

A penile yeast infection can often clear up on its own, although it may also spread to other nearby areas of the skin, including the scrotum and buttocks (Thaler, 2018).  

Yeast infections are contagious, so it’s important to get treatment to avoid infecting or reinfecting any potential sexual partners with a yeast infection.

Any irritation or inflammation of the penis increases the chance that you have broken skin on your penis, which in turn increases your chances of contracting or transmitting STIs (sexually transmitted infections) during sexual contact (Anderson, 2011). 

In certain at-risk people, Candida can cause a serious condition called invasive candidiasis, in which yeast can enter the bloodstream and infect other organs. People who are at risk of invasive candidiasis include people who have compromised immune systems (like people with HIV), diabetes, kidney failure or have a central venous catheter (CDC, 2019). 

That depends. Some penile yeast infections may disappear without treatment, some may go away in about a week with medication (see “Treatments” below), and some untreated male yeast infections can linger, causing discomfort and potential complications.   

An untreated penile yeast infection might go away on its own, but it might also stick around, causing negative consequences. 

  • You can transmit the yeast infection to sexual partners (Steckleberg, 2018).
  • In uncircumcised men, the inflammation of balanitis can spread to the foreskin, a condition called balanoposthitis (Perkins, 2020).
  • In uncircumcised men, balanitis can lead to phimosis, a condition in which the foreskin is too tight and can’t be retracted or returned to its normal position over the penis head (Leber, 2020). 

The most common treatment for a penile yeast infection is antifungal cream, such as miconazole or clotrimazole, that you apply to the infected area once daily for one to three weeks or as directed by your healthcare provider. These treatments are typically available over-the-counter (Edwards, 2013).  

Some types of antifungal treatments can also be prescribed by a healthcare provider. If your symptoms are particularly severe or your yeast infection returns, a healthcare provider might prescribe oral fluconazole and topical steroids (Edwards, 2013).

Proper hygiene is always important, especially if you’re not circumcised—the foreskin can allow for buildup of Candida yeast and subsequent infection. Use a mild soap and bathe regularly.

Because Candida can be passed between partners, if your partner is symptomatic, they should seek treatment as well to avoid reinfection.

  1. Anderson, D., Politch, J. A., & Pudney, J. (2011). HIV infection and immune defense of the penis. American journal of reproductive immunology (New York, N.Y. : 1989), 65(3), 220–229. https://doi.org/10.1111/j.1600-0897.2010.00941.x
  2. Centers for Disease Control and Prevention. Candidiasis. (2019, December 17). Retrieved August 10, 2020, from https://www.cdc.gov/fungal/diseases/candidiasis/index.html
  3. Centers for Disease Control and Prevention. Invasive Candidiasis. Risk and Prevention. (2019, December 17). Retrieved August 10, 2020, from https://www.cdc.gov/fungal/diseases/candidiasis/invasive/risk-prevention. html
  4. David, S., Walzman, L., & Rajamanoharan, M. (1997, October). Genital colonisation and infection with candida in heterosexual and homosexual males. Retrieved from https://pubmed.ncbi.nlm.nih.gov/9534752/
  5. Edwards, S., Bunker, C., Ziller, F., & Van der Meijden, W. (2014, August). 2013 European guideline for the management of balanoposthitis. Retrieved from https://pubmed.ncbi.nlm.nih.gov/24828553/
  6. Leber, M. (2020, March 22). Balanitis. Retrieved September 11, 2020, from https://emedicine.medscape.com/article/777026-overview
  7. Lisboa, C., Santos, A., Dias, C., Azevedo, F., Pina-Vaz, C., & Rodrigues, A. (2010). Candida balanitis: risk factors. Journal of the European Academy of Dermatology and Venereology : JEADV, 24(7), 820–826. https://doi.org/10.1111/j.1468-3083.2009.03533.x
  8. Morris, B. J., & Krieger, J. N. (2017). Penile Inflammatory Skin Disorders and the Preventive Role of Circumcision. International journal of preventive medicine, 8, 32. https://doi.org/10.4103/ijpvm.IJPVM_377_16
  9. Perkins, O.S. & Cortes, S. Balanoposthitis. [Updated 2020 May 28]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK553050/
  10. Steckelberg, J. (2018, July 13). Yeast infection in men: How can I tell if I have one? Retrieved September 11, 2020, from https://www.mayoclinic.org/male-yeast-infection/expert-answers/faq-20058464
  11. Thaler, M., (2018, November 20). Men Get Yeast Infections, Too! Retrieved September 10, 2020, from https://www.onemedical.com/blog/get-well/male-yeast-infection

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Help – the steroids are not working – Helping women with refractory vulvar lichen sclerosus

Dr. Leslie Ann Sadownik (biography, no disclosures)

 

What frequently asked questions I have noticed

Lichen sclerosus (LS) is a chronic skin disorder with a remitting and relapsing clinical course. Women commonly present with severe vulvar itch and an urge to scratch the skin. The recommended treatment is a course of topical steroids. Most women will improve with treatment. However, some will report, “the steroids did not help”. 

Meet Janet

Janet is a 53-year-old woman who presents with a 2-year history of distressing vulvar itch. At the beginning she thought she had yeast. She tried over the counter anti-yeast and anti-itch medications. The itch became so bad at night that she had trouble sleeping. She and her partner have not been able to have sex for over a year because it is too uncomfortable. She recently saw her family doctor who noticed whitening of her vulvar skin and suspected lichen sclerosus. She tried using a steroid cream. While, it seemed to help initially as soon as she stopped, the itch returned. She wonders if there is a treatment that will cure her vulvar itch?

Data that answers these questions

It is helpful to approach patients with “unresponsive” lichen sclerosus by asking yourself a series of questions.

Question 1: Is the clinical diagnosis correct?

The diagnosis is usually clinical. LS causes the affected skin to become atrophic (white, thin, crinkled). There is often a symmetrical “figure of 8” inflamed and/or atrophic skin pattern around the vulva and anus. Sometimes, the skin changes are isolated to the clitoris, perineum, or perianal areas (versus the whole vulva). Women with vulvar LS  rarely have LS elsewhere on the body.

The fragile skin may crack or tear. Erosions, fissures, purpura and ecchymoses are common. The tears cause discomfort during urination, bowel movements or sex. Early anatomical changes include: loss of the inter-labial folds, flattening, and/or loss of the labia minora. Advanced changes include: clitoral phimosis and labia adhesions resulting in introital stenosis. LS does not involve the skin above the hymenal ring (vagina or cervix).

A skin biopsy may confirm the diagnosis if the pathology reports the classic histological features of LS (thin epidermis, loss of rete ridges, hyperkeratosis and a band-like lymphocytic inflammatory infiltrate). However, patient may still have clinical disease even if the biopsy reports non-specific changes – a “normal” biopsy does not rule out Lichen Sclerosus.

The differential diagnosis for LS includes: irritant/contact dermatitis, lichen planus, lichen simplex chronicus, vitiligo, mucous membrane pemphigoid, psoriasis, vulvar intra-epithelial neoplasia, paget’s disease, and or urogenital atrophy. There is an overlap between the clinical presentation of LS and lichen planus (LP). Both conditions can cause vulvar itch, whitening of the vulvar skin, and progressive anatomical changes. LP is more difficult to treat and often involves the vestibular and vaginal skin resulting in scarring and or adhesions in the vagina. Women with vulvovaginal LP often have LP elsewhere on the body. For example, in the oral cavity one can find Wickham’s striae, inflammation (gingivitis), erosions and or ulcers.

Question 2: Is the treatment appropriate?

The standard therapy is a course of a super-potent (eg. Clobetasol) or potent (eg. Mometasone Fourate) topical steroid. Moderate or mild potency steroids are preferred for pregnant woman.1 There is no evidence to support hormonal therapy (eg. Testosterone).

Question 3: Are the treatment goals appropriate?

The first goal is to reduce the itch. This should be achieved within weeks of starting therapy. The second goal is to improve the integrity of the skin. Fissures and erosions should heal: patients should be able to resume daily and sexual activities. The whitening of the skin may persist in some individuals but the skin texture should improve. Resolution of all whitening is not an explicit goal of therapy. The third goal is to preserve the vulvar architecture and prevent further changes. Topical therapy will not correct significant anatomical changes.

Question 4: Is the patient adherent to treatment recommendations?
Lee et al. reported that less than 2/3 of patients (67%) comply with therapy recommendations. 2 Factors that may affect patient adherence to topical steroids include: non aesthetic nature of the topical medication (i.e. greasy), time-consuming and complicated regimens, ambiguous dosing instructions (i.e “apply sparingly”), side effects, misbeliefs about the disease and treatment regimen, and cost and affordability. These factors should be explored at each follow up visit.

For women with severe disease (inflammation, erosions, severe symptoms) a follow up visit at 2-4 weeks after staring therapy is recommended. For most women, the first follow up visit can be 2-3 months after starting therapy. Ask the woman to bring her medication to this appointment. Review the amount of medication used over the time period. It is recommended that patients with a “figure of 8” involvement of the genitilia use 1 Fingertip Unit (FTU) per application. One FTU is the amount of ointment expressed from a tube with a 5 mm nozzle, applied from the distal skin crease of the index finger to the tip- approximately 0. 4 g. Thus, a 30-g jar will usually last three months of acute treatment – see Table 1 at the bottom of the article for an example of a treatment regiment.

If the patient appears to be using more or less of the medication, review her application technique. She should apply the medication directly with her fingertip (not a cotton swab) and spread in a film over the vulvar (medial labia majora/inter-labial folds, both sides of the labia minora, and the perineum) and, if involved, perianal skin. As the skin condition often involves changes in the entire vulvar area, it is easier to have patients get into a routine of systematically treating this area rather than only treating “white” or “symptomatic” areas. Simply wash hands with soap and water after application of the medication. In general, ointments should be prescribed initially (they are more potent and contain less potential irritants). Patients may be subsequently switched to creams if they prefer a cream base.

If the disease is stable over time, reduce the potency of the prescribed steroid (from potent to medium to low) at subsequent follow up visits. The majority of women will relapse if they reduce the frequency of the steroid application to less than twice per week or completely stop treatment. Since most patients stop therapy intermittently, patients need explicit instructions on how to manage flare-ups. “Restart daily application for 1-2 weeks until symptoms resolve. If symptoms do not resolve, and or increase, stop the medication and see a doctor. You should not be on daily therapy for more than 4 weeks. Once symptoms improve go back to regular 2-3 times per week application.”

Explore what dosing regimen is most convenient for patients. For example, when starting note that once daily application of steroid (am or pm) is as effective as twice daily. For “twice weekly” maintenance, a simple routine is to use medication on weekends and then use emollients on weekdays.  Give the patient realistic guidelines on how much medication to use over time – a 30 gram jar will last 3 months of initial treatment and 6 months of maintenance treatment.

Patients should be educated that the skin disease, LS, is thinning the skin – the topical steroid is in fact stopping that process, and when applied correctly will not thin the vulvar skin. Care, of course, should be taken to avoid spreading the steroid to unaffected nearby skin (eg. thighs). Most women are disappointed to hear that LS cannot be cured. Women should be reassured that that regular use of topical steroid medication will result in better symptom control and potentially reduce the risk of squamous cell carcinoma.3  If used appropriately, long term use of topical super-potent or potent steroid is also safe and does not cause steroid induced atrophy or increased risk of HPV/HSV or candidiasis infections.4

Question 5: Is there a secondary diagnosis?
A secondary diagnosis is common. Consider any and all of the following: irritant/contact dermatitis, superinfection (candidiasis, HSV, bacterial), high grade squamous dysplasia/cancer, hypoestrogenism, steroid induced atrophy or rebound steroid dermatitis, vulvodynia. Review the patient’s daily skin care routine. Many women continue to use potential irritants (eg. bar soap, panty liners), or engage in harmful behavior (eg. frequent washing of the skin). Patients may be allergic to a component of the topical steroid. It may be helpful to discontinue all topical medications for 1 month and then re-assess. For patients who suffer from recurrent: candidiasis, herpes simplex virus or urinary tract infections reduce the potency of the steroid, and or add on prophylactic therapy (e.g. antiviral coverage). Consider VIN or cancer for persistent erosions, fissures, ulcers or plaques – biopsy any persistent skin lesions. Many women will develop vulvar LS in the menopausal years. If women are reporting persistent dryness, burning and dyspareunia consider adding local vaginal estrogen therapy. If there is objective improvement but patients report unchanged symptoms consider a diagnosis of vulvodynia.

Question 6: Is there an alternative treatment for this patient?

Alternative treatments include; higher potency topical steroids, intralesional/intramuscular steroids, and or topical calcineurin inhibitors. Topical tacrolimus 0.1% ointment can be an effective treatment for steroid non-responsive LS. The medication is costly and patients often report significant burning upon application. The standard dose is 0.1% applied BID for 6 weeks however I have found that reducing the dose and/or frequency of application is often better tolerated by patients starting therapy, for example, tacrolimus 0.03% applied daily and then increased as tolerated. Less commonly reported treatments for LS include: topical and systemic retinoids, phototherapy and photodynamic therapy. Current evidence is weak for the use of: adipose-derived stem cells, platelet rich plasma, or laser as treatment for vulvar LS and should not be recommended at this time.5,6  Surgical intervention is limited to excising pre-malignant/malignant lesions and/or correct anatomical defects. A referral to a specialist in vulvar skin disorders is often warranted when a patient, despite adherence to standard topical steroid therapy, has persistent symptoms and or signs of LS.

What I recommend (practice tip)

Take Home Message: Most treatment “failures” of vulvar lichen sclerosus are due to patients using an inadequate amount of topical steroid medication (“applying sparingly”) on an irregular basis (“only when I need it”). Many women with chronic vulvar diseases will have a secondary diagnosis that is contributing to persistent symptoms.

Frequently Asked Questions and Answers:

  1. Is a skin biopsy necessary to diagnose Lichen Sclerosus? No, the diagnosis is usually clinical; but early on in the disease the findings may be very subtle. Women must be off all topical steroids for 3 weeks prior to taking a skin biopsy.
  2. How long do you need to follow women with Lichen Sclerosus? Once the condition is stable annual follow up is recommended.
  3. What is the risk of squamous cell carcinoma? The Incidence of squamous cell carcinoma in vulvar lichen sclerosus is estimated to be between 0. 3-4.9%.3

References:

  1. Chi C, Wang S, Kirtschig G. Safety of topical corticosteroids in pregnancy. JAMA Dermatol. 2016;152(8):934-935. DOI: 10.1001/jamadermatol.2016.1009. (Request with CPSBC or view with UBC)
  2. Lee A, Bradford J, Fischer G. Long-term management of adult vulvar lichen sclerosus: a prospective cohort study of 507 women. JAMA Dermatol. 2015;151(10):1061-1067. DOI: 10.1001/jamadermatol.2015.0643. (Request with CPSBC or view with UBC)
  3. Fistarol SK, Itin PH. Diagnosis and treatment of lichen sclerosus: an update. Am J Clin Dermatol. 2013;14(1):27-47. DOI: 10.1007/s40257-012-0006-4. (View)
  4. Kai A, Lewis F. Long-term use of an ultrapotent topical steroid for the treatment of vulval lichen sclerosus is safe. J Obstet Gynaecol. 2016;36(2):276-277. DOI: 10.3109/01443615.2015.1049252 (Request with CPSBC or view with UBC)
  5. Eshtiaghi P. Fact or fiction? Adipose-derived stem cells and platelet-rich plasma for the treatment of vulvar lichen sclerosus. J Low Genit Tract Dis. 2019;23(1):65-70. DOI: 10.1097/LGT.0000000000000440. (View with CPSBC or UBC)
  6. Digesu GA. The energy based devices for vaginal “rejuvenation,” urinary incontinence, vaginal cosmetic procedures, and other vulvo-vaginal disorders: An international multidisciplinary expert panel opinion. Neurourol Urodyn. 2019. DOI: 10.1002/nau.23927. (Request with CPSBC or view with UBC)

Resources:

Handout for patients: http://bcvulvarhealth.ca/wp-content/uploads/2017/06/bccvh_lichen_sclerosus.pdf

Table 1:

Example of a
treatment regimen
for lichen sclerosus
You have been prescribed: topical mometasone fourate 0.1% 
First month:

Once at day (morning or night), apply a thin layer of the ointment to the

affected skin areas, not forgetting the skin around the anus if this is involved.

Second month: Apply on alternate nights. Use an emollient on days “off”.
Third month:

Apply twice a week (eg. Mondays and Thursdays or on weekends Saturdays & Sundays).

Follow up with your doctor after you have finished 3 months of treatment and then once per year.

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Candidiasis: Practice Essentials, Background, Pathophysiology

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  • Eiland EH, Hassoun A, English T. Points of concern related to the micafungin versus caspofungin trial. Clin Infect Dis. 2008 Feb 15. 46(4):640-1; author reply 641. [Medline].

  • CDC. Candida auris. Centers for Disease Control and Prevention. Available at https://www.cdc.gov/fungal/candida-auris/tracking-c-auris.html#world. March 29, 2019; Accessed: April 5, 2019.

  • Ostrowsky B, Greenko J, Adams E, et al. Candida auris Isolates Resistant to Three Classes of Antifungal Medications — New York, 2019. Centers for Disease Control and Prevention. Available at https://www.cdc.gov/mmwr/volumes/69/wr/mm6901a2.htm. January 10, 2020; Accessed: January 17, 2020.

  • US Food and Drug Administration. FDA allows marketing of the first test to identify five yeast pathogens directly from a blood sample [news release.] September 22, 2014. Available at http://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm415728.htm. Accessed: September 30, 2014.

  • Brooks M. FDA clears rapid blood test for sepsis-causing pathogens. Medscape Medical News. September 23, 2014. [Full Text].

  • Alexander BD, Pfaller MA. Contemporary tools for the diagnosis and management of invasive mycoses. Clin Infect Dis. 2006. 43:S15-S27.

  • Odabasi Z, Mattiuzzi G, Estey E, et al. Beta-D-glucan as a diagnostic adjunct for invasive fungal infections: validation, cutoff development, and performance in patients with acute myelogenous leukemia and myelodysplastic syndrome. Clin Infect Dis. 2004 Jul 15. 39(2):199-205. [Medline].

  • Shepard JR, Addison RM, Alexander BD, et al. Multicenter evaluation of the Candida albicans/Candida glabrata peptide nucleic acid fluorescent in situ hybridization method for simultaneous dual-color identification of C. albicans and C. glabrata directly from blood culture bottles. J Clin Microbiol. 2008 Jan. 46(1):50-5. [Medline].

  • Lewis R. Candida: New Rapid Blood Test Could Cut Mortality. Medscape Medical News. Apr 25 2013. Available at http://www.medscape.com/viewarticle/803135. Accessed: Apr 30 2013.

  • Neely LA, Audeh M, Phung NA, Min M, Suchocki A, Plourde D, et al. T2 magnetic resonance enables nanoparticle-mediated rapid detection of candidemia in whole blood. Sci Transl Med. 2013 Apr 24. 5(182):182ra54. [Medline].

  • [Guideline] Pappas PG, Kauffman CA, Andes DR, Clancy CJ, Marr KA, Ostrosky-Zeichner L, et al. Clinical Practice Guideline for the Management of Candidiasis: 2016 Update by the Infectious Diseases Society of America. Clin Infect Dis. 2016 Feb 15. 62 (4):e1-50. [Medline]. [Full Text].

  • [Guideline] Pappas PG, Kauffman CA, Andes D, Benjamin DK Jr, Calandra TF, Edwards JE Jr, et al. Clinical practice guidelines for the management of candidiasis: 2009 update by the Infectious Diseases Society of America. Clin Infect Dis. 2009 Mar 1. 48(5):503-35. [Medline].

  • [Guideline] Pappas PG, Rex JH, Sobel JD, et al. Guidelines for treatment of candidiasis. Clin Infect Dis. 2004 Jan 15. 38(2):161-89. [Medline].

  • Kett DH, Shorr AF, Reboli AC, et al. Anidulafungin compared with fluconazole in severely ill patients with candidemia and other forms of invasive candidiasis: Support for the 2009 IDSA treatment guidelines for candidiasis. Crit Care. 2011 Oct 25. 15(5):R253. [Medline].

  • Andes DR, Safdar N, Baddley JW, Playford G, Reboli AC, Rex JH, et al. Impact of treatment strategy on outcomes in patients with candidemia and other forms of invasive candidiasis: a patient-level quantitative review of randomized trials. Clin Infect Dis. 2012 Apr. 54(8):1110-22. [Medline].

  • Clancy CJ, Nguyen MH. The end of an era in defining the optimal treatment of invasive candidiasis. Clin Infect Dis. 2012 Apr. 54(8):1123-5. [Medline].

  • FDA. FDA limits usage of Nizoral (ketoconazole) oral tablets due to potentially fatal liver injury and risk of drug interactions and adrenal gland problems. Available at http://www.fda.gov/Drugs/DrugSafety/ucm362415.htm. Accessed: August 6, 2013.

  • Lowes R. FDA, EMA Come Down Hard on Oral Ketoconazole. Medscape Medical News. Available at http://www.medscape.com/viewarticle/808484. Accessed: August 6, 2013.

  • Chandrasekar PH, Sobel JD. Micafungin: a new echinocandin. Clin Infect Dis. 2006 Apr 15. 42(8):1171-8. [Medline].

  • Vazquez JA, Sobel JD. Anidulafungin: a novel echinocandin. Clin Infect Dis. 2006 Jul 15. 43(2):215-22. [Medline].

  • Charlier C, Hart E, Lefort A, et al. Fluconazole for the management of invasive candidiasis: where do we stand after 15 years?. J Antimicrob Chemother. 2006 Mar. 57(3):384-410. [Medline].

  • Sobel JD, Revankar SG. Echinocandins–first-choice or first-line therapy for invasive candidiasis?. N Engl J Med. 2007 Jun 14. 356(24):2525-6. [Medline].

  • Reboli AC, Rotstein C, Pappas PG, et al. Anidulafungin versus fluconazole for invasive candidiasis. N Engl J Med. 2007 Jun 14. 356(24):2472-82. [Medline].

  • Kuse ER, Chetchotisakd P, da Cunha CA, et al. Micafungin versus liposomal amphotericin B for candidaemia and invasive candidosis: a phase III randomised double-blind trial. Lancet. 2007 May 5. 369(9572):1519-27. [Medline].

  • Kullberg BJ, Sobel JD, Ruhnke M, et al. Voriconazole versus a regimen of amphotericin B followed by fluconazole for candidaemia in non-neutropenic patients: a randomised non-inferiority trial. Lancet. 2005 Oct 22-28. 366(9495):1435-42. [Medline].

  • Schuster MG, Edwards JE Jr, Sobel JD, Darouiche RO, Karchmer AW, Hadley S, et al. Empirical fluconazole versus placebo for intensive care unit patients: a randomized trial. Ann Intern Med. 2008 Jul 15. 149(2):83-90. [Medline].

  • Cornely OA, Lasso M, Betts R, et al. Caspofungin for the treatment of less common forms of invasive candidiasis. J Antimicrob Chemother. 2007 Aug. 60(2):363-9. [Medline].

  • Pachl J, Svoboda P, Jacobs F, et al. A randomized, blinded, multicenter trial of lipid-associated amphotericin B alone versus in combination with an antibody-based inhibitor of heat shock protein 90 in patients with invasive candidiasis. Clin Infect Dis. 2006 May 15. 42(10):1404-13. [Medline].

  • Khan FA, Slain D, Khakoo RA. Candida endophthalmitis: focus on current and future antifungal treatment options. Pharmacotherapy. 2007 Dec. 27(12):1711-21. [Medline].

  • Kauffman CA. Clinical efficacy of new antifungal agents. Curr Opin Microbiol. 2006 Oct. 9(5):483-8. [Medline].

  • Sable CA, Strohmaier KM, Chodakewitz JA. Advances in antifungal therapy. Annu Rev Med. 2008. 59:361-79. [Medline].

  • Skiest DJ, Vazquez JA, Anstead GM, et al. Posaconazole for the treatment of azole-refractory oropharyngeal and esophageal candidiasis in subjects with HIV infection. Clin Infect Dis. 2007 Feb 15. 44(4):607-14. [Medline].

  • Jaijakul S, Vazquez JA, Swanson RN, Ostrosky-Zeichner L. (1,3)-ß-D-Glucan (BG) as a Prognostic Marker of Treatment Response in Invasive Candidiasis. Clin Infect Dis. 2012 May 9. [Medline].

  • Ullmann AJ, Cornely OA. Antifungal prophylaxis for invasive mycoses in high risk patients. Curr Opin Infect Dis. 2006 Dec. 19(6):571-6. [Medline].

  • Husain S, Paterson DL, Studer S, et al. Voriconazole prophylaxis in lung transplant recipients. Am J Transplant. 2006 Dec. 6(12):3008-16. [Medline].

  • Giglio M, Caggiano G, Dalfino L, Brienza N, Alicino I, Sgobio A, et al. Oral nystatin prophylaxis in surgical/trauma ICU patients: a randomised clinical trial. Crit Care. 2012 Apr 10. 16(2):R57. [Medline].

  • Pfaller MA, Pappas PG, Wingard JR. Invasive fungal pathogens: current epidemiological trends. Clin Infect Dis. Aug 1 2006. 43 (Suppl 1):S3-S14. [Full Text].

  • Leleu G, Aegerter P, Guidet B. Systemic candidiasis in intensive care units: a multicenter, matched-cohort study. J Crit Care. 2002 Sep. 17(3):168-75. [Medline].

  • Zaoutis TE, Heydon K, Localio R, et al. Outcomes attributable to neonatal candidiasis. Clin Infect Dis. 2007 May 1. 44(9):1187-93. [Medline].

  • Vallabhaneni S, Kallen A, Tsay S, et al. Investigation of the First Seven Reported Cases of Candida auris, a Globally Emerging Invasive, Multidrug-Resistant Fungus — United States, May 2013–August 2016. MMWR. November 2016. 65:[Full Text].

  • Cunha BA. Antibiotic Essentials. 9th ed. Sudbury, MA: Jones & Bartlett; 2010.

  • Brooks M. Micafungin Sodium (Mycamine) Gets Pediatric Indication. Medscape [serial online]. Available at http://www.medscape.com/viewarticle/807188. Accessed: July 2, 2013.

  • Brexafemme (ibrexafungerp) [package insert]. Jersey City, NJ: https://www.accessdata.fda.gov/drugsatfda_docs/label/2021/214900s000lbl.pdf. June 2021. Available at [Full Text].

  • Why You Should Think Twice About Using Steroids to Treat Your Dog’s Itch

    Allergic itch affects many dogs and can present itself in ways other than scratching (like licking, chewing, rubbing, or scooting). The aim of treatment is to provide fast, effective, and safe relief for your dog.

    The most important things you can do is work with your veterinarian to find the cause of your dog’s itch. Your dog’s itch can be caused by things like fleas, mites, and bacterial or yeast infections. One of the most common causes of itching is allergies to dust mites, molds, and pollens or less commonly to carpets, wool, or shampoos. Finding the cause of the itch gives both you and your pet the best chance of successful long-term control of itching.

    In the past, allergic itch was treated with antihistamines which were largely ineffective for most dogs, or with corticosteroids (prednisone) which worked but had undesirable side-effects, shown below.

    Side Effects of Corticosteroids in Dogs

    • Excessive urination.
      33% of dogs treated by steroids have to go to the bathroom more often1, meaning more late-night potty trips and accidental urination for an otherwise potty-trained dog.
    • Increased thirst.
      45% of dogs experience an insatiable thirst as a side effect from steroids1, meaning you’ll be filling up that water bowl over and over. Some dogs even result to drinking out of the toilet bowl to satisfy their need for water.
    • Increased hunger.
      Not only can increased hunger cause weight gain2 (which can lead to orthopedic problems), but it can cause your dog to steal food (including from the trashcan), and even nip children trying to take food out of their hands3.
    • Heightened stress and anxiety.
      Steroids have the potential to increase anxiety-related behaviors, like a lack of obedience, barking more often, and being restless, nervous, or fearful3.

    Dogs, pet parents, and corticosteroids don’t always get along. Dog owners spend an average of 5 hours per week dealing with the side effects of dogs on steroids1. These side effects can put a strain on the special bond you share with your dog. Ask your veterinarian about alternative, targeted allergic itch treatment for your dog’s itchy skin that can give you and your dog a positive experience.

    7 Easy Ways to Manage Yeast Infections in Dogs

    If your dog is tilting their head, scratching their ears, licking their paws, or having a musty odor, they might have a yeast infection.

    Yeast infections are a common condition among dogs with folds or allergies. Yeast infections in dogs can cause inflammatory skin conditions in the folds between the genital region, ears, and paw pads.

    This infection is quite common among dogs whose immunity has been suppressed or compromised by medications. Yeast infections can occur more often during allergy seasons, especially in dogs that have been taking antibiotics or steroids.

    Antibiotics don’t cause this infection, but being on antibiotics for a very long period can diminish the dog’s normal flora, which helps keep yeast under control.

    Steroids can also affect a dog’s immunity, which can result in yeast overgrowth.

    7 Ways of Managing Yeast Infections

    Instead of watching your pooch struggle with discomfort, trying to scratch itchy skin, try these effective methods of managing yeast infections in dogs.

    Rinse Your Dog With Apple Cider Vinegar

    According to The Crazy Pet Guy, the first step to managing yeast infection is getting rid of the itch. Apple cider vinegar is the best solution for fungal infections that works with dogs, especially if your pooch loves the water. All you have to do is apply diluted apple cider vinegar directly on your dog’s coat and massage his/her whole body. 

    Apple cider vinegar can help restore your pet’s healthy pH levels and stop yeast overgrowth. Remember, yeast loves wet environments, so you can immediately apply this solution after your dog has finished swimming or after bathing him. 

    Stop Feeding Your Dog Yeast

    Yeast is a dimorphic organism that exists in two forms in your dog’s body. It can exist as a benign single-celled organism that lives peacefully with the bacteria. Or it can sometimes grow out of control and become toxic. So the best way to stop the growth of yeast in your dog’s gut is by removing carbs and sugar from your dog’s diet.

    Carbs are complex chains that are composed of sugar molecules. Therefore, when your pet consumes carbohydrates, it is broken down into sugar that feeds the yeast. So, limit dog foods that contain millet, oat, rice, peas, corn, wheat, and potatoes.

    Apply Coconut Oil Mixture on the Yeasty Region

    After you have stopped the itch, you can start working on your dog’s skin’s affected parts. And one of the best homemade solutions for treating the yeast infection is by massaging the affected region with a coconut oil mix at least once every week. 

    Just melt about 8 oz of virgin oil into a small bottle and two drops of lemon essential oil and about ten drops of lavender oil. Shake the mixture and then apply on the affected part of your dog’s skin. This mixture can last for a few months, so you can store it in a safe place and apply it to your dog every week.

    Soothe the Yeast Infected Ears

    Unless the ears are in bad shape, it’s ideal to leave your dog’s ears alone. The infected ears can often show you how well you are managing the yeast infection inside the dog. But, if they are in bad shape, you can treat them using a veterinary-recommended ear cleaner.

    Reduce the Amount of Heavy Metals Your Dog Consumes

    Yeast has a high affinity for most heavy metals, especially mercury. These metals generate free radicals that can cause severe health problems.

    Since the body cannot remove them on its own, these metals tend to accumulate over time. And a large amount of some heavy metals like mercury, lead, chromium, cadmium, and arsenic can be quite toxic to your dog.

    Yeast tends to bind to heavy metals and stop them from getting into the dog’s system, which is good news. However, heavy metals are toxic to competing bacteria. The heavy metals can reduce the population of the competing bacteria resulting in the outgrowth of yeast. Therefore, if you want to stop a yeast infection in dogs, you must reduce the number of heavy metals it consumes. So you can reduce the heavy metals by doing the following:

    • Avoid feeding your dog low-quality fish oil or fish-based diets.
    • Stop giving your pet fluoridated water.
    • Feed him organic food.

    Start Feeding Your Dog Supplements and Foods That Fight Yeast Infections

    Since yeast is a fungus, you can kill them by giving your dog anti-fungal foods. Look for dog food and treats containing caprylic acid, Pau D-Arco, and olive leaf.

    Pau D’Arco is rich in lapachol, which kills yeast. Olive leaf and caprylic acid are believed to break down the cell membrane of yeast.

    Increase the Population of Other Beneficial Bacteria

    The next step is increasing the population of the competing bacteria to keep the yeast in check.

    You can increase the beneficial bacteria by adding probiotics in your dog’s meal. There are numerous probiotics that cannot fight yeast that lives in the dog’s gut. So, you can start by increasing their population before you introduce probiotics like Bacillus subtilus and Bacillus coagulans.

    These probiotics are spore-forming and can fight yeast infections. And since probiotics cannot live in your dog’s guts for a very long time, you can also introduce prebiotics. Prebiotics can help grow the population of beneficial bacteria at a faster rate than probiotics.

    Finally, you can remove the heavy metals left in your dog’s guts by the dead yeast by giving them food containing chlorella and sulfur. Sulfur can bind to the heavy metals and lower the oxidative damages done by these metals in organs.

    Helpful Products for Balancing Yeast In Dogs 

    All featured products were chosen at the discretion of the Great Pet Care editorial team and not directly recommended or endorsed by the author of this article. Great Pet Care may make a small affiliate commission if you click through and make a purchase.

    After consulting with your dog’s veterinarian to address the underlying cause of yeast overgrowth, it’s time to prevent a recurrence. While natural home remedies may suppress yeast growth, it’s best to eliminate the problem altogether. We’ve curated a list of the best products to help balance yeast in dogs. By safely and effectively keeping your dog’s yeast problem at bay, she won’t get caught in a vicious cycle of vet visits, antibiotics, and harsh medical treatments.

    Best Probiotic with Fiber Supplement for Dogs

    Our pick: Great Poop Probiotic with Fiber

    Yeast can live and grow in any number of places on and in your dog’s body. When yeast gets out of control, inflammatory skin conditions can develop in a number of places including folds of skin, the genital region, ears, and paw pads. Pawing, scratching, or biting any of these areas can be one of the first signs of a yeast infection. Once your dog’s vet examines her and recommends a course of action, a multipurpose probiotic is a great way to prevent yeast infections from recurring. 

    Highlights

    • Complete all-in-one formula to form a high fiber solution for gut and immune health 
    • Firmer, well-formed poops mean less straining and discomfort to defecate
    • Contains beneficial bacteria in a handy chewable form
    • Two billion powerful CFUs (colony-forming units) for proper gut balance
    • American-made without corn, soy, artificial preservatives, or flavoring 
    • 120 chicken-flavored chews per container which can last months 

    Things to Consider

    • May take a few days to see desired results
    • Only available in a chewable version 

    Best Cleaning Wipes For Yeasty Dog Folds

    Our pick: Pet MD Chlorhexidine Antiseptic Dog & Cat Wipes

    Yeast loves to grow and thrive in dark, moist places on a dog’s body, such as facial folds, in between toes, underarm areas, and in the groin. Unlike liquid cleaners, Pet MD Chlorhexidine Antiseptic Dog & Cat Wipes are mess-free pre-moistened wipes. Formulated with an advanced veterinary formula of chlorhexidine and ketoconazole, fungal and bacterial infections don’t stand a chance of advancing. Keep a container on hand for travel and in between baths.

    Highlights

    • Helps control the itchiness of hot spots, yeast-prone areas, and canine acne
    • Easier to use than dog shampoo 
    • May lessen the amount of itching, scratching, and licking in yeast-prone areas 
    • Advanced veterinary formula from a trusted name brand
    • Made in a regulated manufacturing facility in small batches in the USA
    • Soothing skin-friendly formula with aloe and glycerin 

    Things to Consider

    • Alcohol-based solution
    • Do not allow your dog to lick the treated areas until the product dries to prevent ingestion
    • Do not use on open wounds, cuts, or raw areas
    • Wipes include a fragrance

    Best Topical Cream For Inflammation Relief

    Our pick: Zymox Topical Cream Inflammation Relief Hydrocortisone 1. 0% for Dogs & Cats

    Zymox’s veterinarian strength formula targets canine skin irritations caused by yeast, itchiness, hot spots, dermatitis, and more. The no-sting lotion formulated with 1% hydrocortisone is formulated without harsh chemicals that may irritate a dog’s sensitive skin. No need to pre-clean or disinfect the skin thanks to Zymox’s patented LP3 Enzyme System that reacts with the yeast to form antimicrobial properties. This cream is good to keep in your dog’s first aid kit for topical infections, wounds, cuts, and yeast prevention.  

    Highlights

    • Gentle enough to use every day for one to two weeks
    • Suitable for use on and in surface skin folds such as face wrinkles 
    • Available in a non-hydrocortisone formula 
    • Recommended for hot spots, wet eczema, yeasty areas, dermatitis, cuts, and wounds
    • Gently soothes and cleans the skin without burning or stinging
    • Product has a catheter tip for easy, direct application 

    Things to Consider

    • Intended for external use only 
    • If the condition worsens or persists for more than seven days, seek veterinary help
    • Do not on mucous membranes
    • Do not use on animals with known or suspected sensitivity to corticosteroids such as pregnant or lactating females 

    Best Daily Dog Multivitamin Supplement with Probiotic

    Our pick: Daily Great All-In-One Multivitamin for Dogs

    Canine yeast infections happen for a number of reasons. Increasing the beneficial bacteria in your dog’s gut may help. Great Pet’s Daily Great all-in-one multivitamin contains 5 million CFUs to help digestion. Forget having to add multiple supplements to your pup’s diet. Daily Great supports a dog’s skin, coat, and joints with vitamins and minerals. For dogs over 12 weeks of age, this 4-in-1 multivitamin gives your pooch the support she needs to live a happy, healthy life. Since many dogs aren’t fond of having a pill shoved into their throats, Daily Great is formulated in an easy-to-dispense soft chew. No more hiding pills in her food!

    Highlights

    • Contains glucosamine and chondroitin for hip and joint support
    • Infused with omega 3 for healthy skin and coat
    • Loaded with vitamins and minerals in a soft, tasty chew
    • Made in America with a probiotic digestive aid
    • Tasty chicken liver flavored chew dogs love 
    • Proper balance to support a dog’s daily needs 

    Things to Consider

    • Suggested to give one dose with each meal
    • Serve two chews per day for dogs 30 pounds or less, more depending on weight
    • Divide the dosing between AM and PM 

    Final Thoughts

    Yeast infection is a severe infection that can affect your dog’s peace. This infection can leave them biting the itch off their skin the whole day. And in severe cases, it can leave them with an ear infection that causes odors and discomfort.

    So, you must start treating them as soon as you notice the symptoms of yeast infections. Make sure you consult your veterinarian to ensure you don’t confuse yeast infections with allergies.

    Sponsored by The Crazy Pet Guy

    About the Author

    Cynthia Garcia is the editor and content creator at the Crazy Pet Guy. She’s a passionate pet rescue supporter and in her free time, she’s always looking for ways to help the community.

    90,000 DIFFERENCE BETWEEN DAIRY, HERPES AND YEAST INFECTION | COMPARE THE DIFFERENCE BETWEEN SIMILAR TERMS – LIFE

    Thrush vs. Herpes vs. Yeast Infection Fungal infection and herpes infection affect the female reproductive system and oral cavity. These are general presentations and can be confusing.

    Thrush against herpes against yeast infection

    Fungal infection and herpes infection affect the female reproductive system and the oral cavity. These are general presentations and can be confusing. Yeast infection is also known as thrush because all candidal infections in humans cause a characteristic white discharge. It is important to distinguish between these infections because herpes is a serious condition and yeast can be treated without any lasting harm. In this article, we will detail these infections and the differences between them, highlighting their clinical features, symptoms, causes, research and diagnosis, prognosis, and the required course of treatment.

    What is a yeast infection / thrush?

    Yeast common fungal infection . It is very common in women (vaginal candidiasis) and in patients with poor infection protection, such as diabetics , transplant patients and AIDS patients. It is very important to remember that just because you have a fungal infection does not mean that you have poor defenses. Yeast is an opportunistic infection.When asthma patients use a steroid inhaler for a long time and do not wash their mouth after using the inhaler, fungal infections can develop in the mouth. It is called Oral candidiasis (oral thrush) . It is a whitish plaque on the back of the tongue and cheek mucosa. There may also be bad breath. Regularly rinsing your mouth with an antifungal solution will get rid of the infection very quickly. With oral candidiasis, the infection can spread to esophagus and the cause is esophageal candidiasis (esophageal thrush) .Women get 90,005 vaginal candidiasis very often. These women complain of genital itching and a whitish, thick, creamy consistency with an unpleasant odor. vaginal discharge . After coitus, pain in the lower abdomen and burning pain in the genitals of the male partner may occur. Some women complain of superficial dyspareunia due to vaginal candidiasis.

    Although yeast infections can be transmitted through intimate intercourse, yeast infections are not medically classified as sexually transmitted diseases (STDs) .Since yeast is sexually transmitted and can cause urethritis in men, it can be considered a sexually transmitted infection (STI) and not a sexually transmitted disease.

    Fungal infections are almost always localized. In immunocompromised people, they can cause systemic infections. Fungal meningitis is one such example. Fungal infections do not change the composition of the blood, except in systemic cases. Lymphocytosis is the main feature.

    What is herpes?

    Herpes simplex virus 1 and 2 are responsible for a wide range of disorders. Herpes is divided into two main categories depending on the location of the infection: orofacial and genital herpes. HSV 1 affects the mouth, face, eyes, throat, and brain. HSV 2 causes anogenital herpes. After the virus enters the body, it enters the bodies of nerve cells and remains dormant in the ganglia. Antibodies formed against the virus after the first infection prevent re-infection of the same type.However, The immune system cannot completely remove the virus from the body. Genital herpes , which is one of the representations that can become a diagnostic problem, shows accumulations of papules and vesicles surrounded by inflamed skin on the outer surface of the penis or labia. Herpetic gingivostomatitis affects the gums and oral cavity. In most cases, this is the first symptom of herpes.This causes bleeding gums, tooth sensitivity and gum pain. Blisters appear in clusters in the mouth. It is more serious than labial herpes. Labial herpes manifests itself in the form of groups of characteristic blisters on the lips. These presentations have unique characteristics that set them apart from the common thrush. In addition to these manifestations, herpes can cause other conditions.

    Herpetic white is a very painful infection of the cuticle of the nails of the fingers or toes.Herpetic edema is transmitted on contact. Fever, headache, swelling lymph node are accompanied by herpetic proteins. Herpes meningitis and encephalitis This is believed to be due to the retrograde migration of the virus along nerves to the brain. It mainly affects the temporal lobe. Herpes is the most common cause viral meningitis . Herpes esophagitis occurs in people with immunodeficiency and is accompanied by painful difficulty swallowing.Bell’s palsy and Alzheimer’s disease are known to herpes associations.

    Analgesics and antiviral drugs are the main methods of treating herpes. Barrier methods can prevent cold sores. If a mother becomes infected during the last days of pregnancy, there is a high risk of transmitting the infection to her baby. Acyclovir can be prescribed after 36 weeks. Caesarean section It is recommended to minimize contact during delivery.

    What is the difference between thrush and yeast infection?

    • Yeast is fungus and herpes is viral infection .

    • A fungal infection is also known as thrush because all candidal infections in humans cause a characteristic white discharge.

    • Herpes is considered a sexually transmitted disease, but yeast is not by definition.

    • Although both affect the mouth and genitals, yeast causes a thick, creamy vaginal discharge and thick, creamy plaques in the mouth.

    • Herpes, on the other hand, causes small blisters to form in clusters or otherwise.

    • Herpes lesions are painful, but yeast lesions are not.

    • Yeast usually does not cause long-term systemic infections and does not have a dormant stage in the body, as in herpes.

    • Herpes infection responds to antiviral drugs, and yeast responds to antifungal therapy.

    Read more:

    1. Difference between chlamydia and yeast infection

    2. Difference between UTI and yeast infection

    3. Difference between chlamydia and gonorrhea

    4. Difference between herpes and ingrown hair

    5. Difference between HPV and herpes 6.

    9000 genital warts and herpes

    7. Difference between acne and herpes

    8. Difference between pimple and herpes

    9. Difference between syphilis and herpes

    10. Difference between HSV 1 and HSV 2

    Candidiasis – KVD No. 2

    What is thrush (candidiasis)?

    About 75% of women during childbearing age suffer from thrush or candidiasis, which is caused by yeast-like fungi of the genus Candida. This disease occurs in the form of candidal vaginitis or vulvovaginitis. These fungi normally inhabit the skin, mouth, intestines, and vagina. In 20% of healthy women of childbearing age, fungi of the genus Candida are found in the genital tract.The abnormally rapid growth of fungi replaces the “good” bacteria and causes clinically manifest vaginal inflammation. It occurs most often in young, sexually active women and is a commonly diagnosed condition.

    Candidal vaginitis (CV), in general, is not included in the group of sexually transmitted infections, but it is possible to get this infection from partners in whom the fungi are present in the mouth or genital tract. Men with genital candidiasis usually do not have clinical manifestations.

    Causes of the disease and risk factors

    Candidal vaginitis is an infection associated with risk factors that disrupt the normal flora of the vagina (“good” bacteria) resulting in rapid growth of fungal yeast.

    Risk Factors:

    • Disorder of the normal microflora of the genital organs
    • Long-term use of antibiotics
    • Long-term use of local antiseptics
    • Presence of urogenital genital infections
    • Use of condoms containing spermicides (nonoxynol-9)
    • Hormonal disorders – Long-term use of hormonal drugs
    • Use of hormonal contraception
    • Pregnancy
    • Increased blood sugar – Diabetes mellitus and prediabetes
    • Sugar abuse
    • Secondary immunodeficiency – HIV infection
    • Long-term immunosuppressive therapy
    • Chronic inflammatory diseases
    • Malignant neoplasms
    • Tuberculosis
    • Radiation exposure

    Manifestations of the disease

    Acute candidal vaginitis is manifested by a pronounced picture, the duration of the disease in the acute form does not exceed 2 months.

    Manifestations:

    • Profuse or moderate curdled vaginal discharge;
    • Hyperemia, edema, rash on the skin and mucous membranes of the vulva and vagina;
    • Itching, burning, irritation in the genital area;
    • Increased itching during sleep or after water procedures and intercourse;
    • Unpleasant odor that worsens after sexual intercourse.

    Diagnostics

    Diagnosis of the disease is carried out on the basis of typical patient complaints, clinical examination and laboratory tests.

    Laboratory diagnostics includes:

    • microscopy (examination of a smear under a microscope), the smear must be fresh, no more than 2 hours from taking. With the correct collection and preparation of a smear, the sensitivity of the method reaches 40 – 60%;
    • determination of the acidity of the vaginal contents;
    • Bacteriological culture of vaginal contents is the most sensitive method for confirming the diagnosis. This is a very important test, since up to 40% of fungi are not sensitive to the antimycotics usually prescribed in antenatal clinics;
    • PCR (polymerase chain reaction) – allows you to quickly identify the pathogen in the smear;
    • additional blood tests, expert advice are needed to determine the causes of candidiasis.

    Treatment of the disease

    General recommendations:

    • personal hygiene;
    • Refusal from tight-fitting synthetic underwear, replacing it with cotton;
    • Use of sanitary napkins is preferred over tampons during menstruation.

    Treatment is carried out with special antifungal antibiotics – antimycotics – which can be applied topically or taken orally. A prerequisite is to determine the sensitivity of fungi of the genus Candida to antimycotics.Blind administration of fluconazole (Diflucan, Flucostat) is unacceptable.

    It is very important to eliminate the predisposing conditions and risk factors for the development of candidiasis, to determine the presence of concomitant diseases.

    Control of cure is carried out 7-10 days after completion of treatment.

    Prevention

    The best way to prevent sexually transmitted infections is long-term sex with one healthy sexual partner. It is important to discuss STI issues with your sexual partner before sex.Prevention of infections is possible if partners know about diseases and how they spread.

    Latex male condoms, when used correctly, reduce the risk of infection transmission.

    Any manifestations such as pain or discomfort when urinating, an unusual rash, or discharge may be a sign of an STI. This is a signal for the termination of sexual intercourse and immediate examination in a specialized clinic – KVD. If a patient is diagnosed with STIs, he must inform his sexual partners about this, so that they also undergo a full examination and appropriate treatment.This will reduce the risk of serious complications and prevent the possibility of re-infection.

    Patients with STIs should refrain from unprotected sex during treatment, otherwise re-infection of the sexual partner is possible.

    90,000 What can cause vaginal itching during your period?

    Itching of the vagina may be due to normal hormonal changes caused by menstruation. It can also signal sensitivity or allergies to pads, tampons, or other hygiene products that a woman uses during critical days.

    This article outlines some of the potential causes of vaginal itching during menstruation and other stages of the menstrual cycle. We’ll look at some home remedies and treatments for vaginal itching and when to see a doctor.

    Causes of itching during critical days

    Two common causes of vaginal itching on your period are hormonal changes and hypersensitivity or allergy to hygiene products.

    Hormonal changes

    There is a delicate balance in the vagina between various bacteria and yeasts. Hormonal changes can cause a shift in the ratio of these microorganisms. And this, in turn, can lead to vaginal itching.

    Hormonal changes occur for a number of reasons, including:

    • menstruation,
    • pregnancy,
    • menopause.

    Vagina and allergies

    Vaginal itching may occur due to sensitivity or allergy to foods that come in contact with the skin around the vagina.

    Certain hygiene products capable of causing vaginal itching:

    • gaskets,
    • swabs,
    • soaps and deodorant sprays.

    Other products that may cause itching:

    • synthetic fiber undergarments;
    • laundry washed with harsh detergents or conditioners;
    • latex condoms;
    • spermicides.

    Itching of the vagina may be aggravated by repeated repeated exposure to a sensitive or irritating product.

    Other reasons

    Vaginal itching at any stage of the menstrual cycle, including during menstruation, can be caused by various conditions.

    Vaginal yeast infections

    This is a type of fungal infection caused by the yeast Candida. It is also called a thrush. This yeast usually lives in the vagina and is harmless to humans.

    However, some factors can cause overgrowth of yeast.These triggers include:

    • pregnancy,
    • uncontrolled diabetes,
    • drugs.

    A vaginal yeast infection of the vagina can cause the following symptoms:

    • itching and irritation around the vagina;
    • pain or tingling sensation when urinating or having intercourse;
    • white curdled vaginal discharge.

    Bacterial vaginosis

    The most common vaginal infection in women aged 15 to 44 is bacterial vaginosis.

    This is an infection that occurs when there is an imbalance between good and bad bacteria in the vagina. People with bacterial vaginosis may experience vaginal itching and gray or white discharge from the vagina. The discharge has a fishy smell.

    Trichomoniasis

    Sexually transmitted infection caused by vaginal Trichomonas. According to experts, trichomoniasis is diagnosed in approximately 15-20% of cases of vaginitis.

    Vaginitis is the medical term for inflammation and irritation of the vagina.

    About 70% of people with trichomoniasis do not experience any symptoms. However, if symptoms do occur, they may include:

    • genital itching, burning, or soreness;
    • redness or other discoloration of the skin around the genitals;
    • discomfort when urinating;
    • increased vaginal discharge;
    • Vaginal discharge with a fishy odor.

    Dermatitis

    This medical term refers to a group of conditions that cause skin inflammation.

    About half of all cases of pruritus in chronic vulvovaginitis are attributed to allergic or irritating contact dermatitis.

    These types of dermatitis can occur due to poor hygiene or exposure to harsh chemicals and other irritants.

    Psoriasis

    An autoimmune disease characterized by overgrowth and multiplication of skin cells. These cells then accumulate on the skin, forming psoriatic plaques.

    Psoriasis can develop anywhere on the body, including the vulva and inside the vagina. The genitals are affected by two main types of psoriasis: plaque and inverse.

    Plaque psoriasis appears as patches of inflamed red hot skin covered with gray or silvery-white scaly plaques. They peel off easily and may itch or hurt.

    Inverse psoriasis looks like inflamed areas of the skin – red, smooth and dense. Such spots often affect the skin folds, especially around the genitals, in the armpits, between the buttocks….

    Lichen sclerosus

    An inflammatory skin disorder that causes itchy white patches on the genitals or anus. Lichen sclerosus can affect people of any age, but is most common in women over 50.

    Doctors do not yet know what exactly causes lichen sclerosus. However, daily steroid ointment treatment of problem areas usually helps relieve itching and other symptoms.

    Lichen planus

    An autoimmune disease in which inflammatory cells attack proteins in the skin and mucous membranes.Lichen planus affects moist areas of the body such as:

    • mouth,
    • vagina,
    • the area around the vulva.

    People with lichen planus vulva may have:

    • itchy rash,
    • lacy white stripe leather pattern,
    • painful and persistent ulcers,
    • scarring,
    • yellow or bloody vaginal discharge,
    • pain during intercourse.

    Atrophic vulvovaginitis

    A condition in which the tissues of the vagina become dry, tender, and easily inflamed. Atrophic vulvovaginitis develops due to low estrogen levels that occur in menopausal women.

    Some potential symptoms of atrophic vulvovaginitis:

    • itching of the vulva or vagina;
    • vaginal dryness;
    • vaginal burning;
    • pain during sex;
    • discharge with a characteristic unpleasant odor, in severe cases – bloody;
    • peeling of the skin at the entrance to the vagina.

    Cancer

    Vaginal itching can also be a symptom of gynecological cancers: cancer of the vagina, vulva or cervix.

    Medicines that cause vaginal itching

    In some cases, the use of medications can lead to itching of the vagina:

    • antibiotics,
    • steroid drugs,
    • 90,218 immunosuppressants.

    How to get rid of itchy vagina

    Certain home remedies may help treat or prevent vaginal itching.These funds are aimed at:

    • limit the influence of the source of irritation,
    • reduce excess moisture and associated fungal growth,
    • Maintain an optimal balance of microorganisms inside the vagina.

    These include:

    • refusal to douch, which can cause an imbalance of “good” and “bad” bacteria in the vagina;
    • taking probiotic supplements to help restore the level of “good” bacteria in the vagina;
    • wearing cotton underwear, under which the skin sweats less;
    • Avoiding perfumed soaps and other irritants;
    • Using a non-scented laundry detergent and avoiding fabric softeners;
    • Bathing in warm rather than hot water to avoid irritating the sensitive skin around the vagina.

    Another home method to get rid of itching is to use a special gel for intimate hygiene “Epigen Intim”. This is a product for the delicate care of the intimate area.

    It is recommended by experts for daily use and, in particular, has the property of soothing irritation.

    Gel combines two active elements: activated glycyrrhizic acid and lactic acid. It is the activated glycyrrhizic acid in Epigen Intim gel that gently relieves discomfort and irritation that may occur after epilation and when wearing lace or tight underwear.

    The second important component of the product – lactic acid – helps to maintain the physiological pH level and the natural microflora of the mucous membranes.

    The absence of soap in the gel helps to avoid skin irritation, dryness, tightness and disturbances in the natural balance of the intimate zone.

    Treatment

    The choice of treatment for vaginal itching depends largely on what causes it.

    Some possible therapy options:

    • antibiotics – for bacterial vaginosis or other bacterial infections;
    • antifungal ointments and tablets – for yeast infections;
    • topical steroids – for irritating dermatitis and psoriasis;
    • local estrogens – with atrophic vulvovaginitis;
    • Antihistamines – for contact dermatitis.

    When to see a doctor

    Often vaginal itching during menstruation goes away on its own within a few days. However, if there is no improvement after two weeks, it is worth consulting your doctor.

    In addition, a woman should contact her doctor if she has any of the following:

    • repeated attacks of vaginal itching;
    • vaginal discharge with an unpleasant odor, unusual color or consistency;
    • Wounds or inflammation of the skin around the vagina or vulva;
    • other painful conditions such as diabetes.

    Pregnant women should consult a doctor for itching or any other vaginal symptoms.

    So:

    Vaginal itching during menstruation is a common symptom. It may be associated with normal hormonal changes associated with menstruation.

    It can also signal an increased sensitivity or allergy to certain foods that are used during critical days.

    Some other causes of vaginal itching include an imbalance of bacteria and yeast in the vagina, skin conditions, and certain medications.

    Usually, vaginal itching that occurs during menstruation disappears on its own within a few days. But if it persists, it is better to see a doctor for diagnosis and appropriate treatment.

    90,000 Anti-Inflammatory Drugs for Asthma Control – HealthInfo

    The main treatments for most asthma sufferers are steroids and other anti-inflammatory drugs.They not only help control the disease, but also help in the prevention of asthma attacks.

    Steroids and other anti-inflammatory drugs are aimed at reducing swelling and mucus production in the airways. As a result, the sensitivity of the airways decreases, as well as the likelihood of their reaction to asthma pathogens, respectively, patients can better control their condition.

    Major types of steroids and anti-inflammatory drugs for asthma

    Major anti-inflammatory drugs for asthma control include steroids or corticosteroids (inhaled or oral), mast cell membrane stabilizers, leukotriene modifiers and immunoglobulin E blockers.

    What are inhaled steroids?

    Inhaled steroids are the most effective means of reducing airway inflammation and mucus production. The use of inhaled steroids leads to:

    • increased control of the disease
    • reduced exacerbation of symptoms and attacks
    • reduced need for hospitalization

    Note that inhaled corticosteroids, while preventing the exacerbation of asthma symptoms, do not relieve existing symptoms.Doses of inhaled steroids in inhalers can vary.

    For best treatment results, inhaled steroids should be taken daily. Some improvements are noticeable after one to three weeks after starting the drug, the maximum effect of inhaled steroids should be expected after three months of daily administration.

    Inhalation steroids are available in three types: inhaler with dispenser, powder inhaler, nebulizer.

    What are the side effects when taking inhaled steroids?

    Inhaled steroids have few side effects, especially when taken in low doses.At high doses, mycosis of the mouth (a yeast infection in the mouth) and hoarseness can develop, but this is rare. To avoid these side effects, rinse your mouth after each use of the inhaler or spacer. Mycosis is easily treated with an antifungal mouthwash.

    Inhalers are safe for both adults and children. The side effects of these anti-inflammatory drugs are minimal. The doctor will prescribe the optimal dose to control the disease in you or your child.

    It should be noted that many parents are wary of the prospect of prescribing steroids to their children. But inhaled steroids are not the anabolic steroids athletes take to build muscle. These anti-inflammatory drugs are the cornerstone of asthma treatment. Anti-inflammatory inhalers have many benefits.

    For more information on the use of inhaled steroids for asthma in children, see article , Pediatric Asthma.

    What are the benefits of taking inhaled steroids?

    The benefits of taking inhaled steroids far outweigh the risks. Here are some of them:

    • Reduce the frequency of asthma attacks
    • Reduce the use of beta-agonists (inhaled bronchodilators that relieve asthma symptoms)
    • Improve lung function
    • Reduce emergency calls and hospitalizations

    As prednisone improve asthma control?

    The use of systemic steroids (steroids that enter the bloodstream, not just the lungs), such as prednisone, can help treat severe flare-ups of asthma and better control the disease. Prednisone and other steroids are used with other drugs to control sudden and severe asthma attacks or to treat long-term, difficult to control asthma.

    Systemic steroids begin to work three hours after ingestion and give maximum results after 6-12 hours. Sometimes prednisone and other steroids are taken in large doses over several days (called “pulse steroid therapy”). For long-term control of the disease, they can be taken in small doses daily or every other day.

    Side effects of systemic steroids usually appear after several months or even years of use. Among them: acne, being overweight, mood swings or changes in behavior, indigestion, fragility of bones, blurred vision, stunted growth. With short-term use of drugs, for example, to relieve an acute attack of suffocation, these side effects are rare.

    For more information, see article , Prednisone and Asthma .

    How do leukotriene modifiers enhance asthma control?

    Leukotrienes are chemicals found in our body that cause muscle spasm around the airways and the formation of mucus and fluid. Leukotriene modifiers help control asthma by blocking the action of leukotrienes in the body. Studies show that these agents are effective in improving breathing and reducing asthma symptoms.

    Leukotriene modifiers are taken as tablets 1-4 times a day, they reduce the need for other drugs.Studies have shown that these drugs are especially effective for people with allergic rhinitis and may also be helpful for people with allergic rhinitis and allergic asthma at the same time.

    What are the side effects of leukotriene modifiers?

    The most common side effects of leukotriene modifiers are headache and nausea. In addition, leukotriene modifiers can interfere with the action of some other drugs (such as theophylline).Be sure to tell your doctor about any medications you are taking. It is possible that other side effects will be identified as leukotriene modifiers become more widely used.

    What are mast cell membrane stabilizers?

    Mast cell membrane stabilizers, such as inhaled asthma medications that prevent the release of irritating and inflammatory substances from immune cells called mast cells.