What does a yeast infection under the breast look like. How can you identify the symptoms of a yeast infection under the breast. What are the main causes and risk factors for developing a yeast infection under the breast. How can you effectively treat and prevent yeast infections under the breast.

Understanding Yeast Infections: What Causes Them Under the Breasts?

Yeast infections under the breasts are caused by an overgrowth of Candida, a type of fungus that naturally lives on and in our bodies. These infections often occur in warm, moist areas where skin folds create an ideal environment for yeast to thrive. The underside of the breasts is particularly susceptible due to its dark, warm, and potentially sweaty nature.

What conditions promote yeast overgrowth under the breasts? Several factors can contribute:

• Excessive moisture from sweat or inadequate drying after bathing
• Friction between skin folds
• Poor ventilation in the breast area
• Weakened immune system
• Certain medications, such as antibiotics or corticosteroids

Recognizing the Signs: How to Identify a Yeast Infection Under Your Breasts

Identifying a yeast infection under the breasts is crucial for prompt treatment. What are the telltale signs of a yeast infection in this area? Look out for the following symptoms:

• Redness or reddish-brown discoloration of the skin
• Itching or burning sensation
• Raised, bumpy rash
• Small, fluid-filled blisters that may ooze or crust over
• Pain or soreness in the affected area
• A mirrored rash on both sides of the skin fold

If you notice these symptoms, it’s important to consult with a healthcare professional for an accurate diagnosis and appropriate treatment plan.

Risk Factors: Who’s Most Susceptible to Yeast Infections Under the Breasts?

While anyone can develop a yeast infection under their breasts, certain factors can increase the risk. Who is more likely to experience this condition? Consider the following risk factors:

Diabetes and Blood Sugar Control

How does diabetes affect yeast infections? People with diabetes, especially those with poorly controlled blood sugar levels, are at a higher risk of developing yeast infections. Elevated blood sugar provides extra nourishment for yeast, promoting its growth. Additionally, diabetes can weaken the immune system, making it harder for the body to fight off fungal infections.

Breast Size and Support

Does breast size impact the likelihood of yeast infections? Individuals with larger breasts are more prone to developing yeast infections under their breasts. Why is this the case? Larger breasts create deeper skin folds and more surface area for skin-to-skin contact, increasing moisture and friction. Proper breast support through well-fitting bras can help minimize this risk.

Obesity and Skin Folds

How does obesity contribute to yeast infections? Excess body weight can create additional skin folds, not just under the breasts but in other areas as well. These folds trap moisture and heat, creating an ideal environment for yeast growth. Moreover, individuals with obesity may experience increased sweating, further exacerbating the problem.

Climate and Environmental Factors

Can your environment influence yeast infections? Hot and humid climates can significantly increase the risk of yeast infections under the breasts. These conditions promote sweating and moisture retention, providing an optimal setting for yeast to thrive. People living in or visiting tropical climates should be especially vigilant about keeping the skin under their breasts clean and dry.

Clothing Choices

What role does clothing play in yeast infections? Tight-fitting clothes, especially those made from non-breathable materials, can trap moisture against the skin. Bras made from synthetic fabrics that don’t wick away sweat can create a damp environment under the breasts, increasing the risk of yeast overgrowth.

Effective Treatments: How to Tackle Yeast Infections Under the Breasts

When it comes to treating yeast infections under the breasts, several options are available. What are the most effective treatments for this condition?

Antifungal Medications

What medications are used to treat yeast infections under the breasts? The primary treatment involves antifungal medications, which can be applied topically or taken orally in severe cases. Common antifungal agents include:

• Clotrimazole
• Miconazole
• Ketoconazole
• Econazole
• Tioconazole
• Terbinafine
• Amorolfine

These medications work by killing the yeast or preventing its growth. Over-the-counter options are available for mild cases, while more severe infections may require prescription-strength formulations.

Combination Treatments

In cases where itching is severe, what additional treatments might be prescribed? Your healthcare provider may recommend a combination cream that includes both an antifungal agent and a corticosteroid. The antifungal component addresses the underlying infection, while the steroid helps reduce inflammation and relieve itching.

Duration of Treatment

How long does it take to treat a yeast infection under the breasts? Most people see improvement within a week of starting treatment. However, it’s crucial to complete the full course of medication as prescribed, even if symptoms improve, to ensure the infection is fully eradicated and prevent recurrence.

Prevention Strategies: Keeping Yeast Infections at Bay

Preventing yeast infections under the breasts is often easier than treating them. What steps can you take to reduce your risk of developing these infections?

Hygiene and Moisture Control

How can proper hygiene help prevent yeast infections? Maintaining good hygiene is crucial in preventing yeast overgrowth. Consider these practices:

• Wash the area under your breasts twice daily with a gentle, fragrance-free soap
• Thoroughly dry the skin after bathing, using a clean towel or hairdryer on a cool setting
• Apply an over-the-counter antifungal or moisture-absorbing powder to keep the area dry

Clothing and Bra Selection

What clothing choices can help prevent yeast infections? Opt for:

• Supportive cotton bras that lift the breasts and allow air circulation
• Loose-fitting, breathable clothing
• Quick-change out of wet or sweaty clothes

Lifestyle Modifications

Are there lifestyle changes that can reduce the risk of yeast infections? Consider these strategies:

• Maintain a healthy weight to reduce skin folds and friction
• Control blood sugar levels if you have diabetes
• Limit intake of sugary foods, which can promote yeast growth
• Allow skin to breathe by going bra-free when appropriate and safe to do so

When to Seek Medical Attention: Recognizing Severe or Persistent Infections

While many yeast infections can be managed with over-the-counter treatments, some situations warrant professional medical attention. When should you consult a healthcare provider for a yeast infection under your breasts?

• If symptoms persist after a week of self-treatment
• If the infection appears to be spreading or worsening
• If you experience fever or chills, which may indicate a more serious infection
• If you have recurring yeast infections
• If you have diabetes or a weakened immune system

A healthcare professional can provide a definitive diagnosis, rule out other conditions, and prescribe stronger treatments if necessary.

Beyond the Breasts: Understanding Yeast Infections in Other Body Areas

While we’ve focused on yeast infections under the breasts, it’s important to note that these fungal overgrowths can occur in various parts of the body. Where else can yeast infections develop?

Common Sites for Yeast Infections

Yeast infections can occur in several areas, including:

• Genital area (vaginal yeast infections in women, balanitis in men)
• Mouth and throat (oral thrush)
• Skin folds (such as under the arms, in the groin area, or between toes)
• Nail beds

The symptoms and treatments for yeast infections in these areas may vary, but the underlying cause – an overgrowth of Candida yeast – remains the same.

Systemic Yeast Infections

In rare cases, particularly in individuals with severely compromised immune systems, yeast infections can become systemic, affecting multiple body systems. These infections are serious and require immediate medical attention.

Understanding the various manifestations of yeast infections can help you recognize and address the problem early, regardless of where it occurs on your body.

Yeast Infection Under the Breast: Signs and Treatment

Candida is a yeast that lives both inside and outside of your body. It can be found in your gut, mouth, vagina, and on your skin.

This yeast particularly likes the warm, dark, moist folds of your skin, and the underside of your breasts is a prime place for it to take up residence. Under normal circumstances, Candida doesn’t cause any problems.

But in some people—because of things like underlying health conditions or the size of their breasts—skin can break down, causing a rash (called intertrigo). That rash can allow yeast to penetrate, causing a yeast infection under your breasts.

Yeast infections are technically fungal infections.

Kateryna Kon / Science Photo Library / Getty Images

What Does a Yeast Infection Under the Breasts Look Like?

A yeast skin rash can appear under the breasts and along the upper torso, where breast skin rubs against torso skin. In fact, the rash under a breast is often a mirror image of the rash on the other side of the skin fold. The rash also typically:

• Appears red or reddish-brown
• Is raised
• Has oozing blisters and crusting
• Is itchy
• Causes pain

Causes and Risk Factors

Anyone can get a yeast infection on their skin, especially in a dark, moist area like under the breasts. But these skin rashes and infections tend to happen more frequently in certain groups of people. Some things that up your risk include:

Diabetes

When you have diabetes, your body either can’t make or use insulin properly. Insulin is a hormone that keeps blood sugar in check. If blood sugar isn’t well controlled, yeast can overgrow on your skin, leading to a yeast infection.

Diabetes can also predispose you to infection because it’s thought that it may suppress your immune system, making it less able to mount an attack against foreign invaders, such as fungi like yeast, viruses, and bacteria that can cause infections.

Research shows that people with diabetes are more likely to develop infections of all kinds versus people without diabetes. 

Large Breasts

Large, heavy breasts—especially ones that aren’t well supported with a good bra—are more likely than small ones to rub against the skin of the upper torso, creating an intertrigo rash and possible yeast infection.

What’s more, the skin under large breasts may be harder to keep dry and well ventilated, setting the stage for a yeast infection.

Obesity

People who are obese can have deep skin folds and may sweat more than those who weigh less, thanks to thick layers of fat under the skin. Both factors can lead to problems with yeast skin infections.

Climate

Skin can get—and stay—excessively moist in hot, humid environments, giving yeast ample opportunity to multiply and invade.

Clothing

Tight clothing can rub against the skin, causing friction and a skin rash that allows yeast to invade. Undergarments, such as bras made of non-breathable or non-wicking fabric, can hold moisture next to the skin.

Bras that don’t lift and support allow for little cooling and drying ventilation under the breasts and can cause skin to rub against skin—yet more factors that can lead to intertrigo and a yeast infection. 

Treatment

Because yeast is a fungus, yeast infections are treated with anti-fungal creams, ointments, and sprays.

Some anti-fungals are available over the counter (OTC), but in severe cases, your doctor may give you a prescription drug. Some of the medications used to treat skin yeast infections include:

• Clotrimazole
• Econazole
• Ketoconazole
• Miconazole
• Tioconazole
• Terbinafine
• Amorolfine

If your rash is itchy, your doctor may prescribe a combination cream that contains an anti-fungal as well as a steroid to calm the itch. Most people see improvement in a week or so.

Prevention

When it comes to yeast infections, the best defense is a good offense:

• Keep skin under your breasts clean. Wash morning and night with a gentle soap.
• Dry under the breasts thoroughly after bathing. Use a hairdryer on a cool setting to help get what a towel misses.
• Talk to your doctor about using an over-the-counter anti-fungal or moisture-absorbing powder to fend off problems.
• Wear a supportive cotton bra. You can even try wearing a cotton T-shirt under your bra.
• Ventilate the skin when possible (that could mean going bra- and shirtless when in private).
• Wear loose-fitting clothing.
• Change out of wet or sweaty clothes promptly.
• Lose weight if needed to help reduce the size of the breasts and limit skin friction.
• Limit your intake of sugary foods and get your blood sugar under control if you have diabetes.

A Word From Verywell

Yeast is a naturally occurring fungus that can occasionally overgrow and cause skin infections—under the breasts and elsewhere on the body. These infections are typically easily treated with anti-fungals and are usually nothing to worry about.

Consult with your healthcare provider whenever you notice a rash so it can be properly diagnosed and treated. It’s particularly important to get your doctor’s input if the rash seems infected (it’s warm to the touch, for example, or it’s wet and oozing).

Is It a Vaginal Yeast Infection or Something Else?

Every year, millions of cases of vaginitis (vaginal inflammation) affect women of all ages, but they are especially susceptible during the reproductive years.1 Fluctuating hormonal levels, bacteria, and sexual activities are just a few of the most common reasons women experience vaginal infections and discomfort. Knowing your body well and understanding your symptoms, causes, risk factors and treatment options will help you decide upon a course of action that is right for you.

How to identify a vaginal yeast infection

Not all women will experience noticeable symptoms of a yeast infection. If the infection is mild, the symptoms may be subtle. Knowing what’s normal for you will help you identify changes in your vaginal health. If you are experiencing any of these symptoms for the first time, consult your healthcare professional for a diagnosis. Most women have one or more of these yeast infection symptoms:

• Burning, redness, and swelling of the vagina and vulva
• Pain when urinating or having sex
• Vulvar inflammation (redness, swelling, rash)
• Vaginal pain, soreness, or burning
• Vaginal discharge that may be thick, white, and lumpy like cottage cheese

The three most common forms of vaginitis are yeast infections, bacterial vaginosis (BV), and trichomoniasis. Symptoms for all three can include some form of vaginal discharge, itching, and irritation, so it is important to understand how they are different so you can get the right treatment. Use the following information as a guide to help identify a vaginal yeast infection:2-5

If you experience any of the following symptoms, ask a healthcare professional before using MONISTAT®, as they could be signs of another type of infection.

• Fever
• Chills
• Rash or hives
• Lower abdominal, back or shoulder pain
• Nausea or vomiting
• Foul-smelling or greenish/grayish vaginal discharge
• Missed periods
• Frequent urination, an urgent need to urinate or difficulty passing urine

Treating a Yeast Infection

If you know that it is a yeast infection from past experience and are familiar with the symptoms, you want an effective and convenient medicine – one that works at the site of the infection. Try MONISTAT®, the #1 OTC antifungal.

MONISTAT® comes in 3 doses: highest dose MONISTAT® 1, regular strength MONISTAT® 3, and low dose MONISTAT® 7. Regardless of which product you choose, you should begin to experience some symptom relief after 3 days, and complete relief in 7 days.

Highest Dose MONISTAT® 1 may be the perfect solution for busy women with active lifestyles. This powerful single-dose product is available in the Ovule® form for use day or night and will stay in place during daily activities, even during exercise.

Regular Strength MONISTAT® 3 is a great option for women who want a less concentrated treatment that provides consistent treatment and relief at moderate dosage levels.

Low Dose MONISTAT® 7 has smaller doses of the active ingredient evenly distributed throughout the week at bedtime. Only 7-day topical yeast infection treatments are recommended by the Centers for Disease Control and Prevention (CDC) for the treatment of yeast infections in pregnant and diabetic women (consult your healthcare professional).

Ringworm symptoms & treatments – Illnesses & conditions

Most tinea fungal infections, including ringworm, are easily treated by using antifungal creams, tablets or shampoo. You can also help to get rid of fungal infections and stop them from spreading by:

• washing areas of affected skin daily and drying thoroughly, paying particular attention to skin folds and between your toes
• in the case of a groin/foot infection, changing your underwear/socks daily, because fungi can persist in flakes of skin
• with a scalp infection, not sharing combs, hairbrushes or hats
• washing clothes, towels and bed linen frequently
• wearing loose-fitting clothes, preferably made of cotton or other natural materials

Read more about preventing ringworm.

Ringworm, groin infections and athlete’s foot

Most cases of ringworm, groin infections and athlete’s foot can be treated using an over-the-counter antifungal cream, gel or spray. There are lots of different types, so ask your pharmacist to help you choose the right one for you. You usually apply antifungal creams, gels and sprays daily to the affected areas of skin for two weeks. The cream, gel or spray should be applied over the rash and to one inch of skin beyond the edge of the rash. Read the manufacturer’s instructions first. You may be advised to use the treatment for a further two weeks, to reduce the risk of re-infection. See your GP if your symptoms have not improved after two weeks of treatment, because you may need to take antifungal tablets. Both terbinafine and griseofulvin tablets can be used to treat ringworm infections, as well as another antifungal medicine called itraconazole (see below).

Treat groin and feet together

Groin infections can sometimes occur at the same time as athlete’s foot. It’s vital to treat both infections at the same time to avoid being re-infected with either condition.

Fungal scalp infections

Scalp infections are usually treated using antifungal tablets, often alongside an antifungal shampoo. There are two main types of antifungal tablet:

The antifungal medicine that your GP prescribes will depend on the type of fungi causing the infection.

Terbinafine tablets

Most people with fungal scalp infections are prescribed terbinafine tablets to take once a day for four weeks. It’s an effective treatment for most cases. Side effects of terbinafine can include:

These side effects are usually mild and short-lived. Some people have also reported that terbinafine temporarily affected their sense of taste.

Terbinafine is not suitable for people with a history of liver disease or lupus (where the immune system attacks healthy tissue).

Griseofulvin

Griseofulvin is a type of antifungal medicine that prevents fungi from growing and multiplying. It’s available in the form of a spray and is usually taken daily for 8-10 weeks. Side effects of griseofulvin can include: 

However, these side effects should improve as your body gets used to the medicine. Griseofulvin can cause birth defects, so it shouldn’t be taken during pregnancy, or if you intend to become pregnant soon after stopping treatment. Men shouldn’t father a child within six months of stopping treatment. Griseofulvin is also not suitable for women who are breastfeeding, and those with severe liver disease or lupus. Griseofulvin can interfere with both the combined contraceptive pill and the progestogen-only pill, so women need to use an alternative barrier form of contraception, such as a condom, while taking it. Griseofulvin may also affect your ability to drive and can enhance the effects of alcohol.

Antifungal shampoo

Antifungal shampoo cannot cure scalp infections, but it can help to prevent the infection spreading and may speed up recovery. Antifungal shampoos, such as selenium sulphide and ketoconazole shampoo, are available from your pharmacist. Ideally, antifungal shampoo should be used twice a week during the first two weeks of treatment. There is no evidence that shaving a child’s head will reduce the risk of an infection or speed up recovery.

Itraconazole

Itraconazole is usually prescribed in the form of capsules for 7 or 15 days. It is not recommended for use in children, elderly people or those with severe liver disease. Side effects of itraconazole can include:

• nausea
• vomiting
• indigestion
• diarrhoea
• headache

Read about how to stop ringworm spreading or coming back.

Fungal nail infections

Fungal nail infections can be treated with antifungal nail paint, but it also often requires antifungal tablets. These tend to work better than nail paints, although they can cause side effects, such as headache, nausea and diarrhoea. Read more about treating fungal nail infections.

How to Treat a Yeast Diaper Rash

Chances are, you’ve changed a lot of diapers since baby arrived. But just when you think you’ve seen everything—impressive amounts of pee, all shades of poop and occasional pink rashes—you spot something that gives you pause and forces you take a closer look: a yeast diaper rash. But don’t worry, it’s not as bad as it sounds. Yeast diaper rash is quite common—and we’ll walk you through how to treat it and prevent it from surfacing again in the future.

What Is a Yeast Diaper Rash?

You might think of yeast diaper rash as a kind of extreme diaper rash. According to Danelle Fisher, MD, vice chair of pediatrics at Providence Saint John’s Health Center in Santa Monica, California, it’s usually caused by candida, a fungus that naturally lives on human skin, typically without incident. Candida loves wet, moist environments, so when given the right circumstances (such as a wet diaper), the fungus can grow out of control and infect the skin, causing problems. When this happens in the mouth or throat, it’s called thrush; when it occurs in the diaper area, it’s a yeast diaper rash.

What causes yeast diaper rash?

Yeast diaper rash is common because the factors that cause it are common: for instance, when baby is in a wet diaper for too long; or when they switch to solid foods (because this can change baby’s stools and exacerbate diaper rash). Yeast diaper rash is also more likely to happen when baby has a reaction to a new diaper or diaper wipes. Antibiotics—which decrease the growth of bacteria and increase the growth of fungus—can also promote yeast diaper rash.

Related Video

Diaper Rash Vs. Yeast Infection

The difference between regular diaper rash and a yeast diaper rash is the underlying cause. Your run-of-the-mill diaper rash is essentially a skin irritation, or what dermatologists call dermatitis. It occurs because baby’s skin is sensitive, and the wetness from urine and poop, plus friction from the diaper, can cause your little one’s skin to get inflamed and feel as if it’s burning.

A yeast diaper rash is caused by an infection with candida. In irritated skin, such as diaper rash, the skin barrier weakens, allowing candida to penetrate and grow beneath it. While both rashes can be painful, a yeast rash can also be intensely itchy, says Fisher.

What does yeast diaper rash look like?

Diaper rash involves a reddening of the skin. “But there are varying degrees,” Fisher says. With a regular diaper rash, you’ll see splotchy, pink or rosy areas of skin in baby’s diaper area. The condition is limited to the skin surface and the surface remains smooth.

But a yeast diaper rash looks much redder and angrier. It could also come with red spots, says Gina Posner, MD, a pediatrician at MemorialCare Orange Coast Medical Center in Fountain Valley, California. Fisher also adds that it could be a rash with unusual borders. “The edges might have tiny red dots, called satellite lesions,” she says. You might also see peeling at the edges. Yeast diaper rash tends to erupt in baby’s folds of skin, like in the upper legs, genitals and bum.

Yeast Diaper Rash Treatment

You may be well stocked with creams and ointments to fight a run-of-the-mill diaper rash, but the proper yeast diaper rash treatment calls for something more. Because you need to knock out the fungus growth, regular diaper rash creams won’t clear a yeast diaper rash. If baby’s rash looks especially intense and/or your typical diaper rash creams aren’t working, call your pediatrician. They’ll want you to bring baby in so they can assess the skin and confirm the condition.

If the pediatrician finds that baby has yeast diaper rash, they’ll likely recommend an antifungal cream, such as nystatin or clotrimazole, Posner says. Nystatin is available by prescription only, and clotrimazole is available both over-the-counter and by prescription.

To help these treatments along, keep the skin as dry as possible, which means more frequent diaper changes and as much time without a diaper as possible, Fisher says. Look for super-absorbent disposable diapers, and don’t secure them too tightly.

Yeast diaper rash can take up to two weeks to resolve, “but it usually resolves much faster than that,” Posner says.

How to Prevent Yeast Diaper Rash

The best way to prevent yeast diaper rash is by keeping baby’s skin healthy and dry. Here’s what to keep in mind:

• Reduce skin contact with pee and poop. Ideally, change baby’s diaper as soon as it gets soiled. That could be about as frequently as every two hours. Opt for diapers that have super-absorbent gelling material, which helps wick away moisture, and protect skin with a petrolatum product (such as Aquafor), which acts as a barrier between the skin and any urine or fecal matter.

• Let the skin breathe. Do this by making sure diapers fit properly and aren’t attached too tightly. Using breathable disposable diapers will help. (We list some of them in this guide. So can letting baby go diaper-free during the day whenever you can.

• Treat regular diaper rash as soon as possible. “If redness occurs, treat it early with a diaper cream with zinc oxide in it,” Fisher says. (Need some product suggestions? These are our favorite creams with zinc oxide.)

Danelle Fisher, MD, is an LA-based pediatrician and the vice chair of pediatrics at Providence Saint John’s Health Center in Santa Monica, California. She received her medical degree from Albert Einstein College of Medicine of Yeshiva University.

Gina Posner, MD, is a pediatrician at MemorialCare Orange Coast Medical Center in Fountain Valley, California. She earned her medical degree from New York Medical College and for over 10 years has volunteered with various organizations in the US and Dominican Republic mentoring and educating children and parents on different health topics.

Please note: The Bump and the materials and information it contains are not intended to, and do not constitute, medical or other health advice or diagnosis and should not be used as such. You should always consult with a qualified physician or health professional about your specific circumstances.

Plus, more from The Bump:

How to Treat and Prevent Diaper Rash

13 Diaper Rash Creams That Work Wonders

Your Ultimate Guide to Baby Rashes

Pediatric Fungal Infections

US Pharm. 2014;39(5):8-11.

Parents of infants and young children are justifiably
concerned about any medical condition they notice in their child. Some
of these conditions, such as common fungal infections, are minor and may
be self-treated, while others should be referred to a physician.
Pharmacists should be prepared to provide appropriate counseling to
parents in these situations.

Tinea Corporis

Tinea corporis is also known as tinea circinata or “ringworm” of the body.¹ It is one of a group of fungal infections, closely related to tinea pedis (athlete’s foot) and tinea cruris (jock itch).² The dermatophytic fungi responsible for these infections include Epidermophyton floccosum and Microsporum canis.
These and the other fungal pathogens all proliferate in conditions of
high temperature and high humidity, making them more common in regions
of the globe with warmer climates, such as tropical and subtropical
areas.²

Whereas tinea pedis and tinea cruris are more common in
postpubertal patients, tinea corporis is more common in those who are
prepubertal. Person-to-person contact can spread the infection.³
Common sites for contracting ringworm include day care centers and any
location where children gather to engage in activities involving skin
contact, such as summer camps. Contact with contaminated fomites is also
responsible for transmission.³

Tinea corporis is also caused by a set of pathogens that
are common on animal skin; thus, another way it is contracted is through
petting and playing with a dog or cat. Kittens and puppies are
especially likely to pass the infection.⁴ Other animal vectors identified by the CDC are cows, goats, pigs, and horses.

Given these modes of dissemination, the epidemiologic
preference for children is logical. Younger children are more likely to
engage in activities that transfer fungi, such as play involving
skin-to-skin contact and petting strange kittens or puppies that roam
their neighborhood.

Other factors also increase risk of infection. Patients
who already have tinea pedis or tinea cruris are more likely to develop
tinea corporis, as the fungi spread to any area where conditions are
favorable for growth. Wearing tight clothing and having excess body
weight are also contributory.²

The locations involved with tinea corporis are the face, trunk, and extremities.²
The condition excludes the feet, scalp, groin, and hands, as tinea
infections in these locations are given other designations (e.g., tinea
pedis, capitis, cruris, and manuum). The fungi penetrate the skin at an
initial entry point and begin to live on the upper layer of dead skin
scales (stratum corneum).⁵ Patients may initially notice a
flat, scaly area. The fungi grow outward in a roughly circular manner
from the initially infected area. The leading edge of growth is
inflamed, reddened, and raised slightly above the surrounding skin. As
the growth line expands outward, the skin in the central portion of the
lesion may begin to appear more normal.² The result is often a
ring of red, inflamed skin sharply differentiated from the uninfected
skin, often with a more healthy-looking center. This characteristic
presentation reflects the old notion that there is a worm beneath the
skin, circling in on itself.⁶ What appears as a worm is in reality the active growth margin. Infected patients often complain that the rash is pruritic.

Treatment: Several non-prescription products
can be recommended for treatment of tinea corporis. Patients should be
advised to apply these to external skin as directed after cleaning the
area with a mild soap; to keep them away from the eyes; and to supervise
children who require them. First-generation antifungals are applied
twice daily for 4 weeks to effect a cure of tinea corporis, and they
should not be used in anyone aged <2 years. Ingredients in this class
include undecylenic acid (e.g., Fungi Cure Liquid), tolnaftate (e.g.,
Tinactin), miconazole (e.g., Micatin Cream), and clotrimazole (e.g.,
Lotrimin AF).²

Second-generation antifungals are characterized by shorter
times to cure for tinea corporis and also by more restrictive age
cutoffs. Terbinafine (e.g., Lamisil AT) cures tinea cruris if used once
daily for 1 week. Butenafine (e.g., Lotrimin Ultra Cream) cures tinea
corporis if used once daily for 2 weeks. They should not be used for
tinea corporis in those aged <12 years.²

Pharmacists should avoid products that claim to be safe
and effective for tinea corporis but are lacking in evidence. One is
Blue Star Ointment, which contains a mix of ingredients (i.e., salicylic
acid, methyl salicylate, menthol, camphor, benzoic acid, lanolin, aloe
vera), none of which is FDA-approved as safe and effective for curing
tinea corporis.⁷

Oropharyngeal Candidiasis (Thrush)

Oral candidiasis, often called thrush, is a common pediatric fungal infection with an attack

rate of 5% to 7% in infants aged >1 month.⁸ It is
not common in healthy adults, although risk factors include HIV/AIDS,
chemotherapy, diabetes, dentures, and therapy with inhaled
corticosteroids or broad-spectrum antibiotics.^8,9

Candida is a normal resident of the mucous membranes.¹⁰
Any condition that would cause the intraoral microbiologic environment
to become imbalanced may lead to candidal overgrowth. An inciting factor
in pediatric patients is administration of broad-spectrum antibiotics.
Antibiotic-induced death of intraoral bacterial species allows the
opportunistic Candida to overgrow.¹¹

Manifestations of oropharyngeal candidiasis include creamy
or velvety white, slightly elevated patches or plaques on the oral
mucosa (e.g., inner cheek, gingiva, palate, tonsils) and tongue. They
may look like cottage cheese and adhere to the area to which they are
attached; scraping them away may reveal a bleeding raw area of tissue.¹¹
The lesions are often painful, and if left untreated, infected areas
increase in number and size. The child may have difficulty swallowing,
and there may be cracking at the corners of the mouth.¹²

Diagnosis and Treatment: Oropharyngeal
candidiasis should be diagnosed by the physician through direct visual
examination of the affected areas, microscopic examination of a
collected sample, or culture.¹³ If oral candidiasis is
confirmed, the physician may choose to wait, as thrush in infants often
resolves on its own within 2 weeks.¹¹ However, if the time of involvement exceeds 2 weeks, treatment is essential to prevent serious sequelae.¹⁴ Physicians may prescribe nystatin suspension for any age or clotrimazole troches in children old enough to use them properly.¹⁴

Since pharmacists are prohibited by their state practice acts from diagnosing medical conditions,¹⁵
it is most appropriate to refer patients with suspected thrush to a
physician for a firm diagnosis and prescription when needed. When a thrush infection is confirmed in infants, pharmacists can recommend that parents sterilize or discard all pacifiers.¹¹ Furthermore, if the baby is bottle-fed, parents should be advised to discard all nipples and purchase new ones.

Diaper Rash

Diaper rash is an irritant derma-titis that affects infants, most commonly those aged between 4 and 15 months.¹⁶
Loose stools are the primary cause of diaper rash, and babies who are
breastfed experience more frequent bowel movements and softer stools
than those fed cow’s milk, which may increase the risk of diaper rash.¹⁷ On the other hand, many parents notice diaper rash more frequently when their baby begins to ingest solid food.¹⁶

Several factors coalesce to damage infant skin and cause
diaper dermatitis. First is that the diaper is an occlusive dressing,
allowing the skin beneath to break down more readily in certain
circumstances.² Also, when urine is in sustained contact with
skin, it allows ammonia within the urine to raise the skin pH. If stool
is also present in the diaper, the higher pH reactivates
skin-destructive enzymes in the fecal material.

The simplest and safest method to treat diaper rash is
liberal application of petrolatum. Powders have a potential risk of
causing deadly inhalation pneumonia in babies if a cloud of powder
surrounds the baby’s nose and mouth.² A general rule is to
refer the baby to a pediatrician if the skin is broken, and especially
if the child has acnelike lesions, blebs, ulcerations, large bumps, or
pustules.¹⁶ Parents should also seek professional care if the
rash worsens or does not improve in 2 to 3 days, if it spreads to the
abdomen, back, arms, or face, or if the baby develops a fever.¹⁶

Fungal Infection: Diaper rash may become infected with Candida.¹⁶Candida,
like superficial tineas, prefers warm, moist locations on the body. The
area beneath a diaper has all of the elements preferred by Candida—warmth from body heat and moisture from urine. While uncomplicated diaper rash is erythematous and inflamed, when Candida
invades the skin, the color changes to a beefy or bright red, and the
child cries violently after urinating, as urine causes a great deal of
discomfort. Parents may also notice smaller red lesions (referred to as satellite lesions) that eventually grow to merge with the larger central lesions.

No antifungal nonprescription product is known to be safe and effective for unsupervised use in diaper dermatitis infected with Candida.²
First- and second-generation topical antifungals are only indicated for
superficial tineas. Vaginal antifungals are only indicated for Candida in the vagina.

If the pharmacist suspects the presence of diaper dermatitis infected with Candida,
a referral for a physician diagnosis is mandatory. The physician can
then prescribe a specific antifungal to cure the condition.

PATIENT INFORMATION

What Is Ringworm?

Ringworm (tinea corporis) is a fungal skin infection that
can affect just about anyone of any age, although it is more common in
children.

What Are Some of the Common Causes?

To get ringworm, you must first come into contact with the
fungi that cause it. You may contract the infection by touching a
person, animal, or object with the organism on it. Pets, shower and pool
surfaces, and combs are all common sites that carry these fungi. The
fungi that cause ringworm are able to thrive on warm, wet parts of the
skin. This includes areas prone to sweating (under the arms or beneath
the breasts) and areas not bathed often. Fungi that have reached the
skin can penetrate damaged skin to begin an actual infection. Once they
have become inoculated into the broken skin areas, they spread quickly.

What Are the Symptoms?

The original infection looks like red spots, but as it
progresses it resembles its namesake and begins to look like a red
circle, or “ring,” with a less inflamed center. The only other major
symptom commonly observed is itching.

How Do I Know If It Is Ringworm?

A healthcare provider usually can tell you whether it is
ringworm by a simple observation of the skin. Occasionally a skin
scraping, which is sent to a laboratory, may be done, but this is
uncommon.

How Do I Treat It?

Try to keep the skin dry, as the fungi enjoy moist
environments, and consult your pharmacist for an antifungal product.
Generally, OTC creams will take care of the infection (e.g., Lamisil,
Lotrimin, Micatin, Tinactin), but sometimes oral medication is
necessary. Follow all the directions on any product before, during, and
after use. If treatment is successful, most infections are eradicated
within 4 weeks.

How Do I Stop It From Spreading to Others?

Because showers and pool areas are so likely to harbor the
fungi, many infections are contracted in these areas. Wearing foot
coverings in community showers or pools will help prevent transmission.
Wash your towels with soap, dry them well, and use a new towel each time
to ensure that towels are not consistently wet.

If you have fungal infections in other areas, such as
athlete’s foot, make sure not to dry the body with towels that have
already touched the feet. If your child has ringworm, he or she can
return to school after you have begun treatment. Pets should be treated
if they are also infected. Steer clear of stray animals to help avoid
transmission.

When Should I Contact My Healthcare Provider?

Ringworm does not usually go away on its own. If you have
any questions upon presentation with these symptoms or during treatment,
or you do not believe self-treatment is working, you should contact
your healthcare provider.

Remember, if you have questions, Consult Your Pharmacist.

REFERENCES

1. Definition of dermatophytes (ringworm). CDC.
www.cdc.gov/fungal/diseases/dermatophytes/definition.html. Accessed
March 28, 2014.

2. Pray WS. Nonprescription Product Therapeutics. 2nd ed. Baltimore, MD: Lippincott Williams & Wilkins; 2006.

3. Ringworm. MedlinePlus. www.nlm.nih.gov/medlineplus/ency/article/001439.htm. Accessed March 28, 2014.

4. Ringworm and animals. CDC. www.cdc.gov/healthypets/diseases/ringworm.htm. Accessed March 28, 2014. 

5. Tinea corporis. MedlinePlus. www.nlm.nih.gov/medlineplus/ency/article/000877.htm. Accessed March 28, 2014.

6. Tinea infections. MedlinePlus. www.nlm.nih.gov/medlineplus/tineainfections.html. Accessed March 28, 2014.

7. Blue Star Ointment. CVS/pharmacy. www.cvs.com/shop/product-detail/Blue-Star-Ointment?skuId=630681. Accessed March 28, 2014.

8. Oral candidiasis statistics. CDC. www.cdc.gov/fungal/diseases/candidiasis/thrush/statistics.html. Accessed March 28, 2014.

9. Oropharyngeal/esophageal candidiasis (“thrush”). CDC.
www.cdc.gov/fungal/diseases/Candidiasis/thrush/. Accessed March 28,
2014.

10. Definition of oral candidiasis. CDC.
www.cdc.gov/fungal/diseases/candidiasis/thrush/definition.html. Accessed
March 28, 2014.

11. Thrush. MedlinePlus. www.nlm.nih.gov/medlineplus/ency/article/000626.htm. Accessed March 28, 2014.

12. Symptoms of oral candidiasis. CDC. www.cdc.gov/fungal/diseases/candidiasis/thrush/symptoms.html. Accessed March 28, 2014.

13. Diagnosis and testing of oral candidiasis. CDC.
www.cdc.gov/fungal/diseases/candidiasis/thrush/diagnosis.html. Accessed
March 28, 2014.

14. Treatment & outcomes of oral candidiasis. CDC.
www.cdc.gov/fungal/diseases/candidiasis/thrush/treatment.html. Accessed
March 28, 2014.

15. Talking to the pharmacist. KidsHealth. http://kidshealth.org/parent/general/body/pharmacist.html. Accessed April 14, 2014.

16. Diaper rash. MedlinePlus. www.nlm.nih.gov/medlineplus/ency/article/000964.htm. Accessed March 28, 2014.

17. Weaver LT, Ewing G, Taylor LC. The bowel habits of milk-fed infants. J Pediatr Gastroenterol Nutr. 1988;7:568-571.

18. Newman J. Using gentian violet. Pregnancy &
childbirth. About.com.
http://pregnancy.about.com/cs/breastfeedinginfo/a/aanho6.htm. Accessed
April 14, 2014.

To comment on this article, contact [email protected].

How to tell the difference between diaper rash and a yeast infection

Dr. Linda, my newborn has had a diaper rash for 5 days now and nothing is helping. What am I doing wrong? Could it be a yeast infection?

You are not doing anything wrong! It may be that your baby has a yeast infection called Candida dermatitis. Candida is a yeast which lives on some babies’ skin especially if their moms had a yeast infection during delivery or if they received antibiotics.

Lets start by talking about diaper rashes.

Irritant diaper rash, which is little red bumps, happens from the friction between the moist surface of your baby’s skin and the diaper which is why the rash doesn’t appear in areas where there is no friction such as the thigh folds.    

It starts out as a dry red rash and gets redder, wetter and more irritated as the rash gets worse.

Who gets diaper rash?

Babies who don’t get their diapers changed frequently enough, babies with diarrhea and babies exposed to antibiotics. Bottle fed babies also tend to get more diaper rashes. Since irritant diaper rashes make it easier for babies to get a yeast infection of the skin you want to do everything you can to prevent them.

How to prevent diaper rash:

Breastfeeding is a great way to prevent diaper rashes, but, however you feed your baby, keeping your baby’s diaper area as clean and dry as possible is the foundation of preventing diaper rashes of any sort. The moister your baby’s skin stays the more likely she is to develop a diaper rash.

Yeast Infection

A yeast infection rash (Candida dermatitis) is the result of irritated skin getting invaded by Candida, a yeast living on the skin of some normal newborns especially if their mothers had a vaginal yeast infection or were treated with antibiotics.

Yeast infection rash is an irritated, red rash which can look dry or moist.

Babies with both irritant diaper rash and with a yeast infection tend to be fussy and may cry when they have a bowel movement, pass urine and when you change their diapers so it can be challenging to tell the difference when the yeast infection is mild.

Here’s what you need to know about diaper yeast infection:

The yeast infection rash will get worse even with good care. You’re keeping the diaper area dry and clean, you’re giving your baby diaper free times and you’re not using chemicals on your baby’s skin and the rash is still getting worse.

The rash and redness of the yeast infection will spread into the skin folds where an irritant rash won’t.

The diaper area affected by the yeast infection may have white cheesy material on it especially in the thigh folds.

A yeast infection rash will last longer than three days even when you do everything you can to make it better.

When to see the doctor

If your newborn has any of the above,  if the rash spreads outside the diaper area, or it oozes or bleeds you need to see your doctor as soon as possible. If your newborn baby has a temperature of above 100.4 F( 38C), develops blisters or pimples, or is acting sick please see your doctor immediately.

Make sure your doctor looks inside your baby’s mouth and at your nipples if you’re breastfeeding. Yeast infection can also affect your baby’s mouth in the form of thrush which looks like thick white patches on the inner surfaces of your baby’s cheeks that you can’t remove easily. The yeast infection can also be on your nipples if you’re breastfeeding making them red and irritated and possibly painful. If your baby has thrush or you have a yeast infection of your nipples it’s important that these get treated at the same time or else the yeast infection in the diaper area will not go away or will keep coming back.

How to treat a diaper yeast infection

Keep the area as clean and dry as possible. Gently wipe the area clean with each diaper change. Use water with soft paper towels or soft washcloths washed in dye-free, fragrance-free detergent. If you want to use commercial diaper wipes choose fragrance and alcohol-free wipes, the fewer chemicals you use on your baby’s skin the better. Avoid wipes that contain alcohol or chemicals like methylisothiazolinone because they can increase skin irritation.

If you need to use soap, use fragrance-free and dye- free soaps. Be aware that even natural substances like essential oils can cause irritation to newborn babies’ skin.

Next, let the area air dry or pat it dry. Rubbing the rash will irritate it more. If you can, give your baby diaper free times during the day. You can put a nice barrier underneath her ( in case of accidents) and use the time to bond with her. Make eye contact, talk to her or sing to her.

Diaper yeast infections are usually treated with antifungal ointments, Nystatin or Gentian violet. Your doctor will prescribe one of these or, if it’s available over-the-counter, tell you the best one to use. Follow your doctor’s directions and you should notice an improvement in the yeast infection within a day to a day and a half.

Talk to your doctor about using probiotics to help prevent further yeast infection in your baby.

There are many home remedies that are used for diaper rashes but there are no studies on their use or safety in newborns.

Once the yeast infection is gone, if you want to use diaper creams to prevent irritant diaper rashes, choose pastes or ointments rather than creams or lotions. Pastes and ointments are thicker so they offer more protection and they contain fewer chemicals than  creams and lotions. Good barrier substances are Zinc oxide, Vaseline, Desitin, triple paste, A&D or Balmex.

As always I would love to hear from you. What is your favorite home remedy for diaper rashes?

Have a Happy, healthy day,

Related

Fungal infections – Online Dermatology

Fungal infections usually caused by Candida albicans which is a yeast that many people normally carry without having any discomfort. However, if the immune system deteriorates, or if the normal bacterial flora is disturbed, the fungus can proliferate and cause problems. The risk of fungal infections is higher in infants, pregnant women and the elderly.

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Symptoms

In moist folds of skin in small children, yeast fungi (candida) can begin to grow and turn into a red, oozing rash. The infection thrives between the buttocks, underneath the diaper. Candida infection in the mouth called the cod in small children. The rash is glaring red, often with little “dents” on the edges. It can easily develop if the child recently has been treated with antibiotics.

Even adults can get the infection in the mouth. For example, you can get fungal infection if you do not wash your mouth after using cortisone spray or if you have dentures. For women, it is common of the vagina. Most people will at some time in life experience such an infection.

For adults, the infection gives a red rash under breasts, buttocks, groin and skin folds. In the mouth, can result in white coatings and spots on the tongue and insides of cheeks, appears as red irritated and possibly simultaneously burning mucosa on removable dentures, or cracks and irritation in the corners of the mouth.

Candida can cause discomfort on the skin, mouth, and vagina. For specific information:

Try our FREE dermatology search engine and get peace of mind within a second

What can I do?

It is difficult to protect against fungi because yeast is naturally on the skin. You can prevent infection by keeping skin folds, for example, the neck, groin, under the breasts and arms clean and dry.

Should I seek medical care?

An infection is easy to confuse with an eczema or a rash – have a doctor look at the symptoms if they do not subside. Sometimes you need to take scraping samples from the baby’s skin to check for microscopic fungal threads.
Contact your healthcare provider if the affected area remains the same after treatment, if you suspect that you have an infection in your mouth or if you have impaired immune function and signs of a fungal infection.

Treatment

The best way to prevent and fight the infections in infants is to air the skin’s many folds that are collecting dampness. If there is no improvement, the damaged skin may need treatment with a cream or ointment containing fungicide. Older children may experience a different kind of fungus, ringworm, on any part of the body. It is a rash caused by the so-called filamentous fungi that provide ring-shaped, erythematous patches on the skin. Ringworm, and also fungus on the scalp, need to be treated with prescription drugs. (Note that the circular / ring-shaped rash may also be signs of tick infection – Lyme disease – which needs to be treated).

Is this what you have? Try our FREE Skin Image Search today and get peace of mind 

Source:

Centers for Disease Control and Prevention. Fungal Diseases. Available at: https://www.cdc.gov/fungal/.

U.S. National Library of Medicine. Fungal Infections. Available at: https://medlineplus.gov/fungalinfections.html

American Osteopathic College of Dermatology. Fungus Infections: Preventing Recurrence. http://www.aocd.org/?page=FungusInfectionsP

90,000 Feline Atopic Dermatitis – Exvet Veterinary Clinic

The author is a dermatologist at the Exvet veterinary clinic Valery Yurievich Skorokhod.

Atopic dermatitis (atopy) is a type 1 hypersensitivity reaction that causes itching and skin lesions in cats, associated with the presence of specific IgE (immunoglobulins) to allergens from the environment. This type of allergy is the second most common after flea bite allergy.

Symptoms of atopic dermatitis

The main symptom of an allergic cat is itching (including excessive grooming). Sometimes itching can be seasonal, but it can be a year-round manifestation of allergies. It is believed that in 75% of cases the most characteristic age of onset is up to 3 years, but in 22% of cases, atopic dermatitis began after 7 years.

It can be difficult for owners to assess the presence and severity of itching. cats can show symptoms only in private or at night, especially if the cat does not make the characteristic “scratching” with its paws, but only licks itself.Of course, cats are very clean animals, but when their grooming becomes excessive, the first symptoms appear: extensive self-induced alopecia.

It can also be accompanied by miliary dermatitis (small crusts in the “collar” zone or along the spine) and a complex of eosinophilic granulomas (which includes lesions such as indolent ulcer, chin granuloma, eosinophilic plaque, linear granuloma, granuloma in the oral cavity). These allergy manifestations are common in cats and are not seen in humans or dogs.

Despite such a variety of symptoms, these are all common manifestations of allergies. In addition, itching in the head / neck area is often common, but may occur elsewhere. Also, these lesions are often complicated by a secondary bacterial / yeast infection, which further increases itching and complicates the course of the underlying disease.

The complexity of diagnosis is that in cats any type of allergy (flea bite, food or atopic dermatitis) can have the same clinical picture.Therefore, the list of differential (possible) diagnoses is quite large.

Differential diagnoses for suspected atopic dermatitis in cats

• Primary – hypersensitivity to flea saliva, food allergy, allergy to insect bites, demodicosis, dermatophytosis, otodectosis, cheiletiellosis, psychogenic alopecia, pemphigus foliaceus.

• Secondary – otitis externa, otitis media, pyoderma (superficial or deep), malassezia dermatitis.

Atopy is a clinical diagnosis that is confirmed after exclusion of all other causes of itching.

Unfortunately, there is no specific test that 100% guarantees the reliability of the result.

For the correct diagnosis of atopic dermatitis, it is necessary to carry out a specific procedure

• Ensure intensive antiparasitic treatment of all animals living in the same room (+/- carry out antiparasitic treatment of the room) within 8 weeks;
• check and eliminate secondary bacterial / fungal infections;
• conduct an elimination diet for 8-12 weeks;
• Analyze the influence of possible stress factors and improve the conditions of keeping the cat;
• only after that, with the persistence of symptoms, can we talk about confirmation of atopic dermatitis.

Atopy is treated for life

We cannot eliminate allergens from the environment, but we can manage the disease by preventing skin inflammation and itching, and infection multiplication.

The most common treatment is the use of glucocorticosteroids (hormones). Because cats have fewer sensory receptors, they are much less likely to have side effects (compared to dogs).However, with long-term treatment, there is a risk of developing diabetes, heart failure, urinary tract infections, etc. In the absence of other treatment options, it is necessary to try to select the minimum effective dose, use additional drugs that can help reduce the dose of hormones and regularly (every 4-6 months) take a blood test for fructosamine (+/- glucose) levels, do an ultrasound of the urinary system and check the level of liver enzymes.

Non-hormonal drugs include cyclosporine (Atopica).Unfortunately, it is not certified in Ukraine. However, it is possible to use a medical analogue. It is safer compared to hormones with long-term use, but it is more expensive and does not act as quickly.

Recently, foreign studies with oclacitinib (Apoquel) appear. It is a non-hormonal canine drug that has not been shown to be very effective against pruritus in canine doses in cats. Research is underway on its “off lable” use at higher doses, and the results of these studies are encouraging.However, existing publications cover a 1-month application period and there is as yet no data on its safety for long-term use in cats.

The use of preparations containing polyunsaturated essential fatty acids can improve the condition of the skin and coat and, under certain conditions, even reduce itching.

With regard to the use of antihistamines, despite their availability and safety, they have very low efficacy and their use is questionable.

To control secondary infections, local and, less often, systemic antibiotic treatment +/- antifungal drugs are used. The need for their use is assessed by the doctor at the appointment based on the symptoms and the results of additional diagnostics (skin cytology, cultures).

Regular antiparasitic treatments are also important.

Antigen-stimulating immune therapy (ASIT) is the only treatment option that can change the “mechanism” of allergy.It is performed after an intradermal allergy test or a serological blood test for immunoglobulins. Then a vaccine is made from these allergens, which must be applied over several months (usually 10-12 months). The effectiveness of this method in cats according to various literature data is from 50 to 80%. In cats that respond well to vaccination, the effect may persist for up to several years, but then the vaccine must be re-administered. Today it is an expensive and inaccessible method of treatment in Ukraine.

Please note: only a specialized specialist can diagnose atopic dermatitis and prescribe treatment. Self-medication using information from the Internet is dangerous!

Clinics Chaika – Chaika.com

Vulvovaginal candidiasis (yeast vaginitis, thrush) is the most common cause of inflammatory diseases of the vulva and vagina. Acute and recurrent course of the disease are distinguished. Most often, candidiasis occurs in women with a regular menstrual cycle, much less often in postmenopausal women who do not use estrogen-containing hormone therapy, and in girls before the onset of menstruation.Vulvovaginal candidiasis is caused by the fungus Candida, which usually lives in the gastrointestinal tract, sometimes in the vagina. By itself, the presence of candida does not cause any symptoms, but when the normal flora of the gastrointestinal tract and vagina changes (due to medication or disorders in the immune system), the amount of candida can increase and lead to illness.

The most common symptoms of vulvovaginal candidiasis include:

• itching and irritation of the vulva and vagina;
• pain, irritation when urinating;
• pain during intercourse;
• redness and swelling of the vulva and vagina;
• in some women, the nature of the discharge from the genital tract does not change, some note abundant cheesy or watery discharge.

The symptoms of vulvovaginal candidiasis are similar to those of other diseases such as bacterial vaginosis, trichomoniasis, dermatitis. Therefore, it is often difficult to find out whether the existing symptoms are associated with a fungal infection.

Risk factors for the development of vulvovaginal candidiasis include:

• Antibiotics. Most antibiotics target a wide variety of bacteria, including bacteria that make up the normal vaginal flora, which protects against fungal infections.
• Hormonal contraceptives (birth control pills, patch, vaginal ring). The risk of developing a yeast infection is higher in women who use contraceptives that contain estrogen.
• Other types of contraception. A vaginal sponge, a diaphragm, or an intrauterine device can increase the risk of developing a yeast infection. Spermicides usually do not increase the risk of infection.
• Weakened immunity. Fungal infections are more common in people with weakened immune systems due to HIV or certain medications (steroids, chemotherapy, immunosuppressive therapy).
• Pregnancy. During pregnancy, vaginal discharge always becomes more abundant, but does not necessarily accompany a yeast infection.
• Diabetes mellitus. Women with diabetes are at higher risk, especially if their blood sugar levels are often above normal.
• Sexual activity. Vaginal yeast infections are not sexually transmitted infections. They can occur in women who are not sexually active, but are more common in women who are sexually active.

Infection and allergies: interrelationships and interactions | Tsarev S.V.

The article is devoted to the relationship and interaction of infection and allergy

For citation. Tsarev S.V. Infection and allergy: relationship and interaction // BC. 2016.No 12.P. 800–803.

The last few decades have seen a widespread increase in viral infections, their more severe clinical course, with resistance and torpidity to the therapy. The steady growth of allergic pathology is also generally recognized.Accordingly, in clinical practice, we can often see a combination of infection and allergy in one patient. However, this is not a simple addition of two pathologies, but a more complex process of interaction and mutual influence. First, the infectious agents themselves can act as a causal allergen. Secondly, the infection can form an allergic disease in a person predisposed to this. An example is the formation of bronchial asthma after a respiratory viral infection suffered in early childhood.Thirdly, the infection acts as a trigger for the exacerbation of an allergic disease and causes the progression of the disease. An illustrative example is a viral infection in patients with allergic rhinitis and bronchial asthma (BA). There was a correlation between the seasonal rise in the incidence of acute respiratory viral infections (ARVI) and the frequency of hospitalizations due to exacerbation of asthma. This is most clearly manifested in children. In addition, a link was found between lethal exacerbations of asthma and respiratory viral infection.
The opposite effect is also possible – the influence of allergies on the infectious process. Firstly, against the background of allergies, conditions are created for the addition of a secondary infection or the occurrence of an infectious disease. Allergic inflammation, especially long-lasting, including sluggish, gives rise to a tendency to infection and persistence of an infectious agent. For example, hay fever, in the absence of therapy or inadequate treatment of allergic rhinitis / rhinosinusitis, can ultimately lead to purulent sinusitis.Secondly, allergy affects the clinical picture of an infectious disease and can modify its course.
Infectious allergy
Allergies can be caused by a variety of infectious agents: viruses, bacteria, micromycetes (molds and yeasts). In some cases, infection may be the only sensitization factor, being a causal allergen and a source of allergic disease. In other cases, with polysensitization, infectious allergens may be one of many etiological factors.For example, with seasonal allergic rhinitis, sensitization to pollen allergens can be combined with allergies to molds (Alternaria, Cladosporium), the spores of which appear in the air in early spring.
In patients with atopic dermatitis, pathogenic and opportunistic flora is one of the constantly present links of pathogenesis. Staphylococcus aureus, Malassezia furfur (Pityrosporum ovale, P. orbiculare), Trichophyton, Candida are of major importance. Such an infection not only and not so much causes “secondary infection” as it itself acts as an important factor in maintaining allergic inflammation of the skin as a sensitizer and superantigen.The atopic response to staphylococci is due to the production of class E immunoglobulins (IgE) both to the protein components of their structure and to the produced toxins.
ARVI is of particular importance in changing the barrier permeability of the airways and, thereby, in facilitating the presentation of the allergen to dendritic cells. In this regard, the role of viral infection in the formation of respiratory sensitization may be one of the main ones. The coincidence of the respiratory infection transferred in early childhood and the onset of the development of sensitization to aeroallergens was noted.Allergy in such cases usually develops in 1-2 months. after suffering a respiratory viral infection. In patients with pre-existing allergies, the combination of a viral infection and contact with a causative allergen leads to an increase in the level of sensitization to this allergen. But a respiratory viral infection can itself act as an allergen in patients with asthma and other allergic diseases. In patients with atopy with ARVI, virus-specific IgE is found, an increase in the level of total IgE (it increases in atopics and remains normal in other patients), an increase in both the immediate and late phases of the allergic reaction.Moreover, the level of specific IgE correlates with the likelihood of recurrence of episodes of wheezing. A viral infection in patients with allergic diseases causes eosinophilic inflammation of the bronchial mucosa, which persists after clinical recovery. The ability to activate eosinophils, as well as to increase the level of leukotriene C4 in the nasal secretions of asthma patients, was found in rhinovirus and in respiratory syncytial infection.
Infection as a factor of formation

allergic disease
The most common and socially significant viral infections include influenza, ARVI, herpesvirus infection, etc.The formation of asthma in childhood is a multifactorial process that includes a genetic predisposition and the impact of environmental factors at critical moments in a child’s development. A postponed respiratory viral infection (respiratory syncytial infection, rhinoviruses and especially their combination), accompanied by wheezing, in children of the first 3 years of life, increases the risk of developing childhood asthma in subsequent years. It was noted that in children born to parents with allergies, for 1-2 months.before the onset of an allergic disease, an upper respiratory tract infection was detected. In cases when bronchial asthma debuts after a respiratory viral infection, the following additional predisposing factors can be distinguished: smoking in the mother, the presence of BA in the mother, an increased level of total IgE in the blood serum. The highest risk of developing childhood asthma is when atopy is combined with wheezing syndrome as a result of ARVI. Frequent and severe respiratory infections in childhood increase the risk of developing AD and chronic obstructive pulmonary disease (COPD) in adulthood [1-3].
The combination of smoking and childhood respiratory syncytial infection further increases the risk of developing AD. A study of 1246 children randomly selected at the time of birth, followed by an analysis of their health at 22, 26, 29, 34 years of age showed that smoking significantly increases (p = 0.003) the likelihood of developing AD in people with virologically confirmed respiratory syncytial infection transferred to during the first 3 years of life [4]. At the same time, data on the ability of the Epstein – Barr virus to trigger IgE synthesis and form AD are contradictory.
Various authors indicate that the violation of the barrier function of the mucous membrane of the respiratory tract and intestines due to viral infection creates conditions for the development of sensitization [5, 6].
According to the well-known pathophysiologist Professor V.I. Pytsky, “the role of viral and especially respiratory syncytial infection in early childhood seems to be reduced to“ selection ”and preparation for the development of bronchial asthma in those children who have genetically determined bronchial hyperreactivity … factor or contributing conditions for the implementation of its action, then the existing hyperreactivity will exist without the transition to bronchial asthma ”[7].
Infection as an exacerbation trigger

and pathogenetic factor of allergic disease
Patients with allergic diseases are more likely to suffer from respiratory viral infections. In conditions of infection, allergic diseases have clinical and immunological features, in general, the course is more severe. In some cases, a secondary infection can determine the outcome of an allergy. So, when Lyell’s syndrome occurs, a secondary infection plays an important role in the prognosis and possible death of this serious condition.Accordingly, anti-infective therapy improves the course and prognosis of an allergic disease, reducing the severity of the course, the frequency and severity of exacerbations.
Respiratory viruses are of particular importance in allergic pathology. ARVI is the most common cause of exacerbation of any form of bronchial asthma. In 9 cases out of 10, a respiratory viral infection provokes an exacerbation of asthma. The most significant are rhinovirus and respiratory syncytial virus.
The ARVI mechanism has a staged process:
– reproduction of the virus in the cells of the respiratory tract;
– viremia, leading to the development of toxic and toxic-allergic reactions;
– damage to the mucous membrane of the respiratory tract with the predominant localization of the process in any of its departments;
– possible bacterial complications from the respiratory tract and other body systems;
– reverse development of the pathological process.
Affecting the epithelium of the respiratory tract, viruses suppress its activity, the function of mucociliary clearance, the function of macrophages and T-lymphocytes. Influenza virus neuraminidase, by modifying the surface glycoproteins of cells, promotes bacterial adhesion and the development of secondary bacterial infection.
In BA patients, the role of viral infection is determined not only by the development of allergies and increased inflammation of the respiratory tract. It is very important to increase the level of airway reactivity.Bronchial hyperreactivity is an essential component of asthma. Against the background of a viral infection, an increase in bronchial reactivity occurs in all people. However, AD patients are initially hyperresponsive; therefore, the additional effect of the virus leads to an exacerbation of the disease. At the same time, virus-induced bronchial hyperreactivity persists in patients with atopic diseases for much longer than in healthy people. Under the influence of the virus, a violation of neuroregulatory mechanisms is noted:
– an increase in the activity of the parasympathetic nervous system due to a decrease in the expression of the functional activity of presynaptic M2 receptors, which leads to an increase in the secretion of acetylcholine with the development of bronchial obstruction and hyperreactivity;
– a decrease in the activity of neutral endopeptidase, which is responsible for the activation of tachykinins;
– decrease in NO production.
In the development of bronchial obstruction, structural and mechanical changes in the bronchial wall (its thickening), overlap of the lumen of small bronchi with mucus, and cellular detritus are also important.
In recent years, virus-induced AD has been commonly distinguished as a special phenotype of asthma. In a review of information on the mechanisms of exacerbation of virus-induced AD by experts from the European Respiratory Society, the most significant factors are shown:
– genetic features that determine the body’s susceptibility to severe viral infections;
– disturbances in the innate and adaptive immune response to viral infection [8].
A viral infection can theoretically cause both activation and suppression of the immune system. Damage to the columnar ciliated epithelium and impairment of mucociliary clearance facilitates the access of antigens to the submucous layer of the airways. Patients with asthma, as a rule, tolerate ARVI more severely than healthy people due to a decrease in the antiviral immune response. There is a relationship between the atopic phenotype of AD and a decrease in antiviral immunity. In atopics, the synthesis of interferons (IFN-α, -β, -λ) is impaired, which correlates with the severity of asthma symptoms, decreased lung function, and markers of inflammation.In response to exposure to the influenza virus, dendritic cells of patients with atopic AD decrease the production of IFN-α. The same occurs in peripheral blood mononuclear cells of patients with asthma infected with respiratory syncytial virus ex vivo: there is a decrease in IFN-α production compared to healthy controls [9]. Epithelial cells of asthma patients infected with rhinovirus 16 ex vivo also produce a reduced level of IFN-β compared to healthy individuals [10]. In patients with rhinovirus infection, asthma patients have a decreased level of IFN-λ secretion in the broncho-alveolar lavage and respiratory epithelial cells [11].Under the influence of rhinoviruses, there is also an increase in the expression of adhesion molecules and a change in the activity of ICAM-1 (type 1 cell adhesion molecules).
In addition, in atopic patients, the regulation of Toll-like receptors (TLR3, TLR7, TLR8, TLR9), which recognize the RNA of respiratory viruses and stimulate the production of interferons, is impaired. Suppression of phagocytic activity of alveolar macrophages with blockade of intracellular bactericidal processes is also noted. All this leads to the activation of the bacterial flora and the emergence of a mixed infection.
One of the consequences of a decrease in antiviral protection is the persistence of the virus in the respiratory tract. More than 40% of children 4–12 years old with BA after 8 weeks. after ARVI, rhinovirus RNA is retained in the body. In these children, asthma attacks are more severe [12].
Most viral diseases are the result of exposure to exogenous viruses. However, in some cases, the disease develops as a result of the reactivation of endogenous viruses hidden in specific cells of the body: this is how diseases caused by Herpes simplex and Herpes zoster, some types of cytomegalovirus, progressive multifocal leukocephalopathy (papovaviruses JC or VK) can develop.
Interesting data have been obtained on the interaction of H. zoster and AD. A population-based case-control study was conducted in the USA: 1113 people were studied, including 371 patients with shingles and 742 people in the control group. Among the patients with shingles, 23% had a history of bronchial asthma, while in the control group it was only 15%. Covariant analysis showed the presence of a reliable relationship between the two types of pathology: it turned out that herpetic infection is more common in BA patients [13].
For H. simplex, it was shown that exacerbations of herpes infection significantly more often occur in patients with allergies and herpes correlates with the level of total IgE and IL4 (interleukin 4), which is a pro-allergic cytokine.
Treatment of viral infection

in patients with allergic diseases
When a respiratory viral infection occurs in patients with asthma and allergic rhinitis, treatment should have two directions: 1) treatment of an allergic disease in accordance with the standards and clinical guidelines; 2) treatment of a viral infection.The tactics of managing patients with allergic diseases in ARVI should provide for a pathogenetic approach, the complexity and stages of therapy.
Treatment of virus-induced AD is a rather difficult task. As a rule, it is not possible to identify the pathogen, and drugs with a direct antiviral effect are active against a narrow spectrum of viruses (mainly influenza and herpes viruses). It should also be borne in mind that even adequate basic asthma therapy does not always protect the patient from virus-induced exacerbation.The Clinical Guidelines for the Management of Patients with Lower Respiratory Tract Infections (developed by the European Respiratory Society Working Group for Cooperation with the European Society for Clinical Microbiology and Infectious Diseases (ESCMID)) noted that there is no evidence of the effectiveness of regular use of any drugs with in order to prevent episodes of viral bronchial obstruction. In addition, we must take into account, as mentioned above, the high probability of attaching a secondary bacterial infection.The Pharmacovigilance Risk Assessment Committee (PRAC) of the European Medical Association has published an analytical review on the risk of pneumonia in patients with COPD during therapy with inhaled glucocorticosteroids (ICS). The conclusion of the PRAC experts confirms that patients with COPD receiving ICS treatment have an increased risk of pneumonia. The review was carried out at the direction of the European Commission dated May 7, 2015 (Directive 2001/83 / EC, article 31). The same applies to BA patients with COPD: in the latest updated version of 2016.The Global Strategy for the Treatment and Prevention of Bronchial Asthma (GINA) (http://ginasthma.org) added that the treatment of asthma with ICS should be carried out taking into account the “risk of side effects, including pneumonia”. But even with “pure” BA (without COPD), the risk of pneumonia and lower respiratory tract infections increases against the background of GCS treatment [14]. To all that has been said, it must be added that against the background of ARVI, the effectiveness of the action of the main bronchodilating agents – β2-agonists, decreases. This is most likely due to the development of β2-adrenergic receptor desensitization caused by a respiratory viral infection.Perhaps an additional role is played by the hyperproduction of mucus, which makes it difficult for the drug to contact the corresponding adrenergic receptor.
Drug treatment of a viral infection can be etiotropic (antiviral therapy), symptomatic (antipyretics, mucolytics, bronchodilators, etc.) and prophylactic (vaccination, immunomodulators). Antiviral drug therapy involves specific and non-specific methods. Specific methods include vaccination, administration of immunoglobulins, specific adaptive cellular immunotherapy, etc.One of the main methods of nonspecific correction of immune system dysfunction is immunomodulatory therapy. Immunomodulators are drugs that restore an impaired immune response in therapeutic doses.
The question of the need for antiviral therapy is decided individually. Even with the flu, antiviral therapy is not required. According to international recommendations, in the typical mild course of influenza, for most people, it will be sufficient to use symptomatic therapy to relieve symptoms such as pain and fever, without the use of antiviral drugs [15].However, in patients with respiratory allergies, antiviral therapy is often warranted. The use of antiviral drugs in the early stages of a viral infection helps to prevent severe forms of the disease, reduce the frequency of complications and hospitalizations, and also prevent the transmission of the pathogen. The following antiviral drugs are available: influenza virus neuraminidase inhibitors (oseltamivir and zanamivir), M2 protein inhibitors (amantadine and remantadine), influenza virus NP protein oligomerization inhibitors (ribavirin).Ribavirin is a synthetic analogue of nucleosides with a pronounced antiviral effect. Possesses a wide spectrum of activity against various DNA and RNA viruses, but has limitations in application due to its high toxicity. Inosine pranobex also belongs to antiviral drugs, combines a direct antiviral effect and immunomodulatory effect. In the treatment of herpes infection, acyclovir, valacyclovir, famciclovir are used. The relative disadvantage of direct antiviral agents is their limited effectiveness only when administered in the first 24 hours, the high cost of the course of treatment, the risk of side effects, the development of viral resistance (reliably detected in amantadine and rimantadine), restrictions on use in some patients, in particular in pregnant women.
Antiviral agents also include interferons and interferon inducers. Considering the decrease in the production of interferons in acute respiratory viral infections in patients with atopy and virus-induced asthma, such therapy is pathogenetically justified. Recombinant alpha-2b interferons and combination drugs are available. It is believed that interferon inducers have an advantage over interferons themselves: the synthesis of interferon with the introduction of inducers is balanced and physiological, which eliminates the side effects observed with interferon overdose; inducers do not possess antigenicity, they cause prolonged production of endogenous interferon in physiological doses and have low toxicity [16].
Interferon inducers can be conditionally divided into synthetic and natural. Synthetic include fluorenes, acridanones, purine derivatives (antiviral drug inosine pranobex), polymers, etc. Natural compounds are polyphenols, polymers of double-stranded RNA. The effect of induction of interferons is also claimed in many drugs that do not belong to the group of interferon inducers.
In the complex therapy of ARVI in patients with allergies, the antihomotoxic drug Engystol (sublingual tablets) is used.It has antiviral, anti-inflammatory, detoxification and immunomodulatory effects [17]. In the acute phase, take 1 tablet every 15 minutes for no more than 2 hours, then in a standard dosage – 1 tablet 3 times a day, dissolving under the tongue half an hour before a meal or 1 hour after a meal. Newborns and children under 1 year of age are prescribed 1/4 of a tablet; from 1 to 6 years old – 1/2 tablet; from 6 years to 12 – 3/4 tablets per appointment.
Almost all BA patients have concomitant allergic rhinitis.Respiratory viral infection, activating allergic inflammation, leads to a longer course of the disease and increases the likelihood of complications. Characterized by a protracted course of rhinitis, the appearance of rhinosinusitis. For the treatment and prevention of such a situation, it is advisable to use in complex therapy another antihomotoxic drug – Euphorbium compositum (nasal spray), which is effective in rhinitis and sinusitis of various origins [18]. For adults and older children, Euphorbium compositum is prescribed 1-2 doses in each nostril 3-5 times a day; children under 6 years old – 1 dose 3-4 times a day.
As you know, antibiotics do not affect viral infection. Nevertheless, they can be used in case of secondary bacterial infection (sinusitis, bronchitis, pneumonia, exacerbation of tonsillitis, pyoderma, etc.). As already noted, for such a development of events in patients with allergic diseases, there are all the conditions.
Thus, the treatment of a viral infection in patients with allergic diseases should be complex. It implies the unconditional use of basic anti-inflammatory drugs, the use of symptomatic agents (bronchodilators in patients with asthma, decongestants – rhinitis, antipyretics at high temperatures).According to indications, antiviral, antibacterial and immunomodulating drugs are used.

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Candidiasis in men, the treatment of this disease, the following drugs are most often used. :: ACMD

Many are sure that candidiasis is a purely female disease, but this is not the case. The disease can manifest itself in both sexes, only in men, candidiasis is most often asymptomatic. The occurrence of thrush is due to the multiplication of microscopic yeast-like Candida fungi.They are present in small quantities in every organism, but with a drop in immunity and under the influence of many other factors, their number can increase to a visual manifestation.

Manifestation of candidiasis in the stronger sex

Due to the special structure of the male organ, as well as with a healthy lifestyle, regular hygiene and culture of sexual relations, candidiasis in the stronger sex, if it happens, is asymptomatic. When symptoms appear, the patient may find:

• painful sensation when urinating, during sexual intercourse;
• the appearance of redness on the head of the penis and foreskin, swelling is possible;
• Constant itching and burning sensation;
• curdled plaque on the mucous membrane of the penis, sour smell.

All this is a reason for contacting a specialist. Perhaps thrush is only an indirect sign of another disease.

Chronic candidiasis in men

If candidiasis has become chronic, it will be very difficult to recover from it. He gets the so-called “immunity” to certain medications, and also penetrates deep into the body. For treatment, you will need to take a course of antifungal drugs in the form of tablets.

It should be noted that if candidiasis nevertheless turned into a chronic form, then it can be an addition to more serious diseases of the hormonal background, problems with immunity or carbohydrate metabolism.In this case, a full and extended diagnosis is necessary.

Treatment of candidiasis in men

For the treatment of candidiasis in men, it is necessary to do a number of tests to understand the big picture. If a disease is diagnosed, then the partner is also examined. What does the treatment process look like?

• Use the necessary antifungal drugs.
• Promote a culture of personal hygiene.
• Change their diet in order to normalize the functioning of the gastrointestinal tract.

What drugs are used to treat the disease?

To overcome this disease, the patient is prescribed antifungal drugs. They can be in the form of ointments or tablets, the ingestion or external use of which can regulate the number of pathogenic microorganisms.

The most commonly used drugs are based on the following substances:

• Miconazole. It comes in the form of a spray or cream. When applied, it violates the integrity of various pathogenic microorganisms.
• Ketoconazole. Presented in the form of creams, sprays, tablets. A decrease in the population of fungi occurs due to a destructive effect on the biosynthesis of some components of the fungal cell membrane.
• Econazole. It comes in the form of creams. It acts on the lipid structure of the membrane of fungi, having a bactericidal and fungicidal method.
• Clotrimazole. Presented in the form of creams, ointments and solutions. It has a positive effect on yeast and moldy fungi, kills gram-negative and gram-positive bacteria, dermatophytes.

Diagnosis and treatment of the disease

When the first signs of thrush appear, a man should consult a urologist. It is he who treats this disease in the stronger sex. To establish a diagnosis, a smear should be taken for bacterioscopic examination and bacterial culture. Additionally, the patient can be assigned tests:

• for the presence of genital infections;
• take a blood sugar test;
• for Wasserman reaction;
• to pass a general blood and urine test.

If the appearance of thrush has causes (sugar, infection of the genitals, etc.), then appropriate treatment is carried out by narrow specialists. If only one thrush is found, treatment is symptomatic with local preparations.

To reduce the risk of candidiasis, it is necessary to adhere to preventive measures, namely: observe personal hygiene, exclude promiscuous and unprotected sexual intercourse, do regular independent examination of the genitals for various changes, maintain a high level of protective functions of the body.Be healthy!

What to do if an animal licks itself

Your animal uses its tongue for the same purposes as a human hand – to scratch, clean itself. But excessive or persistent fur licking can be a symptom of the disease.

Most animals use their tongues to clean their hair. Dogs can lick their paws after walking to remove chemicals such as lawn fertilizer or salt from their skin. But there are other reasons for excessive grooming: loneliness, stress, boredom, some dogs lick themselves after exercise to relieve muscle tension.

Other causes:

* Allergies (hypersensitivity to flea bites, food allergies, atopic dermatitis)

Atopic dermatitis (non-food allergy) is more common in animals. The most common allergens are house dust, mold, pollen. In this case, the animal should receive constant treatment, and the owners need to frequently clean the apartment, preferably with drugs that kill dust mites.

– skin infections (bacteria, yeast)

– parasites (fleas, ticks, some gastrointestinal parasites)

– Obsessive-compulsive disorders (mental illness)

– autoimmune skin diseases, sometimes skin tumors

What can be done at home ?

You can bathe your dog in cool water with a hypoallergenic shampoo (for example, with

colloidal oats).Cats should not be bathed; it is better to moisten the skin and coat with a towel. This will help remove dirt and allergens from your skin and hair. Check to see if there is something stuck to the fur between your dog’s or cat’s toes.