Thrush is a fungal
infection caused by Candida yeasts, and especially Candida albicans.
It is also known as
yeast infection, Candida, candidiasis, candidal balanitis, and moniliasis.
It mostly affects
women, but if it occurs in males, candidiasis affects the head of the penis and
the foreskin. It can lead to inflammation of the head of the penis, known as
balanitis.
Oral thrush affects the
mucous membranes, for example, of the mouth.
Fast
facts on thrush in men
Here are some key
points about male candidiasis. More detail is in the main article.
Candida normally lives on the skin and mucous
membranes, but if too much grows, it can cause symptoms.
Symptoms include an
itchy rash, red skin, swelling, irritation and itching around the head of the
penis, lumpy discharge under the foreskin or pain when urinating and during
sex.
Risk factors include
the use of antibiotics or corticosteroids, immunosuppression, diabetes, poor
hygiene, using too many cleansing products.
Genital candidiasis is
not considered a sexually transmitted infection (STI), but transmission can
occur during vaginal intercourse.
Oral or local
antifungal treatments can be used to treat candidiasis.
Good hygiene practices
can help prevent it.
Symptoms
In men, thrush affects
the head of the penis and, if present, the foreskin. It can also be found on
other areas of skin or mucous membrane, for example, in the mouth. This is
known as oral thrush.
There are often no
symptoms, but if symptoms appear, there may be an itchy rash on the penis.
Around the head of the
penis there may be:
red skin
swelling
irritation and soreness
itchiness
inflammation
white patches
Symptoms affecting the
foreskin include:
thick, lumpy discharge
under the foreskin, producing an unpleasant odor
difficulty pulling back
the foreskin
There may be pain
during sex or when passing urine.
Treatment
Many mild infections do
not require treatment. Some medications are available, and there are also home
remedies that may help.
Medication
Antifungal topical
creams or oral medication may help relieve symptoms. They are equally
effective. Both topical and oral forms are available online.
Diflucan is a capsule
containing 150 milligrams (mg) of the antifungal drug fluconazole.
It is available either
from the doctor or over the counter (OTC) from the pharmacy. Only one capsule
is needed.
Another type of
antifungal is known as imidazole, a class of drugs that includes:
Clotrimazole
Econazole
Ketoconazole
Miconazole
Creams are applied
topically, directly onto the affected area, usually once a day for 3 to 7 days.
Nystatin is another
topical antifungal. It is sold under numerous brand names, but it is less
effective than the topical imidazoles.
A man who has not been
treated for thrush previously should see a doctor before treating themselves.
Home remedies
Good hygiene prevents thrush and helps treat it.
Tips for good hygiene include:
washing the penis
carefully with warm, running water
not using perfumed
shower gels or soaps on the genitals, because they can cause irritation
drying the penis
carefully after washing
wearing loose-fitting
cotton underpants to help keep the genital area dry and cool
In men with a foreskin,
poor hygiene underneath it can lead to the build-up of a cheesy-looking
substance called smegma. Smegma can cause irritation.
Do
Probiotics Work?
Women who get recurrent
yeast infections often try probiotics and other alternative treatments
containing Lactobacillus bacteria, but there is conflicting evidence about
whether or not this works, and no evidence that it works in men.
Complications
In rare cases, a man
with weakened immunity who has genital thrush may develop invasive candidiasis.
This is a fungal infection of the blood that can cause the fungus to spread
quickly throughout the body.
This can be fatal, and
it is a medical emergency.
Emergency treatment in
hospital protects organs from the infection while antifungal drugs are
administered to kill it.
Sometimes, if a man
with weakened immunity develops thrush, he may be advised to go to the
hospital, as a precaution against this systemic infection.
Factors
That Increase This Risk Include:
HIV infection
diabetes
use of
immunosuppressant drugs, for example, by transplant patients
undergoing high-dose
chemotherapy or radiotherapy treatment for cancer
having a central venous
catheter (CVC) for medication
being on dialysis
Causes
Candidiasis is caused
by a yeast fungus, Candida.
Candida fungi occur
naturally inside the body and on the skin, but at levels that do not cause
problems. The immune system keeps them in check.
However, if certain
conditions disturb the balance, the fungus can thrive and candidiasis can
develop. The fungal cells produce hyphae, structures that penetrate the tissue.
Risk
factors that make candidiasis more likely include:
use of broad-spectrum
antibiotics, which can upset the balance of normal microbial flora and allow
the Candida to overgrow
taking medications that
suppress the immune system, such as chemotherapy or corticosteroids
having a weakened
immune system, due, for example, to HIV or kidney dialysis
poorly-managed type-1
or type-2 diabetes, because yeasts thrive more easily in higher levels of blood
sugar
obesity, especially if
there are rolls of fat where yeast can thrive
poor hygiene,
especially if a man is not circumcised
bath foam, soaps,
shower gels, lubricants, and other products, which can irritate and damage skin
of the penis, leaving it open to infection
not drying carefully
after washing, because the fungus can thrive in warm, moist conditions
having a poor diet
Is
it sexually transmitted?
Genital candidiasis is
not classed as a sexually transmitted infection (STI). It is usually acquired
through sexual activity, but it can develop without sexual contact. A partner
with a fungal infection does not always transmit it.
However, men are
advised to avoid unprotected sex with a female partner who has thrush until
treatment has cleared up the infection.
Diagnosis
Thrush may disappear
without treatment. However, if it does not go away, and if treatment does not
remove the infection, it is important to see a doctor to rule out other
possible problems, such as diabetes, which can make infection more likely.
Screening for STIs may
be appropriate.
If the rash is severe
or if the doctor is unsure of the diagnosis or suspects an underlying cause, a
swab from around glans penis and under the foreskin may be sent to the lab for
testing.
If there are persistent
sores or ulcers that do not heal, a biopsy may be necessary.
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