A candidal skin infection is usually not serious and is usually easily treated with an antifungal cream.
What is candida?
Candida is a type of yeast (fungus). Small numbers of candida normally live on your skin and do no harm. Sometimes, under certain conditions, they can multiply and cause infection. The common sites for candida to cause infection are your vagina (vaginal thrush), your mouth (oral thrush) and your skin. This leaflet just deals with candidal skin infections. See separate leaflets called Vaginal Thrush (Yeast Infection) and Oral Thrush (Yeast Infection) for more details.
Is a candidal skin infection serious?
Usually not. Most infections occur in people who are otherwise healthy (although they are more common if you are overweight). Treatment usually works extremely well. In some people, the candidal skin infection may be the first indication of another condition such as diabetes.
Why does candida sometimes multiply and cause infection on the skin?
The chance of a candidal skin infection developing is more likely in the following situations:
- Areas of skin that are moist or sweaty are ideal for candida to thrive. Therefore, the common sites affected are in the folds of skin in your groin, armpits and under large breasts. (Another name for inflammation within a fold of skin or under a breast is 'intertrigo'. Candidal infection is a common cause of intertrigo.) Nappy rash is sometimes due to candida. Obese people may develop candidal infection between folds of skin. It can also affect skin between your fingers and toes and at the corners of your mouth.
- If you have diabetes.
- If you take a long course of antibiotics or steroid medication.
- If you have a poor immune system. For example, if you have AIDS, or have chemotherapy, or have certain types of serious blood disorder.
What are the symptoms of a candidal skin infection?
In affected folds of the skin (under breasts, groin, etc) a typical red rash develops. The rash is usually sore and itchy. Small blister-like swellings may develop on the rash. Skin scale can accumulate on the rash to produce a white-yellow, curd-like substance over the affected area. If the areas between toes or fingers are involved, the affected skin may become thickened, white and soft.
What is the treatment for candidal skin infection?
An antifungal cream usually clears the infection within a week or so. Creams commonly used include:
- Ketoconazole (in adults only, not suitable for use in children).
Sometimes a mild steroid cream is added to reduce inflammation and itch whilst the antifungal cream is working. The most commonly added steroid cream is hydrocortisone. These combination creams are easier to use. A steroid cream should not be used on its own for a fungal skin infection.
Occasionally, if your rash is widespread, antifungal tablets called fluconazole are prescribed. These are usually taken once a day for two weeks.
Your doctor may recommend that you wash your skin with a moisturising cream or ointment (emollient) which is more sensitive on your skin than soap products. Certain emollients are useful as soap substitutes in this situation.
Some people with a candidal skin infection can develop an added infection caused by another type of germ (bacterium). It is important to see your doctor if your skin infection does not improve or if it worsens, as you may need an alternative treatment for a bacterial infection. This is usually a different cream containing an antibiotic, such as fusidic acid. Occasionally antibiotic tablets or medicine may be needed.
Can candidal skin infections be prevented?
To minimise the risk of a candidal skin infection:
- Keep areas likely to be affected as clean and dry as possible.
- Always dry well after washing, particularly in your groin, armpits and under large breasts. Some people use a hair dryer to dry these areas after washing to ensure they are dry before putting clothes on.
- Wear light, loose, absorbent clothing and avoid wool and synthetic fibres. This helps to keep your skin from becoming too moist.
- Losing weight may help if obesity is contributing to this problem.
- Avoid anything wet being in contact with the skin for very long. So, change nappies or incontinence pads as soon as they are wet. If you have been exercising and are in wet, sweaty clothes, change into dry clothes as soon as you can.
- If you are troubled with repeated infections at the angle of your mouth and you wear dentures:
- Remove the dentures each night to clean them.
- Sterilise the dentures overnight.
If the infection keeps coming back for no apparent reason, a test to check for sugar (diabetes) may be advised by a doctor.
Further reading and references
; NICE CKS, January 2014 (UK access only)
; DermNet New Zealand
Hi,My girlfriend has had this skin infection for months now, doctors have given her antibiotics to clear it up which haven't helped at all, if anything it's getting worse, I'm not sure they even know...Seaspray99
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