Different types of yeast infections

Yeast infections are usually harmless infections that can occur anywhere on the body, when there is an overgrowth of the fungus Candida. Candida is present in some measure on skin and in bodily orifices.  The fungus lives in harmony with the body in places like the mouth, throat, gut and vagina, without normally causing harm. When the fungus has the opportunity to multiply and overgrow, it can lead to a yeast infection (Candidiasis).

The two most common types of yeast infection affecting women are oropharyngeal candidiasis and vaginal candidiasis.

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Oropharyngeal candidiasis 

Candidiasis of the mouth and throat is called oropharyngeal candidiasis or thrush. If it reaches the esophagus it is called esophageal candidiasis. Esophageal candidiasis is one of the most common infections found in people with HIV or AIDS. 

Symptoms

Common symptoms of oral candidiasis include:

• White patches on the inner cheeks, tongue, roof of the mouth and throat
• Redness or soreness
• Cracks and redness at the corners of the mouths
• Loss of taste 
• Pain when eating or swallowing
• Cotton-like feeling in the mouth

When the candidiasis reaches the esophagus, you might experience pain and difficulty when swallowing. 

Risk factors

Oral candidiasis is uncommon in healthy individuals. There are conditions and medications that are associated with a higher chance of getting oral candidiasis. These include:

• Wearing dentures 
• Uncontrolled diabetes
• A suppressed immune system caused by conditions such as cancer and HIV
• Taking antibiotics or corticosteroids such as inhaled corticosteroids used for the management of asthma
• Having a medical condition that causes dry mouth or taking a medication that causes dry mouth
• Smoking

The individuals who are more susceptible to esophageal candidiasis are those with a weakened immune system that prevents their body from fighting off the infection. 

Prevention

Maintaining good oral and denture hygiene is essential in the prevention of oral candidiasis. Make sure to brush and floss your teeth twice a day. If you wear dentures, make sure to clean them regularly. Visit your dentist as regularly. If you use inhaled corticosteroids for asthma, make sure to rinse your mouth out after each use. 

Treatment

Antifungal medication is used to treat oral candidiasis. For mild to moderate infections, the course of antifungals is 7 to 14 days, usually applied to the inside of the mouth. These medications include clotrimazole, miconazole and nystatin. For the treatment of severe cases, fluconazole is the most common treatment. It is usually prescribed as an oral and sometimes intervenous medication. For the treatment of esophageal candidiasis, fluconazole will be used.

Vaginal candidiasis 

There is a healthy balance of bacteria and yeast in the vagina. When this balance is thrown off, candida has an opportunity to grow and hence leave you with a yeast infection.

Symptoms 

Common symptoms of vaginal candidiasis include:

• Vaginal itching or soreness
• Pain during sexual intercourse
• Pain during urination
• Vaginal discharge - usually thick and white, and can be foul-smelling

Vaginal candidiasis is usually mild, but it can develop into a more serious infection. If caught early, the infection can be easily treated, preventing any long-term complications.

Risk factors

Vaginal candidiasis can happen to any woman but has a higher chance of occurring with:

• Uncontrolled diabetes
• Pregnancy
• Use of hormonal contraceptives such as birth control pills 
• Conditions that weaken the immune system such as HIV or cancer
• Antibiotic use

Prevention

Adopting these practices can help reduce the chance of developing a vaginal yeast infection:

• Avoid wearing tight or wet clothes
• Wear cotton underwear
• Do not use scented products on your vagina
• Avoid hot tubs and very hot baths 

Treatment

You can use over the counter medications or doctor-prescribed medications to treat vaginal candidiasis. 

Over-the-counter medications:
Vaginal creams: These are applied to the inside of your vagina to help kill off the bacteria. They might come with an applicator to help you measure the right dose and to enable easy application. These can be slightly messy and leak, so its best to use them at bedtime. Medications include:

• Clotrimazole 
• Miconazole

Tablets or suppositories:
Some of the aforementioned medications, such as clotrimazole and miconazole, can come in the form of tablets or suppositories. The suppositories are inserted into the vagina where they dissolve. These are sometimes preferred over creams as they are less messy and also require fewer doses. 

Prescribed medications:
Antifungals: A doctor might prescribe long-term therapy with similar antifungals for persistent or recurrent yeast infections.  A two week course may be prescribed, followed by a weekly dose for 6 months. 
Oral medication: A doctor might prescribe you a single dose of fluconazole or, if the infection is more severe, multiple doses omay be prescribed. 

Even though yeast infections are usually harmless, if they are not treated properly, they can evolve into a more severe form of infection. This could be harder to treat and even life-threatening. If you notice symptoms of a yeast infection, it is important to go seek help and treatment as soon as possible. If you are susceptible to yeast infections, make sure to take the necessary precautions to minimize the chance of an infection occuring.  

References

1. Candidiasis, CDC, 2019
    

Information

Reviewed by Dr Roy Kedem, MD

Information last reviewed 10/13/21

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