Symptoms
Thrush is an infection caused by yeasts (a type of fungus) called ‘candida’. Thrush can occur on the moist areas of the skin, vagina or in the mouth. Another common but different, fungal infection of the skin is tinea (ringworm). Symptoms of thrush on the skin are a red itchy rash, with skin that is cracked with small sores or blisters. Symptoms of vaginal thrush are a thick, cottage-cheese like, white discharge from the vagina with itching, burning, redness and swelling around the vaginal area. There may be stinging when passing urine and discomfort during sex. Symptoms of thrush in the mouth are white creamy-looking patches on the tongue, roof of the mouth, gums or tonsils. The mouth is red and sore with irritated gums, especially under dentures, and there may be split skin and pain in the corners of the mouth. The sense of taste may be altered.
Causes
Thrush on the skin is more likely with:
- warmer weather and profuse sweating, particularly if overweight with sweaty skin folds
- babies with severe nappy rash
- poor hygiene or changing undergarments infrequently.
Vaginal thrush is more likely with:
- antibiotics or oral contraceptive use
- changes in hormones during menstruation or pregnancy
- medical conditions like diabetes, immune deficiency, or iron deficiency
- wearing tight-fitting underwear that prevents adequate circulation.
Thrush in the mouth is often associated with:
- taking medicines such as corticosteroids (e.g. preventer asthma inhaler medicines)
- medical conditions like leukemia, HIV, diabetes or dry mouth
- medical treatments like radiation or chemotherapy
- wearing dentures or smoking.
Lifestyle options
Thrush infection responds well to treatment. To prevent recurrence:
Skin thrush:
- Wash and shower regularly. Dry the skin well, particularly under skin folds. Apply a barrier cream to prevent rubbing of skin folds.
- Change nappies and undergarments regularly.
- Wear loose-fitting clothes.
Vaginal thrush:
- Use pH-balanced, unperfumed soap-substitutes on the vaginal area (avoid soap).
- Avoid perfume sprays or douches (washes), scented tampons and pads or scented toilet paper.
- After passing a bowel motion, wipe the bottom area from the front towards the back to avoid spreading candida from the anus into the vagina.
- Wear comfortable cotton underwear.
Thrush in the mouth:
- Rinse the mouth and brush your teeth after using preventer asthma inhalers.
- Brush the teeth twice a day and use dental floss.
- Clean dentures daily and check the gums if there is any irritation or soreness.
Pharmacy Options
Always inform pharmacy staff if you are taking any other medicines, or if you have any other health conditions, because some over-the-counter medicines may not be suitable for you. Different medicines are available to treat thrush infections that occur in different areas of the body.
Skin thrush:
- Antifungal treatments, such as nystatin or clotrimazole are available as ointments, creams, lotions, gels or powders. Some may also be combined with anti-inflammatory medicines like hydrocortisone. These products must be applied to the skin continuously for 2 weeks after the infection clears.
Vaginal thrush:
- Antifungal treatments, such as clotrimazole and nystatin are available as vaginal creams and pessaries (vaginal tablets). Some are also available as combination packs containing creams and pessaries. Ask your pharmacist for instructions on how to use them. These medicines are best used at night before going to bed. They can damage condoms or diaphragms. Sex should be avoided during treatment for vaginal thrush.
- Antifungal oral tablets, such as fluconazole is a single-dose oral antifungal treatment. Tell your pharmacist if you are pregnant or breastfeeding as some medicines may not be suitable.
Oral thrush:
- Antifungal treatments may be recommended. Ask your pharmacist for instruction on how to use these as you may need to use them for a few days after symptoms clear. Your doctor may also prescribe a lozenge called Amphotericin B. Use oral thrush medicines after food to avoid swallowing them. It helps increase contact time in your mouth. Liquids and gels should be swirled around the entire inside of the mouth. If a breastfeeding baby has oral thrush, the mother can get thrush on her nipples and may need antifungal medicines.
Ask your pharmacist for advice on the most suitable treatment for you.
See a doctor if:
- infections do not resolve with recommended treatments
- you experience increasing pain
- there is bleeding, you have diabetes or are being treated for cancer or with immunocompromising medicines
- you are pregnant, get repeated vaginal thrush infections (more than 3 per year), or the discharge from your vagina is frothy or has a strong smell.
More information
Health Direct: www.healthdirect.gov.au
MyDr: www.mydr.com.au
Disclaimer: The information provided is a guide only, is current at time of publishing, and is not intended to replace the advice of your pharmacist or doctor.
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