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Candida & Yeast Infections

Candida is a yeast that normally lives on the skin and in the mouth, gut and vagina. When it overgrows it can cause vaginal yeast infections, thrush or skin rashes — common and usually easy to treat — and, in people who are already very ill, serious infections of the blood and organs.

What is Candida?

Candida is a yeast, a kind of fungus. Everyone has it on their skin and in places such as the mouth, throat and vagina, and most of the time it causes no symptoms. An infection, called candidiasis, happens when Candida grows out of control (CDC). Other germs normally keep it in balance; antibiotics, illness or changes in the body can upset that balance (MedlinePlus, ACOG). The species seen most often is Candida albicans (CDC).

Types of Candida infection

  • Vaginal yeast infection (vaginal candidiasis): itching or soreness, pain during sex, pain or discomfort when urinating, and abnormal discharge (CDC). The discharge is often thick, white and like cottage cheese, without a bad smell (Office on Women’s Health).
  • Thrush (mouth and throat): white patches on the tongue, inner cheeks, roof of the mouth or throat; redness or soreness; a cotton-like feeling; loss of taste; pain when eating or swallowing; and cracking at the corners of the mouth (CDC). In babies it can look like a white coating on the tongue, and they may not want to feed (NHS).
  • Esophageal candidiasis (the tube from the throat to the stomach): pain and difficulty swallowing. Most people who get it also have thrush (CDC).
  • Skin infections: an itchy, red, spreading rash, most often in warm, moist skin folds such as the armpits, groin and under the breasts. Candida is the most common cause of diaper rash in babies, and it can also infect the nails and the corners of the mouth (MedlinePlus). For a different common fungal skin infection, see our Athlete’s Foot guide.
  • Invasive candidiasis: a serious infection of the blood (candidemia) or internal organs that mainly affects people who are already in the hospital or very ill (CDC). A related concern is Candida auris, an often drug-resistant species that spreads among patients in healthcare facilities (CDC) — see Invasive candidiasis and Candida auris below.

Candidiasis doesn’t spread between people (CDC). A vaginal yeast infection isn’t a sexually transmitted infection, though a partner can occasionally get itching or a rash (MedlinePlus, Office on Women’s Health). The popular idea of a hidden “candida overgrowth” that a special diet can cure is a separate claim — see The “candida diet” claims below.

How common is it?

Vaginal yeast infections are among the most common fungal infections (CDC). CDC’s treatment guidelines estimate that 75% of women will have at least one episode and 40% to 45% will have two or more (CDC STI Treatment Guidelines). Thrush is much less common in healthy adults, and the risk is highest in babies under one month old (CDC). Invasive infection is rarer but serious: CDC estimates about 25,000 cases of candidemia in the United States each year (CDC).

What raises the risk?

How is it diagnosed?

For vaginal symptoms, a clinician usually looks at a small sample of discharge under a microscope or sends it for a culture (CDC). Testing matters because other vaginal infections cause similar symptoms (CDC): the Office on Women’s Health notes that studies show two out of three women who buy yeast infection medicine don’t actually have one (Office on Women’s Health). Finding Candida without symptoms is not a reason to treat, since 10% to 20% of women carry it normally (CDC STI Treatment Guidelines). Thrush can usually be recognized just by looking in the mouth; esophageal infection is usually confirmed with an endoscopy (a thin camera passed down the throat); and invasive infection is diagnosed with blood or tissue cultures (CDC).

See a doctor, nurse or ob-gyn first — rather than self-treating — if:

Side by side

Six approaches compared

For every condition we look at the same six approaches: what each involves, what it typically costs, and what a patient can realistically expect.

ApproachWhat it involves Estimated costWhat to expect
Conventional medicine (AMA) Antifungal medicines: over-the-counter vaginal creams and suppositories (miconazole, clotrimazole and others) or a prescription pill (fluconazole); antifungal gels, liquids or lozenges for thrush (nystatin, clotrimazole, miconazole); creams for skin and diaper rash; hospital IV treatment for invasive infection; and a longer, clinician-led plan for repeat infections. At one pharmacy: Monistat 7 cream about $14, Monistat 3 suppository and cream combo about $20. Doctor or clinic visit: cost estimate being researched. Most vaginal and mouth infections clear within days to about two weeks with proper treatment. Repeat infections are common for some people and need testing and a longer plan. Oral fluconazole is not recommended in pregnancy.
Chiropractic Being researched — coming soon.
Acupuncture Being researched — coming soon.
Herbal medicine Probiotics and live-culture yogurt, boric acid vaginal capsules (for some repeat infections, under a clinician’s care), and remedies such as tea tree oil and garlic; the “candida cleanse” diet. Cost estimate being researched. Probiotic evidence is limited and mixed; boric acid has a place only under medical guidance and must never be swallowed; tea tree oil and garlic are not shown to work; no trials show the candida diet treats any condition.
Massage therapy Being researched — coming soon.
MBHA Wellness Coach Cotton underwear and breathable clothes, no douching or scented products, changing out of wet clothes, mouth and denture care, rinsing after steroid inhalers, blood-sugar habits, taking antibiotics only as prescribed, and knowing when to see a clinician instead of self-treating. Cost estimate being researched. Everyday habits can lower the chance of another infection. A coach supports you; a coach never diagnoses an infection or replaces treatment.

Approach 1 of 6

Conventional medicine (AMA)

Candida infections are treated with antifungal medicines, which come as creams, oral gels, lozenges and rinses, pills, or medicine given through a vein. The type and length of treatment depend on where the infection is, how severe it is and your overall health. Take antifungals exactly as directed, for as long as directed (CDC). We don’t list doses or treatment lengths here — follow the package or your clinician.

1. Vaginal yeast infections

If you are pregnant. CDC recommends only vaginal (topical) azole treatments during pregnancy. It advises against oral fluconazole, because studies suggest even a single dose might be linked to miscarriage and birth defects (CDC STI Treatment Guidelines). The Office on Women’s Health likewise says to use miconazole or clotrimazole vaginal creams or suppositories, and not to take the oral fluconazole tablet (Office on Women’s Health). Tell your clinician if you are pregnant or planning to be before taking fluconazole (MedlinePlus).

2. Infections that keep coming back

Repeat infections deserve a proper work-up rather than another round of self-treatment. Clinicians may take a culture to identify the yeast, since some less common species don’t respond as well to the usual medicines, and resistance to fluconazole is becoming more common (CDC STI Treatment Guidelines, CDC). Treatment is usually a longer first course followed by a maintenance antifungal for up to six months (Office on Women’s Health, CDC STI Treatment Guidelines). This controls symptoms well but is rarely a permanent cure (CDC STI Treatment Guidelines). People with diabetes or a weakened immune system may need longer treatment, along with work on the underlying condition, such as blood sugar (CDC STI Treatment Guidelines). Boric acid is one option clinicians use for some hard-to-treat infections — see Herbal medicine.

3. Thrush and esophageal infection

  • Mild to moderate thrush is usually treated with an antifungal gel or liquid used in the mouth — clotrimazole, miconazole or nystatin; severe infections may need fluconazole by mouth or through a vein (CDC, MedlinePlus).
  • Fluconazole is almost always used for esophageal infection (CDC).
  • If you use a steroid inhaler, rinse your mouth or brush your teeth after each use (CDC). Don’t stop the inhaler on your own — talk with your clinician.

4. Skin and diaper rash

Antifungal creams, ointments or powders treat yeast skin infections; keeping the skin dry and open to air helps (MedlinePlus). Older children and adults with a yeast skin infection should be tested for diabetes (MedlinePlus). For yeast diaper rash, nystatin, miconazole, clotrimazole and ketoconazole creams are commonly used, but ask your baby’s provider first; keep the area clean and dry, give diaper-free time, and don’t use talcum powder (MedlinePlus).

5. Control blood sugar

If you have diabetes, keeping blood sugar well controlled helps prevent vaginal infections and thrush and can help skin infections clear (MedlinePlus, MedlinePlus, MedlinePlus).

Who to see

Your primary care provider, an ob-gyn (ACOG), or for a child, the pediatrician. A dentist is part of the team for thrush, especially if you have diabetes or wear dentures (Cleveland Clinic). Repeat vaginal infections that don’t respond may need a specialist (CDC STI Treatment Guidelines).

What it costs

  • Monistat 7 (miconazole) vaginal cream: about $14 (retail listing: Pasteur Pharmacy).
  • Monistat 3 (miconazole) suppository and external cream combo pack: about $20 (retail listing: Pasteur Pharmacy).
  • Store brands with the same active ingredient often cost less; prices change.
  • Doctor, clinic or ob-gyn visits, lab tests and prescription medicines: MBHA cost estimate being researched.

How well it works — what to expect

Most of the time, vaginal yeast symptoms go away completely with proper treatment (MedlinePlus). Cleveland Clinic says most clear up within a few days, though it may take a full week, and that a vaginal yeast infection won’t go away on its own (Cleveland Clinic). With treatment, thrush usually clears within one to two weeks in people with a healthy immune system (Cleveland Clinic). Yeast skin infections often clear, especially when the underlying cause is corrected, but repeat infections are common (MedlinePlus).

Find a medical doctor in our directory

Approach 4 of 6

Herbal medicine

Many people look for natural options, especially when infections keep coming back. Here is what the evidence says. None of these should replace a proper diagnosis — symptoms of a yeast infection look a lot like other infections that need different treatment (Office on Women’s Health).

Probiotics and yogurt

  • MedlinePlus says eating yogurt with live cultures or taking Lactobacillus acidophilus tablets while on antibiotics may help prevent a yeast infection (MedlinePlus). The Office on Women’s Health answers “maybe”: some studies suggest a benefit, but more research is needed to say for sure (Office on Women’s Health).
  • A 2017 Cochrane review of 10 trials (1,656 women) looked at probiotics added to standard antifungal treatment. On low- or very-low-quality evidence, they slightly raised short-term cure rates and lowered relapse at one month, but this didn’t carry through to longer-term cure (Cochrane review, 2017).
  • CDC’s treatment guidelines say there is no substantial evidence to support probiotics or homeopathic medicines for treating a vaginal yeast infection (CDC STI Treatment Guidelines).
  • Safety: probiotics have a long history of apparently safe use in healthy people, but the risk of harm is greater in people who are seriously ill or have a weakened immune system, and some products have contained microbes not listed on the label (NCCIH).

Boric acid

Boric acid safety. Boric acid capsules go in the vagina and must never be swallowed. Swallowing large amounts of boric acid can cause stomach and bowel upset, kidney problems or death. Pregnant women should avoid it. Keep it well out of children’s reach, and if someone swallows a capsule, call Poison Control at 1-800-222-1222 (Poison Control). Use it only with your clinician’s guidance.

Tea tree oil

The U.S. National Center for Complementary and Integrative Health says a small amount of evidence suggests tea tree oil applied to the skin might help acne and athlete’s foot, but for other conditions there isn’t enough evidence to say whether it is useful (NCCIH). It should never be swallowed — not even tea tree mouthrinses — because taken by mouth it can cause confusion, unsteadiness, inability to walk and coma. On the skin it can cause redness or irritation (NCCIH). Because thrush is in the mouth, tea tree oil is not a safe home remedy for it.

Garlic

Garlic is active against Candida in the lab, but in a 2014 trial of 63 women who carried vaginal yeast without symptoms, garlic tablets taken by mouth did not lower yeast counts compared with a dummy pill, and more women in the garlic group reported side effects (trial, BJOG). Fresh raw garlic used on the skin can cause severe irritation and chemical burns, and garlic supplements may raise the risk of bleeding — tell your clinician if you take them, especially with blood thinners or aspirin (NCCIH).

In short: live-culture yogurt is a reasonable food choice, and boric acid has a real but limited place under medical care. Nothing here replaces an antifungal when you have a confirmed infection. For the “candida cleanse” diet, see The “candida diet” claims below. We don’t list strengths or doses.

Approach 6 of 6

MBHA Wellness Coach

Yeast infections are common and nothing to be embarrassed about. An MBHA Wellness Coach can help you build habits that make another infection less likely — and help you recognize when to see a clinician instead of treating yourself.

Everyday habits for vaginal health

Mouth and denture care

Babies and breastfeeding

  • Sterilize pacifiers regularly and bottles after each use, replace bottle nipples and nipple shields weekly, and wash bras, breast pads, bibs and cloths on a hot wash. If your baby has thrush, don’t freeze breast milk to use later (NHS).
  • Yeast can also infect the nipples during breastfeeding. Sore, flaky, shiny or cracked nipples or shooting breast pain during or after feeds are reasons to call your doctor (Office on Women’s Health).

Medicines and blood sugar

Know when to self-treat — and when not to

MedlinePlus says treating yourself at home is probably fine only if your symptoms are mild with no pelvic pain or fever, this isn’t your first infection and you haven’t had many, you aren’t pregnant, and you aren’t worried about a sexually transmitted infection (MedlinePlus). Treating something that isn’t a yeast infection can delay the right care and may make future yeast infections harder to treat (Office on Women’s Health, CDC STI Treatment Guidelines). A coach can help you keep a simple symptom diary to bring to your appointment — and will always point you to the warning signs above. A coach is never a substitute for medical care.

Another approach

The “candida diet” claims

You may have read that “candida overgrowth” or “yeast syndrome” in the gut causes fatigue, headaches, brain fog and many other symptoms, and that a strict diet cutting out sugar, white flour, yeast and cheese will clear it. Here is what credible sources say.

  • Candida is a normal resident. Everyone has it, and most of the time it causes no symptoms (CDC). Finding Candida on a vaginal culture without symptoms is not a reason to treat (CDC STI Treatment Guidelines).
  • Little proof supports “yeast syndrome.” Mayo Clinic says there isn’t much proof to support this diagnosis, and that a true, significant yeast overgrowth in the digestive tract is diagnosed with an endoscopy and biopsy and treated with antifungal medicine (Mayo Clinic).
  • No trials support the diet. There is little proof that diet changes improve a significant yeast overgrowth, and no clinical trials show a candida cleanse diet works for any known medical condition (Mayo Clinic).
  • Long-term antifungals didn’t help either. In a 1990 trial in women thought to have “candidiasis hypersensitivity syndrome,” the antifungal nystatin relieved vaginal symptoms but was no better than a placebo for whole-body symptoms such as fatigue or for psychological symptoms. The researchers concluded that long-term nystatin for this purpose appears unwarranted (trial, New England Journal of Medicine).
  • Why some people feel better: cutting out sugar and white flour usually means eating fewer processed foods and more whole foods, which may have health benefits of their own — unrelated to yeast (Mayo Clinic).
  • Where diet does matter: for people with diabetes, keeping blood sugar under control helps prevent yeast infections (MedlinePlus). Cleveland Clinic also lists limiting sugar and yeast-containing foods among its tips for lowering the risk of thrush, alongside good mouth care and not smoking (Cleveland Clinic).

If you have ongoing tiredness, headaches or digestive symptoms, please don’t settle for a self-diagnosis of “candida.” You deserve a real medical check to find out what is going on.

Another approach

Invasive candidiasis and Candida auris

Invasive candidiasis is the most severe form of Candida infection. It happens when Candida gets into the bloodstream (candidemia) or infects organs such as the kidneys, heart, brain, eyes, bones or joints (CDC, CDC). Most people are not at risk (CDC).

Who is at risk

Mainly people who are in the hospital or were recently — for example after long stays in intensive care, with central venous catheters, after abdominal surgery or an organ transplant, or during chemotherapy or dialysis — as well as premature babies and people who inject drugs (CDC). To help prevent it, wash hands often, ask how to keep a central line protected, and tell the care team if the skin around it becomes red or painful (CDC).

How serious is it?

Candidemia is one of the most common bloodstream infections in the United States. About one third of people with candidemia die during their hospital stay, though they are usually very sick already, so it is hard to tell how much the infection itself is to blame (CDC). It is treated in the hospital, most often with an echinocandin antifungal (caspofungin, micafungin or anidulafungin) given through a vein (CDC). Drug resistance is increasing, which makes lab testing to guide treatment more important (CDC).

Candida auris

  • CDC describes C. auris as an emerging fungus that can cause severe, often multidrug-resistant infections and spreads easily among patients in healthcare facilities (CDC). It was first reported in the United States in 2016 (CDC).
  • Patients can carry it on their skin without symptoms and still spread it to surfaces such as bedrails and doorknobs (CDC).
  • Most strains resist at least one type of antifungal, but most infections can be treated with echinocandins; some strains resist all three main classes (CDC).
  • It mostly affects very sick patients with devices such as breathing tubes, feeding tubes or catheters. Healthy visitors and family members generally aren’t at risk. If you have had C. auris, tell any healthcare provider before future care (CDC).

Still being researched: Chiropractic, Acupuncture, Massage therapy. We add each approach once its costs and results are sourced. Are you a practitioner with experience treating Candida & Yeast Infections? Tell us.

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Sources

This page is for education only and is not medical advice. Costs are typical U.S. ranges and estimates; yours will depend on your provider, location and insurance. Talk with your doctor before starting, stopping or combining any treatment. In an emergency, call 911. See our disclaimer.

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