Candida Fungus Skin Infection- Its Causes, Symptoms & Diagnosis

Various kinds of fungus and bacteria remain alive, and growth occurs on the skin. Many of them are not harmful. The body needs certain micro-organisms, to perform routine functions of the body. If they multiply at a rapid rate “uncontrollably”, it results in infections and gets dangerous.

Candia fungus is a dangerous organism. Candida is a “strain of fungus”, which results in skin infection. In typical situations, skin hosts tiny quantities of fungus. The harm or danger is when they start to multiply rapidly and uncontrollably.

Introduction

As per the Centers for Disease Control and Prevention (CDC), greater than 150 “species of candida are present.” Candida Albicans is the ones which majorly cause infection. According to the CDC, at some point in time, seventy per cent of adult women undergo infections caused by yeast. There will be the development of oral Thrush or candida overgrowth in the mouth of approximately 90% of the people with AIDS as per AIDS Research and Human Retroviruses.

There are chances of infection if the excess growth of Candida forms on the skin, known as Candidiasis of the skin or cutaneous Candidiasis.

Kinds of Candida fungus infection include:

• Athlete’s foot
• Oral Thrush
• Vaginal Yeast Infection
• Nail Fungus
• Jock Itch
• Diaper Rash

When the Candida gets into the bloodstream it is termed as Invasive Candidiasis. As per the Centers of Disease Control and Prevention (CDC), 46,000 cases occur every year in the United States (US).

The outcome of this condition is excellent. This condition is not that dreadful and gets treated simply. It might result in harmful conditions if infections are not under control, and there is a recurrence, especially in those individuals with weak immunity. With proper treatment on an immediate or urgent basis, there are chances of a reversal of adverse effect or life-threatening diseases.

An infection of the skin or Candidiasis of skin results in red, itchy rashes that majorly occurs in the skin folds (parts of the skin that folds). Outbreaks spread to different parts of the body. Improvement in hygiene and antifungal creams or powders helps improve the signs and symptoms of fungal infections.

Causes and Risk Factors

This condition can occur in any part of the body, but majorly occurs in the “intertriginous regions.” This region is where there is rubbing of two skin parts. They consist of areas or elements such as armpits, groin, under the breast and skin-folds and parts between the fingers and toes. Candida also results in infection of the nails, corners of the nails, margins or borders of the nails.

Growth of fungus occurs in conditions such as warm, mild wet and sweaty conditions. For any infection to occur, skin acts as a barrier or protective layer. There is a fungal infection that results in an injury or cut on the outermost layer of the skin. Candida results in causing harmful diseases, i.e. pathogenic when situations favour them to divide or multiply. These situations occur in hot and slightly wet climates; hygiene is poor and restrictive clothing, i.e. tight clothes which avoids free bodily movements.

Candida infections also occur in:

• Infants, majorly on the buttocks, cause of diaper rashes. Inside the diaper, it gets wet and warm, resulting in the growth of fungus.
• Overweight or obese individuals
• Diabetic Individuals
• Hypothyroidism or underactive thyroid gland
• Inflammatory conditions
• Individuals with weak immune systems
• Individuals working in a wet environment
• Women who are pregnant
• Increased chances of cutaneous Candidiasis if individuals on antibiotics, chemotherapy and steroid therapy.
• Most often, the cause of vaginal yeast infection is Candida. These are common infections that occur as a result of antibiotic use.
• There are possibilities of fungal infection in individuals on certain medicines. Some causes due to drugs are topical corticosteroid, birth control pills and antibiotics. If an individual is on these medicines, it is essential to monitor for signs and symptoms of candida infection regularly.

Symptoms of infection of the skin 

Depending on the location of the body, the symptoms vary or differ.

These include

• Rashes result in extreme infection and redness of the skin.
• There is the presence of blisters, i.e. small pocket of raised body fluid on the upper layer of the skin).
• Patches of red or purple colour (altered or modified surface area)
• Affected parts have a substance that is white and flaky
• Scaling or peeling of the skin with the flakes
• Skin gets cracked
• Soreness
• Erythema, i.e. Patches or superficial reddening of the skin with flakes (loss of the outer layer of the epidermis in big, scale-like flakes). Skin gets cracked and becomes dry
• Maceration, i.e. Excess exposure to moisture results in skin getting soft and breaks down.
• “Creamy Satellite Pustules” at the corners of the areas that are affected. (Pustules are pimple with pus)
• Oral Thrush also termed as oral Candidiasis is an infection caused by yeast or fungus. Oral thrush results in red and white cuts in your mouth.

Other conditions that show similarity to Candidiasis of skin are:

Ringworm, Hives, Herpes, and Conditions are related to diabetes, Contact Dermatitis, Seborrheic Dermatitis, Eczema and Psoriasis.

Diagnosis of Candida Infection

The diagnosis majorly is dependent on the way it looks and skin sampling, i.e. skin biopsy, where the physician cuts a small sample of the skin for testing it. Skin biopsy helps diagnose skin infections.

Physicians will take skin scrapings (skin lesion KOH exam, in this test the physician take a tiny skin piece or part, which is placed under solution, i.e. Potassium Hydroxide (KOH) and studied under a microscope.

Physicians will take nail clippings, hair plucking from the areas that are affected and analyzed or studied under the microscope.

After the diagnosis of candida infection, it is vital to identify the “underlying cause.” Post-diagnosis of the causes, it includes modification in lifestyle, to more hygienic and clean, weight loss if overweight or obese, controlling and managing diabetes.

Recommended to take an appointment with the doctor and consult them, after experiencing infection for the first time. This helps the physician in diagnosing the condition accurately and providing proper treatment options. Candida occurs again and again.

Treatment

Treatment for this condition is quite easy. If there is no significant harm to the immune system or the Candida has not entered the bloodstream, individual with candida skin infection does not require to be hospitalized.

The prescription given by the doctors includes drying agents with creams for antifungal use, ointments, lotions, that are skin applicants. There is the availability of suppositories, i.e. other means to deliver drugs. Suppositories means the insertion of a round-shaped object inside the body, mainly from the bottom for delivery of the medicine. Once it enters, it melts or dissolves, and drugs are released; and oral medication.

Doctors will prescribe over the counter drugs (OTC) to be applied on the exteriors of the skin like the ketoconazole or clotrimazole; and azoles, i.e. belongs to antifungal medicines. The availability is in the form of ointments, tablets and creams. The side-effect is not that harmful like other antifungal agents named nystatin or amphotericin B. Amphotericin B, which is an intravenous drug is mainly of use in the hospital environment.

The drugs suggested, depending on the kind of infection and the parts of the body being affected.

For example:

• Vaginal Creams or gels like miconazole are of use for vaginal yeast infections.
• There is the frequent use of Antifungals such as lozenges, tablets or liquid mouthwash for the treatment of Thrush (Infection of skin or mucous membrane caused by Candida).
• The treatment used for athlete’s foot includes sprays, powders and ointment.
• In case of severe infections, oral or Intravenous medications are used.
• Usage of some drugs is one time or two times per day.

For the treatment of candida infections during any trimester of pregnancy, there are certain medications such as miconazole and clotrimazole used. Essential to confirm with the physician related to what medicines are safe for consumption.

Side-effects always come as a part of consuming any medicines.

Side-effects for antifungal medications include:

• At the site of the application occurs itching
• At the point of use, there is an occurrence of redness or mild burning
• Pain in the head
• The stomach is upset or digestion problems
• Skin rashes

If on intravenous antifungals, causes a negative impact which includes:

• Appetite loss
• Sick feeling
• Diarrhoea
• Pain in the muscles and joints
• Rashes

Rarely, antifungal issues result in allergic reactions or extreme reactions of the skin, which includes skin getting peeled off or blister formation.

Individuals with damage to the liver should take antifungal medicines only under the supervision of the doctor. Antifungal drugs likely cause damage to the liver in healthy patients but aggravate in individuals who are already suffering from damage to the liver.

Antifungal medicines and reaction with other drugs include:

• Rifampin (Rifampicin) is an antibiotic.
• Benzodiazepines used for inducing sleep and decreasing eagerness
• Estrogens and Progstrones that occurs in contraceptives and hormone replacement therapy
• Phenytoin, used for the treatment of epilepsy

Candida Infection in Kids

Kids are at higher risk of candida infection in comparison to adults. Due to candida overgrowth, children are more prone to form sinus infections, skin rashes (diaper rashes or others), oral Thrush and pain in the ears.

Symptoms for babies and toddlers include

• Cutaneous Candidiasis (skin infection is present on skin, nails or hair)
• Cracked skin at the corners of the mouth.
• Diaper rashes that are heavy and constant
• Skin rashes similar to eczema
• On the tongue or inside of the mouth or cheeks, there are white or yellow patches
• For more than three months being colicky
• Repeated infections of the ear
• Worse conditions during a damp or wet environment

In old children, the symptoms include

• Cravings for sweets continuously
• Problems in learning
• Frequently being irritated or not happy
• Repeated issues of the ear
• Worse conditions during a damp environment or wet environment

As per a 2010 study, though healthy kids had strong immunity, the rate of topical fungal infections is increasing rapidly among them. Kids develop candidiasis infection post taking antibiotic medicines for the treatment of another condition or disease. There are higher chances of development of candidiasis infections in or around the nail beds who put a thumb in their mouth.

If the child below the age of nine months has repeated episodes of Thrush or infections of the skin, this could be a result of underlying health concern such as HIV or other immune-related conditions or disorders.

The outlook of the condition

With treatment, the candida infection of the skin goes away, and specific individuals make a full come-back without any kinds of complications or issues. Sometimes, it is possible to develop infections again in future post-treatment. There are higher chances of severe or life-threatening Candida infections in individuals who are taking chemotherapy treatments and those with HIV or AIDS.

Treatment for candida skin infection is not significant in healthy individuals. It becomes a significant issue if it affects individuals with compromised immunity, older adults and young kids. Candida skin infection results in an infection that spreads to different parts of the body, majorly in oral Thrush. The parts where it covers include:

• Oesophagus
• Valves of the heart
• Intestines
• Liver
• Lungs

The early you start with the treatment, the outcome is better. To avoid the growth of candida skin infections, taking preventive measures along with first treatment.

Treatment starts, depending on the type of candida infection. It could be oral or cream to be applied.

It takes approximately two weeks for treatment to be useful, but “recurrence” is quite frequent.

Simple guidelines to avoid candida infections includes:

• Wear dry-fit clothes (these clothes move the sweat away from the body and evaporate. This results in dry and comfortable feeling). Dry clothes help remain moisture-free.
• Keep the areas clean and dry, such as armpits, groin areas that are more susceptible to infections.
• After any activity, take a proper shower and dry yourself properly to avoid sweat.
• Important to dry your skinfolds properly, if overweight or obese to avoid any infections.
• To keep the foot warm, wear sandals or foot-wear that are open-toes.
• Regularly change your socks and underwear to avoid infections.
• Essential to immediately change the wet clothes or swimsuits or any work-out clothes that are “sweaty” to avoid infections.
• Important to focus on wearing clothes that are loose fitted.
• On the affected parts, use gentle and scent-free soap.
• To the diet, add probiotic for improvement in the gut bacteria.
• Decrease the quantities of sugar or other sugary beverages from the diet to avoid the growth of infections or micro-organisms.

It is essential to maintain the sugar levels as abnormal blood sugar levels can contribute to the formation of candida infections. Blood sugar levels can be managed by following a proper diet, reducing sugar, work-out or exercise regularly for thirty-minutes minimum three times per week and overall lifestyle changes.

References

1. https://adc.bmj.com/content/67/9/1065
2. https://link.springer.com/article/10.2165%2F00003495-200161001-00001
3. https://www.mdpi.com/2076-2607/5/2/32