Yeast Infection (Candida Infection)

What a yeast infection is

Candida lives in small numbers in most people without causing problems. Bacteria, especially lactobacilli in the vagina, and the immune system keep it in check. When that balance is disturbed, yeast multiplies and invades the surface layers of skin and mucous membranes, causing inflammation.

Candida albicans causes most infections. Other species such as Candida glabrata are more common in recurrent or treatment-resistant infections and may need different medicines.

A yeast infection is not a sexually transmitted infection, although it can occasionally pass between partners. Detailed pages cover vaginal yeast infections, oral thrush and all forms of candidiasis.

Yeast infection symptoms by body area

Yeast infection vs bacterial vaginosis vs trichomoniasis

Many people who think they have a yeast infection actually have another cause, which is why testing is useful the first time.

Causes and risk factors

• Antibiotics, which kill protective bacteria
• Diabetes, especially when blood sugar is high
• Pregnancy and higher-estrogen birth control or hormone therapy
• Weakened immunity: HIV, chemotherapy, steroids, transplant medicines
• Moisture and friction: sweating, obesity, tight non-breathable clothing, wet swimsuits
• Inhaled steroids (for thrush), dentures and dry mouth
• Douching and scented feminine products

Diagnosis

Clinicians usually diagnose a yeast infection from symptoms and an exam. For vaginal symptoms, a swab tested with a pH strip and a microscope confirms yeast and rules out BV and trichomoniasis. A culture or PCR is used for recurrent or resistant infections to identify the species. Skin scrapings can confirm skin infections. Blood sugar testing is advised for recurrent infections without a clear trigger.

How to get rid of a yeast infection

Vaginal yeast infection

• Over-the-counter azole creams or suppositories: miconazole, clotrimazole or tioconazole, in 1-day, 3-day or 7-day courses. Follow the label directions. Longer courses may be gentler and work better for severe symptoms.
• Prescription fluconazole tablet: a single oral dose for uncomplicated infection; a second dose a few days later for severe symptoms.
• In pregnancy: use a 7-day topical azole; avoid oral fluconazole unless a doctor advises otherwise.
• Symptoms usually improve within 2 to 3 days and clear within a week.

Creams and suppositories can weaken latex condoms and diaphragms.

Penis

An antifungal cream such as clotrimazole twice daily for 1 to 2 weeks, plus keeping the area clean and dry. Partners of people with vaginal yeast infections do not routinely need treatment unless they have symptoms.

Skin and diaper area

Antifungal cream (clotrimazole, miconazole or nystatin) 2 to 3 times a day until the rash clears and for a few days more. Keep folds dry with absorbent cloth, and change diapers often with diaper-free time.

Mouth

Nystatin liquid or miconazole gel, or fluconazole tablets for adults. See a doctor for thrush in adults without an obvious cause.

Recurrent yeast infections

Recurrent vulvovaginal candidiasis means 3 or more symptomatic infections in a year. It needs a confirmed diagnosis with a culture to check the species. Treatment typically includes a longer initial course, then weekly fluconazole for 6 months under medical supervision. Non-albicans species may need other options such as boric acid suppositories (never swallowed, and not used in pregnancy). Controlling blood sugar and reviewing hormones and medicines also helps.

Prevention

• wear breathable cotton underwear and avoid tight, damp clothing
• change out of wet swimsuits and sweaty workout clothes promptly
• avoid douching, scented soaps, sprays and bubble baths in the genital area
• keep blood sugar well controlled if you have diabetes
• rinse your mouth after using a steroid inhaler
• dry skin folds thoroughly after bathing

Evidence that probiotics or yogurt prevent yeast infections is limited.

Frequently asked questions

What are the first signs of a yeast infection?

Vaginal yeast infections usually start with itching and irritation of the vulva, followed by burning, redness and a thick white discharge. Skin infections begin as an itchy, red, moist rash in folds. Oral thrush starts with white patches and soreness in the mouth.

Can men get yeast infections?

Yes. Men can develop yeast infections of the penis (balanitis), groin and skin folds. They are more common in uncircumcised men and those with diabetes. Symptoms include redness, itching, soreness and white patches. A doctor should check recurring infections.

How long does a yeast infection last?

With treatment, most vaginal yeast infections improve in 2 to 3 days and clear within a week. Mild infections sometimes resolve without treatment, but symptoms can last longer. If symptoms persist after treatment, see a doctor to confirm the diagnosis.

Is a yeast infection an STI?

No. Yeast infections are caused by overgrowth of fungi that normally live in the body. They are not considered sexually transmitted, although sex can occasionally trigger or pass on yeast. Symptoms that do not respond to treatment should be checked for STIs.

How can I tell if it is a yeast infection or BV?

Yeast infections cause intense itching and thick, white, odorless discharge. Bacterial vaginosis usually causes thin, gray discharge with a fishy odor and little itching. They need different treatments, so if you are unsure, a quick swab test at a clinic gives the answer.

Why do I keep getting yeast infections?

Common reasons include frequent antibiotics, uncontrolled diabetes, hormonal changes, a weakened immune system or a less common Candida species that resists standard treatment. Sometimes the problem is not yeast at all. A doctor can culture the discharge and plan longer-term treatment.