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Thrush is a fungal infection caused by Candida yeasts, and especially Candida albicans. It often affects women, but it can occur in men, too.
When thrush occurs in males, it can affect the head of the penis and the foreskin. It can lead to inflammation of the head of the penis, known as balanitis.
Oral thrush affects the mucous membranes, for example, of the mouth.
Fast facts on thrush in men
- Candida normally lives on the skin and mucous membranes, but if too much grows, it can cause symptoms.
- Symptoms include an itchy rash, red skin, swelling, irritation, and itching around the head of the penis, lumpy discharge under the foreskin, or pain when urinating and during sex.
- Risk factors include the use of antibiotics or corticosteroids, immunosuppression, diabetes, poor hygiene, and using too many cleansing products.
- Genital candidiasis is not considered a sexually transmitted infection (STI), but transmission can occur during vaginal intercourse.
- Oral or local antifungal treatments can be used to treat candidiasis.
- Good hygiene practices can help prevent it.
In men, thrush affects the head of the penis and, if present, the foreskin.
It can also occur on other areas of skin or mucous membrane, for example, in the mouth. This is known as oral thrush.
There are often no symptoms, but if inflammation occurs, the following symptoms may appear around the head of the penis:
- itching and soreness
- a blotchy rash with small papules or white patches
- dull red skin with a glazed appearance
- swelling and irritation
There may also be:
- a thick, white, lumpy discharge under the foreskin or in the skin folds, possibly with an unpleasant odor
- difficulty pulling back the foreskin
Pain may be present during sex or when passing urine.
Many mild infections do not require treatment. Some medications are available, and there are also home remedies that may help.
Antifungal topical creams or oral medication may help to relieve symptoms. They are equally effective. Both topicaland oral forms are available from a doctor, over-the-counter at a pharmacy, or online.
According to the Centers for Disease Control and Prevention (CDC), a doctor may prescribe the following drugs:
- Clotrimazole (Lotrimin)
- Econazole nitrate (Specazole)
- Miconazole nitrate (Monistat)
People apply creams topically, directly onto the affected area, usually once a day for 7 to 21 days.
Nystatin is another topical antifungal. It has numerous brand names, but it is less effective than the topical imidazoles.
A man who has not had treatment for thrush previously should see a doctor before treating themselves.
Good hygiene prevents thrush and helps to treat it.
Tips for good hygiene include:
- washing the penis carefully with warm, running water
- not using perfumed shower gels or soaps on the genitals, because they can cause irritation
- drying the penis carefully after washing
- wearing loose-fitting cotton underpants to help keep the genital area dry and cool
In men with a foreskin, poor hygiene underneath it can lead to the build-up of a cheesy-looking substance called smegma. Smegma can cause irritation.
Do probiotics work?
People who get recurrent yeast infections often try probiotics and other alternative treatments containing Lactobacillus bacteria.
There is conflicting evidence about its effectiveness, but laboratory findings published in Biofouling in 2018 suggest that some species of Lactobacillus may reduce the number of Candida cells in some types of candidiasis infection.
However, there is no evidence to suggest that probiotics contribute in any way to the prevention or treatment of Candida infections in men.
Supplements and other products that may help relieve thrush are available for purchase online.
In rare cases, a man with weakened immunity who has genital thrush may develop invasive candidiasis. This is a fungal infection of the blood, and it can cause the fungus to spread throughout the body.
In this way, it can affect different organs in the body, including the brain, the liver, and the heart.
An infection that affects the whole body is systemic. A systemic fungal infection can be fatal, according to the United States National Institutes of Health. and it is a medical emergency.
Emergency treatment in hospital protects organs from the infection while antifungal drugs are administered to kill it.
Sometimes, if a man with weakened immunity develops thrush, he may need to go to the hospital as a precaution.
Factors that increase this risk include:
Candidiasis is caused by a yeast fungus, Candida.
Candida fungi occur naturally inside the body and on the skin, but at levels that do not cause problems. The immune system keeps them in check.
However, if certain conditions disturb the balance, the fungus can thrive, and candidiasis can develop. The fungal cells produce hyphae, structures that penetrate the tissue.
Risk factors that make candidiasis more likely include:
- use of broad-spectrum antibiotics, which can upset the balance of normal microbial flora and allow the Candida to overgrow
- taking medications that suppress the immune system, such as chemotherapy or corticosteroids
- having a weakened immune system, due, for example, to HIV or dialysis
- poorly-managed type-1 or type-2 diabetes, because yeasts thrive more easily in higher levels of blood sugar
- obesity, especially if there are rolls of fat where yeast can thrive
- poor hygiene, especially if a man is not circumcised
- bath foam, soaps, shower gels, lubricants, and other products, which can irritate and damage the skin of the penis, leaving it open to infection
- not drying carefully after washing, because the fungus can thrive in warm, moist conditions
- having a poor diet
Studies show that men who are not circumcised are more likely to develop Candida balanitis.
Is it sexually transmitted?
Doctors do not consider genital candidiasis as a sexually transmitted infection (STI). People usually acquire it through sexual activity, but it can develop without sexual contact. A partner with a fungal infection does not always transmit it.
However, people should avoid unprotected sex with a partner who has thrush until treatment has cleared up the infection.
Thrush may disappear without treatment. However, if it does not go away, and if treatment does not remove the infection, it is important to see a doctor to rule out other possible problems, such as diabetes, which can make infection more likely.
Screening for STIs may be appropriate.
If the rash is severe or if the doctor is unsure of the diagnosis or suspects an underlying cause, they may send a swab from around glans penis and under the foreskin to the lab for testing.
If there are persistent sores or ulcers that do not heal, a biopsy may be necessary.