“Candida Prevention”

The term, “Candida infection”, can mean a number of things.  It can be something as simple as a case of thrush (a mucus membrane infection of the mouth) or something as severe as Candidemia (a blood infection from Candida species), most commonly found in severely ill, hospitalized patients.  In a hospital setting, Candidemia carries a 40% rate of mortality.

In the average person, most Candida infections are somewhere in between. The majority of Candida infections are a one-time event.  For example, many women will develop a Candida vaginal infection sometime during their lifetime and will never again be bothered by another one.  In other people, Candida infections of all kinds can become recurrent and difficult to eradicate. 

There are two situations, however, where one must consider the use of some form of Candida prevention:

As you’ll see, Candida infections involving different body areas may require different prevention strategies.  The prevention strategies used to prevent recurrent mouth infections is far different than what one does to prevent vaginal yeast infections.

High Likelihood Situations

There are several different situations in which an individual is at risk for developing a Candida infection—and possibly a severe infection.

(1) Diabetes: Diabetics or those who are considered “pre-diabetic” are at greater risk for Candida infections, partly because Candida seems to thrive in high sugar environments.  These individuals can benefit from keeping their blood sugar in the best of control and from avoiding sugar in their diet.

(2) Steroids: Those on steroids are relatively immunosuppressed and, if the steroid use must be long term, preventative measures against Candida infection would be beneficial.

(3) Birth Control: Women on birth control pills may want to consider prophylaxis against Candida vaginitis, as this type of infection is often chronic and/or recurrent, depending on the hormone levels.

(4) Antibiotics: Anytime an individual must be on strong or long-term antibiotic therapy, the risk for Candida infections of all types is fairly high.

(5) Immune Deficiency: Those with a true immune deficiency disease, such as HIV or various genetic immunodeficiency diseases, are at an extremely high risk of developing a severe or recurrent Candida infection.  In many cases, prophylaxis against Candida is very important, as Candida in the immunosuppressed is so common.  Once a person like this develops a Candida infection, it becomes both difficult to treat and difficult to prevent a recurrence.

(6) Hospitalization: Those planning major surgery need to consider that the rate of hospital-acquired Candida infections is much higher than it was even ten years ago.  Any planned hospitalization for anything that will temporarily place you in a position of higher susceptibility to Candida, such as surgery, is one for which Candida preventative measures are a good thing.

General Candida Prevention

(1) Good hygiene: Candida is a normal part of our skin flora so that, in truth, it is impossible to get rid of it completely.  Research studies have shown that Candida remains viable (survivable) on both porous and non-porous surfaces and is always on unwashed hands. 

Good handwashing on a regular basis can reduce the risk of transmitting the fungus from one person to another.  This is especially true if one is around children.  A recent study revealed that up to 70% of young children carry significant numbers of Candida in their mouths as compared to only 27% of adults.

(2) Low sugar diet:  If you leave Candida without nutrition to feed on, an infection or overgrowth of the organism is less likely to happen.

(3) Prescription Preventatives:  Doctors use several different kinds of anti-fungal prescription medications as prevention against either recurrent Candida infections or against the development of a single Candida infection in a high risk patient.  The problem with doing this, however, is that the Candida species often develop resistance against the medications so that, if a genuine infection occurs, the anti-fungal medications will be of no help.  There are already trends among hospital-based infections toward more dangerous strains of Candida that are harder to treat.

(4) Probiotics and Prebiotics:  These preparations are quickly taking hold as a valid, medically-proven way to prevent Candidiasis.  Probiotics are an oral form of live bacteria (particularly Lactobacilli and Bifidobacteria) that help the population of microflora in the intestinal tract move away from excesses of Candida and pathogenic (disease-causing) bacteria toward colonies of healthy, non-pathogenic bacteria. 

Researchers have shown that, if the environment inside the intestinal tract is kept healthy, the chance of developing a Candida infection elsewhere in the body is reduced. Prebiotics are small sugar-based molecules (often added to probiotic mixtures) that are indigestible to us but are extremely helpful in the growth and metabolism of healthy bacteria.

(5) Enzymes:  Enzymes are directed at the cell wall and outer coating of the Candida organism. While the use of enzymes like chitinase, cellulase and other proteolytic enzymes for the prevention of intestinal Candida overgrowth is less well studied, these enzymes are readily available and reasonable choices for Candida prevention.  There are some probiotic formulations that have these enzymes included in the combination.  

Condition-specific Measures

(1) Infant thrush: Infant thrush, if recurrent, can be prevented by boiling all toys, nipples and pacifiers at the time the child is being treated for an active infection.  In breastfed babies, the mother may need local treatment to her breasts or even systemic therapy to reduce the chance of reinfection of the child’s mouth during breastfeeding. 

Washing the breast with plain water and drying it carefully after feeding may help as well.  If thrush becomes a serious, recurrent problem, consider seeing a specialist as recurrent thrush can be a sign of immune deficiency in the child.

(2) Candida diaper dermatitis:  Diapered babies have a high risk of developing recurrent diaper rash caused by Candida.  Frequent diaper changes, changing the diaper as soon as it becomes soiled and using a non-detergent baby wipe to wash the baby will all help reduce the risk. 

If necessary, removing the diaper for a period of time or using cloth diapers without rubber pants can prevent recurrences.  Creams and ointments, such as zinc oxide and petrolatum jelly (with or without Vitamins A and D), keep moisture away from the baby’s skin so that Candida is less likely to grow.

In both of the above situations, babies in some areas of Europe can find Candida prevention by drinking readily-available infant formula to which probiotics have been added.  Research has found its use to be as beneficial to a baby’s health as is breast milk.

(3) Candida vaginitis: The prevention of vaginal Candidiasis includes employing many of the general Candida prevention measures.  For example, if a woman uses birth control pills, a change to another form of birth control may help.  Avoiding clothing that is tight and/or made of polyester, including nylons, will allow the vaginal area to “breathe” better, decreasing the risk of a Candida infection. 

In addition, discontinuing the use of condoms containing nonoxynol-9 (a spermicide) will lower the infection risk.  During an active infection, treating the sexual partner at the same time may also help. In some cases, periodically douching with a dilute vinegar solution, boric acid solution or diluted hydrogen peroxide alters the vaginal environment, making it unfavorable for Candida to grow.

In summary, the prevention of Candida infections can involve a simple home remedy, an alternative medical preparation or strong anti-fungal therapy.  Even simple handwashing can reduce one’s risk.  The preventative(s) you choose will depend on the nature and severity of any underlying conditions, the frequency of the particular infection and the part of the body that is normally infected.

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