Candida (Skin & Oral) 🍄
UK guide to cutaneous and oral Candida infection: scope, clinical diagnosis, self-care, and when to refer. Antifungal choices via linked NICE CKS topics.
📖 Scope
- This topic covers antifungal treatment for cutaneous and oral Candida infection.
- Genital thrush (male and female), nipple thrush, and angular cheilitis are outside the scope of this topic.
- Systemic Candida infection, Candida infection of the ear canal, and oesophageal candidiasis are outside the scope of this topic.
- Oesophageal candidiasis can be associated with immunocompromise including HIV infection and requires further investigation and referral to an appropriate specialist.
🧠 Diagnosis & general advice
- Diagnosis is generally made on clinical grounds.
- In case of treatment failure, it may be necessary to send samples for fungal culture.
- Review modifiable risk factors in case of recurrence and refractory disease.
💊 Management
- Confirm cutaneous and/or oropharyngeal candidiasis only; refer if outside scope (see above).
- Choose antifungal treatment using UK primary care guidance for the presentation (links below). Confirm against your Trust formulary and antimicrobial stewardship advice.
- Address self-care and modifiable risk factors (see below).
- Refer if recurrent cutaneous or oropharyngeal disease, treatment failure, or concern for underlying immunocompromise.
🏠 General advice for self-care
- Cutaneous candidiasis, self-management: Candidiasis is particularly likely to affect flexures in warm weather especially in those living with obesity. Keeping these areas dry, particularly skin folds, can help prevent recurrence.
- Oral candidiasis, self-management: Practice good oral hygiene; brush teeth regularly; use warm saline water as a mouth wash; avoid use/overuse of antiseptic mouthwashes, as they alter the flora of the mouth; rinse mouth out with water after using a steroid inhaler; smoking is a risk factor for oral candidiasis and smoking cessation should be considered.
- Denture wearers: clean dentures with an anti-candidal preparation, such as 1% sodium hypochlorite solution; remove dentures overnight.
Educational reference only. Medical disclaimer