Dermatology-Online

Yeast fungi on the skin

What is yeast on the skin?

Yeast fungi is a genus of fungi that includes the fungi Candida albicans, Cryptococcus neoformans and Malassezia furfur. They are also referred to as mushrooms. Yeasts can be found on the skin without this having any disease value, as part of the natural skin flora.

If they cause symptoms, it is usually something called an opportunistic infection. These are infections that occur in states of increased vulnerability of an organism, for example in the case of an immune deficiency or other previous illnesses.
So yeast fungi on the skin are initially not a disease and do not need to be treated.
Yeasts only become a problem that requires treatment when symptoms arise.

Read more on the topic: Yeast infection

Causes of Infection

As soon as the yeast on the skin causes symptoms, it is a skin fungal disease that should be treated. In this context, one speaks of opportunistic infections. Pre-existing diseases, immune deficiencies and other factors can lead to the balance of the skin flora shifting in favor of the yeast fungi and these multiplying unchecked. Then symptoms arise.
The following section describes the different yeasts and their causes:

Candida albicans - skin candidiasis:

The yeast Candida albicans is the most common causative agent of skin candidiasis and is almost exclusively found in humans. The fungus can be detected on the skin of up to 30% of healthy people and has no disease value.

Changes in the skin flora or an immune deficiency can lead to over-colonization with the fungus.
The main risk factors for so-called candidiasis are immune-weakening diseases such as diabetes mellitus, HIV and tumors. Patients who take drugs that weaken the immune system are also at risk.
These include glucocorticoids or cytostatics.
Even after an organ transplant, the risk is increased due to medication that suppresses the immune system.

The fungus can spread easily in skin folds and in a damp environment, which is why too tight clothing, excessive sweating and excess weight promote candidiasis of the skin.

Read more about this clinical picture at: Candidiasis
Malassezia furfur - Pityriasis versicolor:

The yeast Malassezia furfur is part of the natural human skin flora. In some cases, it can cause a fungal skin infection called pityriasis versicolor.
The risk of the fungus spreading like this increases with stress and overweight.
In addition, such pityriasis is found more frequently in patients who suffer from so-called seborrheic dermatitis.
Heavy sweating and hot and humid climates also promote this.

Read more about this clinical picture at: Pityriasis versicolor

diagnosis

The diagnosis of a skin fungus caused by yeast is made by a dermatologist.
First of all, the dermatologist looks at the skin changes and assesses their appearance, as well as accompanying symptoms (inspection). A closer cause can often be narrowed down on the basis of the appearance.

If yeast is suspected, important risk factors such as previous immune-weakening diseases (HIV, diabetes mellitus) and medication (glucocorticoids, cytostatics) are inquired about.

Further dermatological examinations provide more detailed information about the type of fungus:

If a Candida infection is suspected, a small sample can be taken in the form of a smear.
The mushrooms can be colored using a special coloring (Gram coloring) and displayed under a microscope.
If over-colonization with the fungus Malassezia furfur is suspected, the dermatologist can observe the skin changes under the so-called Wood light.
The Wood light is an examination method in which you look at the skin changes under a special light in a darkened room.
Typically, these appear yellow-ocher in pityriasis.

The wood chip phenomenon can still be triggered in the investigation. When brushing the skin changes, fine, whitish scales develop. The fungus can also be detected microscopically.

Concomitant symptoms

First of all, yeast fungi on the skin do not lead to discomfort or symptoms. As part of the natural flora of the skin, the yeasts do not cause any damage and they are not even noticed by those affected.

In certain cases, however, symptoms can arise when the skin balance shifts in favor of the fungi.
This can cause various accompanying symptoms:

Candidiasis of the skin can be accompanied by itching and pain.
Pain is mainly caused by the fact that the skin becomes soft and cracked.
The skin candidiasis occurs preferentially on skin folds and in the spaces between fingers and toes. The softening of the skin is also known as maceration.

Mucous membranes can also be affected (vaginal candidiasis, oral candidiasis).

Read more about Candida Albicans infection in the oral cavity: Oral thrush

In severe cases, the fungus can affect internal organs. The esophagus is most commonly affected. One then speaks of thrush esophagitis, which can be associated with swallowing disorders and pain when swallowing.

Pityriasis versicolor does not usually lead to symptoms apart from the typical skin changes. A feeling of tension in the skin or slight itching can rarely occur.

skin rash

A skin rash (exanthema) in the narrower sense is only the appearance of large areas of similar skin changes. As a rule, yeasts do not cause skin changes on the entire skin or on most of the skin, but rather in specific areas.
Therefore, strictly speaking, they are not rashes.

Since such skin changes are usually also referred to as rashes in the vernacular, the typical skin changes are briefly presented at this point:

Yeasts of the Candida genus typically lead to red spots on the edges of which pustules are often found.
In the spaces between the toes and fingers, Candida continues to cause whitish softening of the skin and cracks.
The fungus Malassezia furfur, on the other hand, causes irregular brownish spots that are discolored by sunlight and then look whitish.
This change of color leads to the name Pityriasis versicolor.

Not sure if your rash is actually caused by a yeast infection? Read about other possible triggers:

Rash - These are the diseases behind it

How are yeasts on the skin treated?

Yeast fungi on the skin are treated differently depending on the type of fungus.

In the case of so-called pityriasis versicolor, which is caused by the yeast Malassezia furfur, local therapy with shampoos containing azole is carried out. Azoles kill the fungus.
The shampoo must be applied to the entire body, including the scalp, and left on overnight.The next morning it can be showered off.
The therapy takes place on several consecutive days. Usually a repetition is necessary after a few weeks.

For stubborn cases, the fungus is treated with tablets that contain azoles.
The treatment of skin candidiasis is also based primarily on local measures. For this purpose, ointments with various fungicidal agents such as clotrimazole, nystatin or ciclopirox are available. It is also important to keep the affected areas dry and well ventilated.
Profuse sweating and tight clothing should be avoided.

Oral therapy with fluconazole or caspofungin must be given in the case of persistent candidiasis or an additional infestation of internal organs, as well as previous immune-weakening diseases.

Which ointments are used?

Various ointments with antifungal agents are used to treat skin changes caused by yeast.
These are ointments that kill the fungal cells.

These are mainly used for candidiasis of the skin. The ointments can contain the active ingredients ciclopirox, nystatin or clotrimazole.

Which medications can help?

Antifungal drugs must be used to treat skin fungi. These are also known as antimycotics in technical terms.

The active ingredients ciclopirox, nystatin or clotrimazole are used to treat candidiasis.
These are suitable for local therapy of skin changes with ointments.
The antifungal agents fluconazole, caspofungin or, in severe cases, amphotericin B are also suitable for internal therapy with tablets.
Azole antimycotics such as clotrimazole or ketoconazole are used for pityriasis versicolor.

Would you like to know more about the proposed drugs, their effects, side effects and use? Read our article for this

Fungal infection drugs

Which home remedies can help?

Home remedies should not be used to treat fungal diseases of the skin.

Unfortunately, you cannot kill the fungus and therefore cannot cure it. The exclusive self-treatment with home remedies only delays the start of therapy and thus also the healing.
The application of vinegar, garlic or lemon to the skin should be avoided, as this can further promote skin damage.

How contagious are yeasts on the skin?

In most cases, yeasts are part of the natural human skin flora, but they can also be transmitted from person to person.

The fungus Malassezia furfur, which causes pityriasis versicolor, is practically non-contagious. It is found on healthy skin in most people and only spreads excessively on the skin if there are existing risk factors.

It is basically the same with candidiasis of the skin. Although the fungus can be transmitted through skin contact, it is found on healthy skin in almost a third of people.
Even transmission of the fungus cannot be equated with infection.
Candidiasis of the skin can only develop if risk factors are present.

For more information, also read the article:

How contagious are yeasts?

What can you do to avoid becoming infected?

The best measures to avoid contracting a yeast fungus are to follow certain behavioral and hygiene measures.
If a person is suffering from candidiasis skin changes, they should not be touched.

Furthermore, you should refrain from sharing laundry and towels.
If you live in the same household, the laundry should be washed with a disinfecting hygienic rinse according to the manufacturer's instructions.

How long do yeasts stay on the skin?

As a rule, yeasts remain on the skin for a lifetime even after therapy.
However, this is not a bad thing.
As part of the natural skin flora, they are primarily not to be assessed as pathological.

If they cause symptoms, the duration of the symptoms depends on various factors such as the start of therapy, previous illnesses and adherence to therapy.
Complete healing can take around 7 to 14 days with consistent therapy.
However, after successful therapy, fungal disease can recur.

What are the special features of a yeast on the scalp?

The scalp can be colonized by the yeast Malessezia furfur.
First of all, this has no disease value.

However, if the fungus leads to pityriasis versicolor, the scalp must always be treated in order for the therapy to be successful.
Azole-containing shampoos are available for treatment and can be used all over the skin, including the scalp.
However, there are usually no symptoms on the scalp itself. When brushing the scalp, it can only cause slight flaking.