Internal Medicine

Penile fungus - candidiasis in men

introduction

Cancidosis in men usually refers to a genital fungus.

This is usually attached to the foreskin and glans of the penis. In most cases, the Candida fungus is responsible for the infection. The most common pathogen is the genus Candida albicans.

Typically, these infections are more prevalent in immunocompromised people. These include diseases such as leukemia and HIV, but also diabetes or the use of drugs that shut down the immune system can cause an immune deficiency.

The penis fungus can usually be recognized by the whitish coatings on the foreskin and glans.

Treatment of a penis fungus

Treatment of penile fungus can usually be limited to local medication.

So-called antimycotics are used. These anti-fungal agents are applied several times a day to the glans and foreskin and kill the offending fungus.

Regular thorough cleaning of the glans is also important. The foreskin should be pulled back as far as possible. The whitish deposits can be removed with a piece of toilet paper.

Therapy is of particular importance when candidiasis in men is not limited to the penis. In this case, systemic antifungal therapy in the form of infusions is appropriate.

In addition, a cause (usually an underlying systemic disease) for the spread of the fungal infection should be sought and treated. Systemic therapy is usually carried out using antimycotics that are given directly into the vein, which is why an inpatient stay is usually possible for treatment. In addition, there are drugs that treat the underlying disease.

In the case of diabetes, for example, these are antidiabetic drugs; in the case of HIV, so-called antiretroviral therapy is started. Cancer diseases usually have a very special and individual therapy scheme, which is put together by a competent oncologist.

Which doctor treats penile fungus?

You can first present yourself to your family doctor with the symptoms of candidiasis.

This usually decides whether to start symptomatic therapy or whether a further examination of the symptoms makes sense. The further examinations below are carried out by a urologist.

This is generally responsible for the urinary tract and the organs involved; in men, the urologist also treats the genital organs.

If there is a systemic disease, doctors from other specialties may be called in. In the case of cancer, oncologists are the treating physicians; in the case of diabetes, an endocrinologist is responsible for treating the underlying disease.

Healing time of a penis fungus

In the case of a purely local infestation with the penis fungus, an improvement in the symptoms can be expected after a few days.

It may take a week or two for the symptoms to go away completely. How long the healing takes depends on the frequency and thoroughness of the therapeutic measures.

The start of treatment also plays a role. If you start the therapy immediately after the onset of the fungal infection, the healing is faster and less complicated than if you only start treatment after a few days or even weeks.

Sexual intercourse should be avoided during the healing phase. However, candidiasis is particularly stubborn when it not only occurs locally on the penis but also spreads throughout the body. Such systemic spread is rather rare in people with a healthy immune system. This spread can occur more frequently in people with immunodeficiency. Due to the weakened immune system, one must expect delayed healing of several weeks or even a few months.

Medicines against penile fungus

In most cases, locally effective drugs can be given against penile fungus. The active ingredients are called antimycotics (= anti-fungal agents).

They are usually applied to the foreskin and glans penis as an ointment. Usually they are quickly absorbed by the genital mucous membrane and can develop their effect there very locally. The advantage of local therapy is that the microbial balance in the rest of the body is not disrupted. Typically, drugs such as Ampho-monoral® (Amphotericin B), Itraconazole or Fluconazole are used.

If candidiasis in men is not limited to the genital area, a systemic fungal infection must be expected. In this case, systemic therapy is also necessary, in which the antifungal agent can act throughout the body. These drugs are usually given through the vein. Amphotericin B is also used here, and triazole antimycotics can also be taken. Nystatin is also an effective drug against the fungal infection. If necessary, caspofungin is used.

Treatment of the underlying disease is also important. Antiretroviral therapy works against HIV, for example. In the case of diabetes, antidiabetic drugs and, if necessary, insulin must be taken. In oncological diseases, a combination of chemotherapeutic agents, sometimes antibodies and possibly radiation and surgery, is usually effective.

What are the causes of penile fungus?

The type of yeast that cause candidiasis in men are usually found naturally on the skin.

One speaks of a so-called normal skin flora. Physiologically, the mucous membranes can already carry the fungus on them.

The fungi are usually in a natural balance with other germs (mostly bacteria). Normally, the bacteria and fungi even protect the skin and mucous membranes.

Only when the normally present mixture of germs is out of balance can a real infection develop. Typical causes for such a disturbance of the balance can be various systemic diseases.

These include, for example, diseases that weaken the immune system, as is the case with HIV and some cancers. However, taking drugs that affect the immune system can also cause penile fungus.

In addition, diseases such as diabetes (blood sugar disease) also have an effect on the immune system's ability to defend themselves and thus promote the onset of such candidiasis.

However, the penis fungus can also be transmitted to the man during unprotected sexual intercourse. If such a new fungus gets into the natural flora of the genital mucous membrane, the germ balance can also upset and infection occurs.

Often this happens especially during phases of physical or physical stress. A narrowing of the foreskin also has a positive effect on men, as this makes cleaning the glans more difficult and the germs can grow undisturbed.

Diagnosis of penile fungus

The diagnosis of candidiasis in men is usually made by the family doctor or urologist.

First, an anamnesis is taken. The doctor asks the person concerned about their symptoms, their duration and the special risk factors for penile fungus.

This is followed by a physical examination of the penis, which may reveal reddening and swelling of the glans. If candidiasis is suspected, a smear should be taken, which can be examined microbiologically. This enables the specific pathogen to be detected and thus influences the choice of therapy.

Read more about this at:

Swollen glans - what's behind it?
Reddened glans - what is the cause?

Accompanying symptoms of penile fungus

The penis fungus manifests itself primarily through whitish coatings on the glans and penis foreskin. These are usually easy to remove, but quickly re-form.

The infection also often leads to an inflammatory reaction. This manifests itself as swelling and reddening of the affected mucous membranes. Pain and overheating of the penis can also occur. Often times, these inflammation symptoms are accompanied by itching.

Read our article on this: Red spots on the glans - how dangerous is it?

In addition, burning or pain occurs in the glans especially when urinating or during sexual intercourse. In addition to the whitish deposits, a purulent discharge can also be noticed.

In addition, small, fluid-filled vesicles occasionally form on the glans. Depending on whether a systemic disease affecting the whole body is the cause of the Candida infection or not, additional symptoms may arise from the underlying disease.

With immune-weakening diseases, you are also susceptible to other diseases such as bacterial or viral infections. Candidiasis can also spread to the internal organs, especially if the immune system is weak. In the course of this it can lead to liver damage, heart muscle inflammation or pneumonia or even to inflammation of the meninges.

Pain from a penile fungus

Pain is a typical symptom of candidiasis in men.

The foreskin and the glans are most affected by the penis fungus, so this is where the pain occurs. They're usually a sign that the fungal infection has caused inflammation of the genital lining.

The pain can occur at rest, but it is also occasionally noticeable if there is additional irritation of the glans, for example from tight underwear. The penis fungus can also cause symptoms such as pain or a burning sensation when urinating and during sexual intercourse.

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