What is thrush?
Thrush is caused by a yeast-like fungal infection commonly known as Candida Albicans. It often affects women, however, it can occur in men as well.
The effect of thrush in men is that it causes inflammation on the head of the penis and the foreskin (prepuce), also known as balanoposthitis.
If it occurs in other areas of mucous membranes; for example in the mouth, this is known as oral thrush.
Is it sexually transmitted?
Genital candidiasis is not considered as a sexually transmitted infection (STI), but transmission can occur through sexual activity. Although, a partner with a fungal infection does not always transmit it, people should avoid unprotected sex with a partner who has thrush until treatment has cleared up the infection.
Symptoms
Thrush can affect both men and women. In men, thrush usually affects the head of the penis, with symptoms being similar to those of vaginal thrush such as:
- Swelling, irritation, itching and soreness around the head of penis
- Rash with small papules, white patches or red skin
- Lumpy, thick, white discharge or a ‘cheese-like’ substance under the foreskin or in the skin folds, sometimes with an unpleasant odour.
- Difficulty pulling back the foreskin
- Pain when urinating and during sex.
How to diagnose thrush
It’s often diagnosed clinically. However, if the rash is severe, we may send a swab from around glans penis and under the foreskin to the lab for testing. If there are ulcers or sores that are persistent, a biopsy may be necessary.
Screening for other Sexual Transmitted Infections (STIs) may be appropriate.
Who is at risk to male thrush?
Candida Albicans tend to multiply in moist and warm conditions and it can grow naturally in healthy individuals. This is why men are less vulnerable to this condition since it doesn’t reproduce well on the head of the penis especially in circumcised men.
Furthermore, as thrush is not a sexually transmitted infection, not every man who comes in contact with vaginal thrush will be affected by thrush.
However, there are few groups of men who are particularly vulnerable such as:
- Uncircumcised men
- Men with a foreskin constriction
- Men with a weakened immune system – for example those on corticosteroids, immunosuppression, and those with diabetes mellitus.
- Poor hygiene, or using too many cleansing products.
- Use of broad-spectrum antibiotics, which can upset the balance of normal microbial flora and allow the Candida to overgrow
How to treat thrush?
Practising good hygiene can help to clear up the infection if you have thrush in and around the penis. Those who had not been treated for thrush previously should see a doctor before treating themselves. There are few antifungal topical creams or oral medication that may help relieve the symptoms and treat the infection. Both topical and oral forms are available in our clinic.
In most cases, we prescribe the creams based on the Centers for Disease Control and Prevention (CDC) which can be applied topically, directly onto the affected area for 7 to 21 days.
They can also be used for prevention other than treating fungal infections. In certain instances, we might need to be started on oral antifungal tablets such as:
- Fluconazole (Diflucan)
- Itraconazole (Sporanox)
Tips to Prevent Thrush
- Clean your penis regularly and use a condom while being intimate with your partner (if they have thrush).
- Make sure to dry your penis properly after washing because the fungus can thrive in warm and moist conditions.
- Avoid using aggressive perfumed soaps or shower gels which can cause irritation on your genitals.
- Wearing loose-fitting cotton underwear to prevent moisture building up under your foreskin.
