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Candida and Psoriasis: The Connection With Yeast Infections

Posted on September 14, 2022
Medically reviewed by
Ariel D. Teitel, M.D., M.B.A.
Article written by
Simi Burn, PharmD

If you have psoriasis, you may experience related conditions that also affect the skin — like candidiasis, or Candida infections. Although more studies need to be done to understand the relationship between psoriasis and candidiasis, researchers have established several connections between the two conditions.

Studies in the journal Mediators of Inflammation have found that people with psoriasis are more likely to experience candidiasis, that candidiasis may trigger psoriasis flares, and that antifungal medications may trigger psoriasis. Furthermore, certain biologics used to treat psoriasis may increase the risk of developing candidiasis.

Read more about biologics for psoriasis.

On MyPsoriasisTeam, the online social support group for people with psoriasis, members share their questions and experiences with candidiasis. “It’s not a great day,” one member wrote. “I have a doctor’s appointment for fungal infections, which are making me miserable. Does anyone else struggle with fungal infections?”

Another member shared, “I have suffered from psoriasis since I was 13 years old. It started with a severe sore throat. Over the years, I started to develop candidiasis.”

“The thought that a yeast infection could be the underlying cause of my symptoms never crossed my mind,” a member shared. “I’ve had oral thrush for years and did not pay it any attention.”

Read on for more information about the connection between psoriasis and candidiasis.

What Is a Candida Infection or Candidiasis?

Candida is a yeast (a type of fungus) that normally lives on the skin, mouth, and digestive tract without causing any health problems. When Candida grows out of control, an infection called candidiasis results. Candidiasis is a fairly common infection and is typically caused by a candida species called Candida albicans.

Candida infections can affect the mouth, throat, vagina, diaper area in babies, skin, or nails. When it occurs in the mouth, it’s called thrush. Symptoms of thrush include:

  • White, curd-like lesions or bumps on the tongue, inside the mouth, or on the throat
  • Redness or soreness in the mouth or throat
  • Pain or difficulty when swallowing
  • Bad breath

A Candida infection in the vagina is called a yeast infection. Symptoms of vaginal yeast infections include:

  • Vaginal pain, itching, or soreness
  • Pain or discomfort when urinating
  • Abnormal vaginal discharge

Symptoms of candidiasis in other parts of the body may produce inflamed, itchy skin, dry skin, raised patches or plaques, and pus-filled bumps. These symptoms can be similar to those of psoriasis, which include scaly plaques; dry, itchy skin; and a patchy discolored rash.

Candida infections can also affect the nails. A condition in which the nail separates from the nail bed, called nail onycholysis, is common in people with candidiasis. This condition is also common in people with plaque psoriasis.

Candidiasis can also cause severe systemic infections of the bloodstream, called invasive candidiasis, but this type of infection is rare.

What Is the Link Between Psoriasis and Candida?

Scientists have found several connections between psoriasis and Candida, and research is ongoing to further understand these relationships. Both psoriasis and candidiasis affect the skin. They also both interact with the immune system. Candidiasis is a fungal infection, so it activates the immune system and takes hold when the immune system is suppressed. Psoriasis, on the other hand, is generally triggered and worsened by an overactive immune system.

Presence of Candida in People With Psoriasis

Several research studies suggest that people with psoriasis are more likely to have Candida in their bodies as compared to people without psoriasis.

One study compared levels of Candida between people with and without psoriasis. The researchers found that people with psoriasis were more likely to have Candida in their mouths and on their skin compared to those without psoriasis.

A study in the International Journal of Dermatology showed that people with psoriasis also had lower levels of immune system antibodies (blood proteins that help the body fight off infections) against Candida. These results suggest that people with psoriasis may have a lower immune system response to protect against Candida infection.

A study from the Journal of the American Academy of Dermatology found that 26 percent of participants with psoriasis also had oral candidiasis, but none of the 140 participants without psoriasis had these infections. The study also found a connection between the severity of psoriasis and the amount of candida — meaning that people with more severe psoriasis symptoms had higher levels of Candida.

Another large systematic review and meta-analysis found that levels of Candida were much higher in people with psoriasis as compared to those without psoriasis. Levels were especially high in the mouth and throat. These findings led the researchers to suggest that having psoriasis may increase one’s risk of Candida presence and infection.

Candida as a Psoriasis Trigger

Psoriasis is a chronic autoimmune condition. Symptoms typically get worse (called a flare or flare-up) and become less intense. Although the exact cause of psoriasis is unclear, it is triggered by certain environmental and biological factors. For example, skin infections or strep throat have been found to trigger psoriasis.

The Candida fungus has been found to trigger the production of cytokines (proteins that play a role in activating the immune system). This process can trigger psoriasis inflammation in the skin, causing psoriasis symptoms to flare.

A research study looked at the amount of different fungal infections in people with psoriasis and found a high presence of candidiasis fungal infections. Researchers concluded that fungal infections may play a role in triggering psoriasis. They also suggested that antifungal drugs, in addition to anti-inflammatory drugs, could be useful for managing psoriasis.

Antifungals as a Psoriasis Trigger

There may also be a connection between some types of antifungal medications and psoriasis. One study looked at people who used the antifungal drugs terbinafine (which is not typically used for Candida infections) or itraconazole (which is typically used for Candida infections like thrush).

People using these medications had an increased risk of psoriasis as compared to those who weren’t using them. However, the researchers concluded that more research needs to be done to better understand and confirm any connection between antifungal use and psoriasis.

Psoriasis Treatments and Candida

Some treatments for psoriasis have been found to increase the risk of Candida infections in people with psoriasis.

Biologics

Biologics target the immune system to help psoriasis symptoms. The three main types of biologics used for psoriasis include tumor necrosis factor-alpha (TNF-alpha) inhibitors, interleukin-23 (IL-23) inhibitors, and IL-17 inhibitors.

People who take biologics for psoriasis and other autoimmune diseases may have a higher incidence of Candida and other infections. However, the overall risk of Candida infection is still low. The benefits of treating psoriasis with biologics usually outweigh the risks of a yeast infection — which can be managed without changing the psoriasis treatment regimen.

Topical Corticosteroids

Topical corticosteroids used for psoriasis treatment can reduce the skin’s ability to fight different types of infections. The use of a topical steroid for psoriasis may increase the risk of infections like those caused by Candida.

Managing Candida Infections With Psoriasis

Some researchers believe that people with psoriasis should be regularly screened for Candida infection. If you have symptoms or are worried about a Candida infection, tell your health care provider or a dermatologist about it right away. They can perform tests to see if it’s candidiasis or a different type of infection.

Treatment

The treatment of candidiasis is typically the same for people with or without psoriasis. Treatment options depend on the type and severity of the infection. It usually involves a topical antifungal cream like clotrimazole (Mycelex) or nystatin (Mycostatin). For more severe candidiasis, an oral medication called fluconazole (Diflucan) may be given.

Prevention

When it comes to Candida infections, prevention is also essential. Measures to prevent candidiasis include maintaining good oral hygiene (brush your teeth twice a day and visit a dentist regularly) and physical hygiene (keep your skin clean and dry). It’s also important to manage stress and medical conditions associated with a higher risk of candidiasis like cancer, HIV, or diabetes.

Talk With Others Who Understand

MyPsoriasisTeam is the social network for people with psoriasis and their loved ones. On MyPsoriasisTeam, more than 111,000 members come together to ask questions, give advice, and share their stories with others who understand life with psoriasis.

Are you living with psoriasis? Have you experienced a Candida infection? How did you manage it? Share your experience in the comments below, or start a conversation by posting on your Activities page.

All updates must be accompanied by text or a picture.
Ariel D. Teitel, M.D., M.B.A. is the clinical associate professor of medicine at the NYU Langone Medical Center in New York. Review provided by VeriMed Healthcare Network. Learn more about him here.
Simi Burn, PharmD is a seasoned pharmacist with experience in long-term care, geriatrics, community pharmacy, management, herbal medicine, and holistic health.. Learn more about her here.

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