Thrush is a yeast infection that causes white patches in the mouth and on the tongue. Thrush is most common in babies and older adults, but it can occur at any age. Thrush in babies is usually not serious.
You get thrush when a yeast called Candida, normally found on the body, grows out of control.
In babies, Candida causes thrush because babies' immune systems are not yet strong enough to control the growth of the yeast. Older people get thrush because their immune systems can weaken with age.
Some people get thrush when they take certain medicines, such as antibiotics or inhaled corticosteroids. People who have certain health problems, such as diabetes or HIV, are also more likely to get thrush.
The most common symptoms of thrush are white patches that stick to the inside of the mouth and tongue.
In babies, it is easy to mistake thrush for milk or formula. It looks like cottage cheese or milk curds. Don't try to wipe away these patches, because you can make them red and sore. Some babies with thrush can be cranky and do not want to eat.
Talk to your doctor if you think you or your child has thrush.
In most cases, doctors can diagnose thrush just by looking at the white patches. Your doctor will also ask you questions about your health. If your doctor thinks that another health problem, such as diabetes, may be related to your thrush, you may also be tested for that condition.
Thrush is usually treated with prescribed antifungal medicine such as nystatin liquid. In most cases, you will put the medicine directly on the white patches. When a baby has thrush, the yeast can cause a diaper rash at the same time as thrush. Your doctor may prescribe nystatin cream or ointment for his or her diaper area.
To treat thrush in adults, at first you will probably use medicine that goes directly on the white patches. If these medicines don't work, your doctor may prescribe an antifungal pill.
If your baby has thrush, it may help to:
If you wear dentures and have thrush, be sure to clean your mouth and dentures every night. You can soak them overnight in a denture cleaner that you buy at the store. Rinse your dentures well after soaking them.
Learning about thrush:
Candida, the yeast that causes thrush, is normally present in small amounts in the mouth and on other mucous membranes. It usually causes no harm. But when conditions are present that let the yeast grow uncontrolled, the yeast invades surrounding tissues and becomes an infection.
Thrush is most commonly caused by the yeast Candida albicans. Less frequently, other forms of Candida can lead to thrush.
There are many types of bacteria in your mouth that normally control the growth of Candida. Sometimes a new type of bacteria gets into your mouth and disrupts the balance of the organisms already there, allowing Candida to overgrow. Health conditions and other things may also be involved.
The yeast that causes thrush can pass from one person to another in different ways.
Thrush can be a mild infection that causes no symptoms. If symptoms develop, they may include the following.
Symptoms of thrush in an infant may include:
Symptoms of thrush in an adult may include:
A breastfeeding mother may get a yeast infection of her nipples if her baby has thrush. This can cause sore, red nipples. She may also have a severe burning pain in the nipples during and after breastfeeding.
Most cases of thrush are mild and clear up with the use of an antifungal mouth rinse. Very mild cases of thrush may clear up without medical treatment. It usually takes about 14 days of treatment with an oral antifungal medicine to cure more severe thrush infections. In some cases, thrush may last several weeks even with treatment.
If thrush goes untreated and does not go away by itself, it can spread to other parts of the body.
Thrush is more likely to recur in:
Complications related to thrush are rare in healthy people but may include:
There are several things that can increase your risk for getting thrush.
Medicines that can cause thrush yeast to grow uncontrolled include:
Exposure over time to certain environmental chemicals, such as benzene and some pesticides, can weaken the body's immune system, increasing your risk for infections, including thrush.
If you think you may have thrush but it has not been diagnosed, see the topic Mouth Problems, Non-Injury to evaluate your symptoms.
Call your doctor today if you or your child has been diagnosed with thrush and:
Thrush in an infant's mouth can spread to the breast of the nursing mother. This can cause nipple redness and pain. Contact your doctor if you have redness and pain in the nipples in spite of home treatment or if you have burning pain in the nipple area when you nurse. Your doctor will likely examine your baby's mouth to find out whether thrush is causing your symptoms.
If you have previously been diagnosed with thrush and you believe you may have another thrush infection, home treatment may help. Very mild cases of thrush may clear up without medical treatment. Talk to your doctor if:
Your family doctor or general practitioner can diagnose and treat thrush. You may be referred to a specialist, such as a pediatrician or an internist.
Other specialists may be required if other organs become infected or other conditions develop. The type of specialist depends on the organs affected and may include the following:
To prepare for your appointment, see the topic Making the Most of Your Appointment.
A visual examination is usually all that is needed to diagnose thrush. In addition to looking in your mouth, your doctor will ask you questions about your medical history.
In rare cases, your doctor may order a KOH test in which one of the white patches is scraped and examined. A KOH test is used only in cases when thrush is not clearly evident by visual examination.
A fungal culture may be done when a diagnosed case of thrush is not responding to prescribed medicines.
Thrush is a yeast infection that can develop in the mouth and throat and on the tongue. Thrush is most common in newborns, infants, and older adults, but it can occur at any age. In healthy newborns and infants, thrush is usually not a serious problem and is easily treated and cured.
Except for the mildest cases, you should treat thrush to keep the infection from spreading. Prescribed antifungal medicines, which slow down the growth of yeast, are the standard treatment for thrush. Thrush is most commonly treated with medicines that are either applied directly to the affected area (topical) or swallowed (oral).
In adults, mild cases of thrush may clear up with simple treatment that can be done at home. This treatment usually involves using an antifungal mouth rinse. Treatment usually lasts about 14 days.
Mild thrush in infants is usually treated with topical medicines until at least 48 hours after the symptoms have gone away.
More severe thrush infections that have spread to the esophagus are treated with an oral antifungal medicine. A topical antifungal medicine may also be used.
For some severe infections, a treatment period longer than 14 days may be needed.
Persistent or recurrent cases of thrush may:
People with weakened immune systems may need to take an antifungal medicine on a continuous basis to prevent thrush infections.
It is very important to get rid of any sources of infection, or thrush will continue to come back. Boil toys, pacifiers, bottles, and other items a child may put in his or her mouth. Or wash the items in warm, soapy water.
It is important to treat conditions that make you more likely to get thrush, such as diabetes, human immunodeficiency virus (HIV), or cancer. For more information, see Prevention.
To prevent thrush:
To reduce the risk of spreading thrush to infants:
If your baby needs medicine to treat thrush, don't put the medicine dropper in the baby's mouth. Drop the medicine on a cotton swab and swab it on the affected area. Throw away the swab, and don't put anything back into the medicine bottle that could be contaminated with the yeast.
If your child has mild thrush, you may only need to clean bottle nipples and pacifiers regularly and massage the inside of your child's mouth with a clean moist cloth.
If you breastfeed, dry your nipples after breastfeeding. And apply lanolin lotion, which may help relieve nipple soreness. Your doctor may also prescribe a medicine that you can put on your nipples.
Gentian violet (1%) sometimes works as treatment for thrush. It is a dye that kills bacteria and fungi, and it is available without a prescription. Talk to your doctor before using gentian violet.
If you develop thrush and have false teeth (dentures), it is important to clean your mouth and dentures every night.
Prescription medicines that inhibit the growth of yeast (antifungals) are used to treat thrush.
Antifungal medicines are either applied directly to the affected area (topical) so the medicine affects only that area, or swallowed (oral) so the medicine affects the entire body. In rare cases, an antifungal medicine will need to be injected into a vein (intravenous, or IV).
Topical antifungal medicines are applied to the affected area. Topical antifungal medicines need to be in contact with the affected area long enough to stop the growth of the yeast.
Because several of the topical antifungal medicines contain sugar, there is an increased risk of cavities when the medicines are used for long periods of time. Using a topical fluoride rinse or gel (if you are not already obtaining fluoride through other means) during treatment may help prevent cavities. Talk to your doctor or dentist before you give your child fluoride products. Too much fluoride may be toxic and can stain a child's teeth.
Unlike topical antifungal medicines, oral antifungal medicines affect the whole body. Your doctor may prescribe a pill if you have a thrush infection in your esophagus. Your doctor may suggest that you use a topical antifungal medicine along with it.
Oral antifungal medicines are used to prevent thrush in certain people with conditions that weaken the body's immune system.
Knapp KM, Flynn PM (2009). Candidiasis. In RD Feigin et al., eds., Feigin and Cherry's Textbook of Pediatric Infectious Diseases, 6th ed., vol. 2, pp. 2741–2751. Philadelphia: Saunders Elsevier.
Other Works Consulted
American Academy of Pediatrics (2012). Candidiasis (moniliasis, thrush). In LK Pickering et al., eds., Red Book: 2012 Report of the Committee on Infectious Diseases, 29th ed., pp. 265–269. Elk Grove Village, IL: American Academy of Pediatrics.
American Public Health Association (2008). Candidiasis. In DL Heymann, ed., Control of Communicable Diseases Manual, 19th ed., pp. 98–101. Washington, DC: American Public Health Association.
Bortoluss R, et al. (2007, reaffirmed 2013). Practice point: Antifungal agents for common paediatric infections. Paediatrics and Child Health, 12(10): 875–878. Available online: http://www.cps.ca/en/documents/position/antifungal-agents-common-infections.
Edwards JE Jr (2015). Chlamydia trachomatis (Trachoma, genital infections, perinatal infections, and lymphogranuloma venereum). In JE Bennett et al., eds., Mandell, Douglas, and Bennett's Principles and Practice of Infectious Diseases, 8th ed., vol. 2, pp. 2879–2894. Philadelphia: Saunders.
Messacar K, et al. (2014). Infections: Parasitic and mycotic. In WW Hay Jr et al., eds., Current Diagnosis and Treatment: Pediatrics, 22nd ed., pp. 1353–1399. New York: McGraw-Hill.
ByHealthwise StaffPrimary Medical ReviewerJohn Pope, MD - PediatricsAnne C. Poinier, MD - Internal MedicineAdam Husney, MD - Family MedicineKathleen Romito, MD - Family MedicineE. Gregory Thompson, MD - Internal MedicineSpecialist Medical ReviewerThomas Emmett Francoeur, MD, MDCM, CSPQ, FRCPC - Pediatrics
Current as ofOctober 17, 2016
Current as of: October 17, 2016
John Pope, MD - Pediatrics
& Anne C. Poinier, MD - Internal Medicine & Adam Husney, MD - Family Medicine & Kathleen Romito, MD - Family Medicine & E. Gregory Thompson, MD - Internal Medicine & Thomas Emmett Francoeur, MD, MDCM, CSPQ, FRCPC - Pediatrics
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