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Thrush is a common yeast infection that can affect men and women. It’s caused by a fungus called candida, which is naturally occurring in the body. Thrush happens when there is a build up of candida, and this can affect many areas of the body, including the:

• mouth and throat
• vagina
• penis
• armpits
• groin
• skin between your fingers

Thrush is usually harmless but can be uncomfortable. Once you start treatment, it will normally clear up in a few days.

Thrush is not a sexually transmitted infection (STI) as it is rarely spread through sex.

Vaginal thrush

Candida is naturally found in the vagina. However, if it multiplies it can cause vaginal thrush. Around 75% of women will experience vaginal thrush at least once in their life. Vaginal thrush can lead to symptoms like:

• thick, white discharge that looks like cottage cheese
• itchiness, soreness, stinging, and irritation of the vulva and vagina, which may get worse when you pee or during sex

Oral thrush

Oral thrush can affect men and women. It’s especially common in babies, whose immune systems are not fully formed yet, and older people, whose immune systems have weakened with age. It’s caused by the build up of candida in the mouth. Oral thrush can lead to symptoms like:

• white, creamy patches in the mouth that look like cottage cheese
• change in taste
• pain or irritation under dentures

Thrush in men

Men can experience penile thrush and symptoms are often similar to those of an STI, so you should see your doctor for a proper diagnosis. Penile thrush can lead to symptoms like:

• thick, white discharge that looks like cottage cheese
• itching when you pee
• difficulty pulling back the foreskin

Thrush is caused by the overgrowth of a fungus called candida. Thrush likes to grow in warm, moist areas and can be caused by a change in the balance of bacteria. This can happen if you:

• are taking antibiotics
• are pregnant
• have poorly controlled diabetes
• have a weakened immune system
• wear tight clothing that does not allow the skin to breathe
• have sex
• have irritated or damaged skin
• take certain medications, such as hormone replacement therapy (HRT)

Oral thrush can also be caused by:

• having a dry mouth
• smoking
• having poor oral hygiene
• wearing dentures that are unclean or do not fit well
• sleeping with dentures

Is thrush contagious?

Yeast can be passed from person to person, however, someone that comes into contact with it may not develop an infection so it’s not generally considered contagious. Thrush is not an STI but there is a small chance that it can be passed on during sex.

Each type of thrush can have different symptoms, some more common than others. In some cases you may experience no symptoms.

Vaginal thrush symptoms

Vaginal thrush will often look like a thick, white discharge consistent with cottage cheese. This can also come with other common symptoms such as:

• itching around the vagina area
• irritation or soreness in the vagina
• burning or itching when peeing
• burning during sex

Other, less common symptoms of vaginal thrush are:

• lower abdominal pain
• a rash or blisters on the vulva
• pain during sex
• pain when you pee

What does vaginal thrush smell like?

If you have thrush, your vaginal discharge may not have an obvious odour but may smell a bit yeasty. If your discharge smells fishy you should speak with your doctor as this could be a sign of an infection like bacterial vaginosis (BV) or an STI rather than thrush.

Oral thrush symptoms

Oral thrush can look like white, creamy patches or spots on the tongue, inner cheeks, and sometimes the gums or roof of the mouth. These patches may look like cottage cheese.

Common symptoms of oral thrush include:

• a loss of taste
• cracks in the corner of the mouth
• pain, irritation, or redness under dentures
• a dry mouth

In babies oral thrush can look like a layer of white across the tongue that does not easily wipe off. They may also not want to feed, or be fussy when feeding. If you think your baby has oral thrush, speak to your doctor for treatment. Oral thrush can be passed to the mother through breastfeeding and can cause nipple thrush. This can lead to red, itchy nipples and flaky or shiny skin around the areolas.

Less common signs of oral thrush are:

• bad breath
• a tingling or numbness of the mouth
• a bitter or metallic taste in the mouth

Symptoms of thrush in men

Like other types of thrush, penile thrush looks like cottage cheese and may cause thick white discharge under the foreskin. Symptoms of penile thrush can also be similar to STI symptoms so you must speak to a doctor if you have any symptoms of an STI.

Other common symptoms of penile thrush include:

• a red, itchy or painful rash on the penis
• difficulty pulling back the foreskin
• irritation or redness around the tip of the penis
• pain or burning when you pee
• pain or discomfort during sex

Less common symptoms of penile thrush include:

• swelling of the foreskin
• cracked or sore foreskin
• sores on the penis

Thrush can be treated with over-the-counter antifungal medication, such as clotrimazole or fluconazole, in the form of tablets or creams. Antifungal medications work by killing the yeast that causes the infection.

Clotrimazole is the generic name for Canesten and other thrush or antifungal medications. It can be applied as a cream, both internally and externally, or taken as a tablet that is put into the vagina (a pessary). For oral thrush, antifungal medication can also be used in the form of mouthwash or gel.

Fluconazole is an antifungal medication that can be used to help treat thrush. It can also be used to help prevent thrush in people who get it repeatedly. It’s usually used in the form of tablets or liquid that you take by mouth.

How effective is thrush treatment

Thrush treatments like clotrimazole or fluconazole are normally highly effective. They can help improve symptoms within a few days, with most symptoms clearing up within 7 days. It is recommended to keep using the medication for 14 days to help stop thrush returning, but you should not use clotrimazole for longer than 14 days unless you are told to by a doctor.

Thrush can come back after treatment. If you're experiencing recurrent thrush (more than 4 times in a year) you should speak to your doctor to help find the best treatment and rule out any underlying conditions that are causing it.

Types of thrush treatment

Thrush can be treated using a mix of internal and external treatments, including clotrimazole creams and fluconazole oral tablets.

Clotrimazole cream

Thrush can be treated using clotrimazole cream, which can be found as a generic treatment, or under the brand name Canesten Cream. There are internal and external creams which can be used together to treat the infection and soothe the symptoms. Clotrimazole creams kill the fungus that is causing the infection by creating holes in the cell membrane.

Clotrimazole internal cream is used once a day at bedtime. It is applied with an applicator. You put the applicator into your vagina as far as you comfortably can. Then you slowly push the plunger until it stops and then remove the applicator. Make sure to follow the instructions provided carefully.

External creams can be used 2 to 3 times a day for 14 days by applying a thin layer to the affected areas and rubbing it in gently with your finger. External creams treat the symptoms of thrush but not the underlying yeast infection so it’s recommended to use with an internal cream or pessary treatment.

Treatment usually works within a few days, but it’s best to continue treatment for 14 days to help stop it coming back.

Clotrimazole pessaries

Thrush treatments that contain pessaries, such as Canesten Combi, should be used at bedtime and are used in a similar way to internal creams. You put the pessary into the applicator, following the instructions provided. Lay on your back with your knees bent and gently insert the applicator as far as you comfortably can. Slowly push the plunger until it stops and then remove the applicator.

Do not swallow a pessary, they are for vaginal use only. Symptoms should start to clear within a few days.

Fluconazole

Fluconazole is an antifungal medication that kills the yeast that causes thrush. It’s sometimes used to help prevent infection in people who experience recurrent thrush. Fluconazole is available over-the-counter and on prescription.

Fluconazole can be taken as an oral tablet or liquid. It can sometimes be taken as an injection but this is usually given at a hospital. Fluconazole can be taken together with an external clotrimazole cream to relieve symptoms straight away until the capsule starts working, such as with Canesten Duo or a generic alternative.

The dose of fluconazole tablets depends on the type of thrush. For oral thrush, 50mg tablets are taken once a day and symptoms should improve within 7 days, but if the infection is serious it may take 1 to 2 weeks to fully work. For vaginal thrush a 150mg tablet is taken as a single dose.

You should talk to your doctor before using fluconazole if you have a heart condition or have experienced kidney or liver problems.

What is the best treatment for thrush?

The best treatment for thrush is an antifungal medication taken orally or applied to the skin as a cream. It’s often most effective to use a combination of an internal treatment to kill the fungus and an external cream to treat the symptoms.

You should talk to your doctor about finding the best treatment for you as some treatments may not be suitable for pregnant women or people with weakened immune systems.

A common side effect of external creams is mild skin irritation, especially at the start of treatment. This can look like:

• swelling, stinging, or itching of the vagina area
• peeling of the skin
• pins and needles or flaking of the skin

If an external cream is not helping to soothe and relieve symptoms, or is making them worse, it’s best to stop using it. Make sure to use an external cream alongside another treatment that will kill the fungus causing thrush. If you get severe symptoms, wash the cream off straight away with water and unfragranced soap.

Common side effects of internal creams and pessaries are:

• swelling or discomfort in the vagina
• bleeding from the vagina
• a burning or stinging feeling
• lower stomach pain

Usually pessaries and internal creams are taken in 1 dose but can also be taken for longer. If you’re only taking a single dose, these side effects should go away within a few minutes to a few hours. If you get side effects from using internal thrush treatments, try using an oral fluconazole capsule if you get thrush again to see if this works better for you.

Oral thrush treatments can have common side effects like:

• nausea or vomiting
• stomach issues such as bloating or discomfort
• diarrhoea
• headaches

These are usually mild and temporary. In some cases, oral thrush treatment can lead to skin rashes.

In rare cases, thrush treatments can cause a severe allergic reaction (anaphylaxis) and you should call 999 if:

• your lips, mouth, throat, or tongue become swollen
• you suddenly become confused, drowsy, or dizzy
• your throat feels tight or you are struggling to swallow
• your skin, tongue, or lips turn blue or pale

If side effects are severe, worsen, or do not stop after you stop using the treatment, you should speak to a doctor straight away. Always check the patient information leaflet that comes with your medication for a full list of side effects.

What to do if you get side effects

Most side effects can be managed at home and as many thrush treatments are single use, they should not last long if you do get them.

You can manage side effects like:

• headaches by drinking water and using paracetamol and ibuprofen
• stomach issues by eating smaller, more frequent meals, taking your fluconazole capsule with food, and using a hot water bottle on your stomach
• diarrhoea, nausea, and vomiting by drinking lots of fluids and avoiding heavy, greasy meals
• skin rash by taking an antihistamine

"If you’re using a contraceptive pill and you have vomiting or diarrhoea for more than 24 hours, or within 3 to 4 hours of taking it, your contraception may not work. You should follow the instructions in your patient information leaflet and avoid having sex until your treatment is finished if possible. Sex can make thrush symptoms worse, and there’s a small chance you can pass it to your sexual partner through oral and penetrative sex. Clotrimazole cream can also damage latex in condoms or diaphragms, reducing their effectiveness."

— Dr Brenda Ikeji, Medical Editor

Thrush treatment can be taken by adults and children over the age of 16, however, it may not be suitable for everyone. You should not use thrush treatments if you are allergic to clotrimazole or fluconazole. People older than 60 should speak with their doctor before using thrush treatments.

You may not be able to use thrush treatment if you:

• are pregnant or think you are pregnant
• are breastfeeding
• have liver problems
• have heart problems
• have diarrhoea

Thrush treatment may not be right for you and you must speak with your doctor if you have any of the following symptoms:

• nausea or vomiting
• foul-smelling vaginal discharge
• lower abdominal pain
• pain or difficulty when trying to pee
• ulcers or blisters on your vagina or vulva (outer part of your vagina)
• irregular bleeding or bloody discharge
• fever or chills

Medications

Thrush treatment is considered generally safe to use with other medications, including herbal supplements. However, you should still talk to your doctor before starting treatment if you are taking other medications to be safe.

Pregnant and breastfeeding women

Pregnant and breastfeeding women should talk to a doctor before starting any thrush treatments.

Creams and pessaries are usually okay to use during pregnancy but you should check with your doctor. Oral thrush treatments, such as fluconazole, may cause harm to the unborn baby so are not recommended to be used by pregnant women.

Weakened immune system

If you have a weakened immune system you should talk to your doctor before starting any thrush treatments as you may need a longer course of treatment or more frequent treatment. Your immune system can be weakened if you:

• have diabetes
• have HIV
• are having chemotherapy

A mild case of thrush will sometimes go away on its own. You will need treatment for thrush if you are experiencing:

• itching
• thick white discharge that looks like cottage cheese
• stinging or soreness when you pee
• stinging or soreness when you have sex
• white creamy patches on the tongue or inner cheeks
• difficulty pulling back the foreskin
• red, itchy rash on the penis

If you think you have thrush you should speak to your doctor for a diagnosis.

How to prevent thrush

There are some things you can do to prevent getting thrush, including lifestyle changes and preventative measures, such as:

• wearing loose fitting underwear
• changing your underwear regularly
• avoiding perfumed soaps and shower gels
• practising good oral hygiene
• cleaning your dentures properly
• avoiding sleeping with dentures
• maintaining a healthy diet
• taking showers rather than baths
• stopping smoking

What does thrush look like on a man?

Penile thrush can look like:

• a red, itchy, and sore rash on the penis
• white, thick discharge under the foreskin
• difficulty pulling back the foreskin
• itching or burning when peeing
• discomfort during sex

Thrush symptoms in men can look like an STI so talk to your doctor for a diagnosis.

How do men get thrush?

Men can get thrush from an overgrowth of the fungus candida, normally in warm, moist areas of the body such as the foreskin or penis. An overgrowth of candida can happen if you:

• are taking antibiotics
• have a weakened immune system
• wear tight underwear that does not let the skin breathe
• have poorly controlled diabetes
• have sex with someone who has thrush, although this is uncommon

Can thrush go away on its own?

Mild cases of thrush can go away on their own within a few days, but most cases of thrush will need some kind of treatment. It is important to speak to a doctor even if your symptoms seem mild.

Why do I keep getting thrush?

Recurring thrush can be caused by an imbalance of the natural bacteria levels in the body. You may be experiencing recurrent thrush because of:

• antibiotic use
• tight clothing
• chronic stress
• smoking
• a poor diet
• using irritating products
• sexual activity
• treatment resistance

If you are experiencing recurring thrush you should speak to your doctor. They can prescribe a longer course of treatment to help stop your symptoms and they may do further tests to see if there is an underlying reason that you keep getting it.

Can antibiotics cause thrush?

Yes, antibiotics can cause thrush as they can kill off some bacteria in the body and allow candida to overgrow. Antibiotics work by killing the bacteria causing whatever infection you’re taking them for, so while they can be beneficial for treating an infection, they can also harm the ‘good’ bacteria that keeps your candida levels in check.

Some commonly known antibiotics that may cause thrush include:

• amoxicillin
• tetracyclines, like doxycycline and minocycline
• some quinolones, like ciprofloxacin and levofloxacin

Can you have thrush without discharge?

Yes, it is possible to have thrush without discharge. If you are experiencing other symptoms of thrush, such as itching or irritation, you should speak to your doctor, even if you do not have discharge.

Can you have sex with thrush?

Yes, you can have sex with thrush, however it is not recommended as sex can worsen the symptoms of thrush, and potentially make them last longer. If you do have sex, it’s recommended to use extra lubricant to reduce friction and irritation.

If you are treating thrush with clotrimazole creams, you should take extra care if you are using condoms as they can cause damage to the latex and make them less effective.

What is the difference between thrush and BV?

Thrush is a fungal infection caused by the overgrowth of yeast whereas BV is caused by a bacterial imbalance. Thrush can be treated with an antifungal medication but BV is usually treated with antibiotics.

Symptoms of thrush and BV can be similar – an easy way to tell if you have thrush or BV is to look at any discharge you may have. Thrush can cause a thick white discharge that may have a mild yeasty smell or no smell at all, and BV can cause thin, watery discharge that may smell fishy.

Can thrush cause a UTI?

No, thrush does not cause UTIs but they can share symptoms and occur at the same time. Thrush is a fungal infection that occurs in the vaginal area whereas UTIs are caused by bacteria and affect the urinary tract.