Candidiasis in Men: Causes, Symptoms, and Treatment

Candidiasis in men, as in women, is caused by Candida albicans. It's more common in uncircumcised men and its most characteristic symptom is itching.

Written and verified by the doctor Mariel Mendoza.

Last update: 30 May, 2022

Candidiasis in men is an infection caused by the fungus Candida albicans. It’s more frequent in the female sex, but this doesn’t exclude the possibility of men suffering from it.

The greater susceptibility in women is due to the fact that the vagina is a humid, covered area with a warm temperature, which allows the microorganism to proliferate. In men, the greatest susceptibility occurs in those who aren’t circumcised.

What causes candidiasis in men?

The Candida fungus, when it affects the penis, produce s inflammation in the foreskin and glans penis, which is called balanitis. That’s why the main manifestations of candidiasis in men are redness of the foreskin and glans penis, the appearance of red and white papules around the penis, an itching and burning sensation, and the covering of the glans penis by a whitish layer.

This infection starts locally, but itching can lead to rupture of the papules and pustules, resulting in the spread of infection and irritation to surrounding areas, such as the groin and scrotum.

Causes of candidiasis in men

Although candidiasis can be transmitted to a man by sexual contact with a woman with a vaginal yeast infection, candidiasis in men isn’t considered to be a sexually transmitted disease as such. So, let’s look at the causes and common risk factors.

Depression of the immune system

Candida is part of the skin microbiota in small amounts, the growth of which is controlled by the human defense system. In cases of concomitant infections, diabetes, autoimmune diseases, chemotherapy, steroid or immunosuppressive treatment, or any other condition that can weaken the immune system, there’ll be increased growth of the fungus.

Sexual contact

Candidiasis in men, as mentioned above, can occur by direct contact of the skin of the penis with a candida-infected vagina.

Excess glucose

Excess glucose is a risk factor for candidiasis in men, so having diabetes makes men more prone to it. This is because the high concentration of sugar in the urine creates an environment that benefits the growth of the fungus.

Non circumcision

Not having the penis circumcised favors candidiasis in men, in view of the fact that it keeps a covered area, with a warm and humid temperature that allows the growth of the fungus.

Alterations of the intestinal flora

The imbalances in the intestinal flora favor the proliferation of yeasts in the feces. Therefore, any contact the penis has with any tissue or object that has passed through the anus can cause candidiasis in men.

However, these yeasts can also be expelled through the urinary tract, and they would have direct access to the glans in this way.

Does intimate hygiene influence candidiasis in men?

Excessive cleaning of the genital area, especially with irritating substances such as perfumed soaps, damages the bacterial flora of the skin. Thus, the natural barrier is weakened, allowing the entry of other microorganisms in greater numbers, such as candida.

What are the complications of candidiasis in men?

The inflammation of the glans and foreskin in candidiasis in men can cause scarring or adhesions in the penis. This leads to pain and difficulty urinating.

In addition, the infection can travel up the urethra and enter the bloodstream, especially in cases where a urinary catheter has been used or in patients with a severely weakened immune system. Systemic infection caused by Candida albicans is called candidemia.

Diagnosis

Candidiasis in men is diagnosed by observing the symptoms. It’s only necessary to take culture secretions from the affected area to confirm the species of fungus in cases that don’t improve with the initial treatment. Confirmation can also be carried out by direct examination with potassium hydroxide.

The advantage of these confirmatory studies is that, in addition to determining the species, they allow us to know which antifungal agents the microorganism is sensitive to by means of an antifungigram. This improves treatment and results.

The treatment of candidiasis in men

The infection usually subsides with topical antifungals. Only in some cases is oral medication required.

Topical antifungals should be applied daily for 7 to 10 days. If they don’t improve the condition, then oral antifungals are associated for 10 to 14 days, depending on the severity.

The most commonly used drugs are ketoconazole, itraconazole, and fluconazole, ingested orally. Clotrimazole is common as a topical cream. If the condition is recurrent, circumcision is considered, as it is usually a factor that limits infectious processes and protects the area from recurrences.

However, treatment doesn’t guarantee that candidiasis in men won’t return. Therefore, it’s important to combine this with  good intimate hygiene habits.

Recommendations to avoid the proliferation of the fungus

In addition, to ensure proper intimate hygiene, the following are recommended:

• Keep the penis area clean and dry. If uncircumcised, clean under the foreskin with soap and water and then return the foreskin to its normal position.
• Don’t wear warm, tight, or wet clothing.
• Preferably wear cotton underwear.
• Use a condom and clean the intimate area after each sexual contact.

Candidiasis in men may be a sign of something else

Risk factors associated with candidiasis in men are a depressed immune system and poor hygiene of the intimate area. For a definitive eradication of the fungus, you’ll need to carry out a joint treatment of the sexual partner, improve hygiene, and rule out processes that can generate immune disorders, such as poorly controlled diabetes.

Sometimes, candidiasis in men has been described as one of the first manifestations of undiagnosed diabetes. Hence, a detailed clinical work-up is essential when a male has this infection.