IN SHORT: There are many claims online about how to treat candidiasis, also known as a yeast infection. Some recommendations are in line with medical advice, while others lack solid evidence.
Candidiasis, often called a yeast infection, is a fungal infection caused by various species of the genus Candida. Although candida is naturally present in the body, it can cause infections when it overgrows, affecting areas such as the mouth, throat, skin, nails, and genitals.
This infection is common in people with a weakened immune system, those taking antibiotics, and infants wearing diapers.
Vaginal candidiasis is a major concern in women's health. There is a plethora of advice available online, with many remedies claiming to offer simple solutions for the prevention and treatment of this condition. From dietary changes to hygiene practices, these suggestions often claim effectiveness without solid evidence.
An example of this is a post that has been making the rounds on Facebook, advising women on simple solutions to treat vaginal candidiasis.
The post reads: "Candidiasis/Yeast Infection in Women: Simple solution: - Avoid sugar, wheat and dairy - Wear cotton underwear - Use organic sanitary pads - Avoid douches & scented soaps. The vagina is self-cleansing. Anti-fungal pessaries worsen the problem."
The post attributes this advice to one "Dr Eric".
The same claim appears here and here. (Note: See more instances listed at the end of this report.)
But are these recommendations accurate? We checked.
Claim 1: "Avoid sugar, wheat, and dairy."
Proponents of alternative medicine argue that reducing sugar intake can inhibit the growth of candida.
The World Health Organization (WHO) defines traditional medicine, also known as alternative or complementary medicine, as the "knowledge and practices based on theories, beliefs and experiences indigenous to different cultures, used in the maintenance of health". These are treatments that generally do not have a scientific basis, and are either used in addition to or instead of conventional medicine.
The candida diet claims to target candida overgrowth by eliminating sugar, gluten, alcohol and certain dairy products. The idea behind the diet is that eliminating these foods deprives yeast of the nutrients it needs to thrive. This theory draws parallels with how sugar feeds yeast in baking and brewing.
Despite claims that these foods make the condition worse, there's little scientific evidence that the diet is effective.
The effectiveness of dietary changes, especially avoiding certain foods, such as dairy and wheat, can vary significantly from person to person.
Eliminating dairy and wheat can lead to potential deficiencies in calcium, vitamin D, fibre and B vitamins, especially if not substituted with alternative sources.
But even if you cut out sugar, wheat and dairy products, certain medicines could still contribute to yeast infections.
David Denning, a professor of infectious diseases in global health at the University of Manchester in the UK, told Africa Check that there was no evidence to support this claim.
Africa Check also contacted the WHO for more information. The WHO media team said there was no evidence that diet could influence or prevent candida and that this claim was generally based on laboratory data that had not been confirmed in humans.
Claim 2: "Wear cotton underwear and use organic sanitary pads."
Wearing cotton underwear is often recommended to prevent candidiasis. Cotton is a natural material that allows air to circulate well, keeping the vulva and surrounding area dry. Moisture lets yeast grow, so staying dry can help prevent infections.
The WHO told Africa Check that certain synthetic fabrics can increase the risk of yeast infections through changes in pH, temperature and moisture. pH is a measure of the acidity or alkalinity of a substance and ranges from 0 to 14, with 7 being neutral.
In general, people who wear cotton underwear and change it regularly have a lower risk of candidiasis than those who wear other fabrics, the WHO said. However, "it is important to remember that many people wear non-cotton fabrics and relatively few develop candidiasis". Other factors, such as perspiration, how often you change your clothes and hormones, also play a role.
Denning said: "Although cotton underwear provides a lower risk of developing candidiasis than other fabrics, this should not necessarily be interpreted as a general recommendation to avoid other fabrics and wear only cotton. In clinical practice, discussion about underwear type is often held with people with persistent or recurrent candidiasis."
He told Africa Check that there was no data to support this claim either, but that it was important to be clean.
Claim 3: "Avoid douches and scented soaps. The vagina is self-cleansing."
The vagina has an excellent self-cleaning system. It produces mucus that contains healthy bacteria, such as lactobacilli, which help to maintain a slightly acidic pH balance. This environment inhibits the growth of harmful bacteria and yeast.
The WHO told Africa Check that "the microbial composition of the vagina is a delicate balance of microorganisms that may be influenced by many factors".
"Intimate vaginal practices, such as douching and intravaginal cleansing, may disturb this balance, resulting in overgrowth of certain microbes such as anaerobic bacteria and yeasts. This could lead to vaginal discharge and change in vaginal odour for example. Intravaginal use of products should therefore be avoided," the WHO said.
The health agency added that external cleaning of the vulva and perineal area during bathing was part of normal personal hygiene.
"However, the vulva is a relatively sensitive area and certain soap products, such as scented [soap], may cause skin irritation which may increase the risk of candidiasis. It is important to use soap gently in the genital area, and preferably 'neutral' products."
Claim 4: "Antifungal pessaries make the problem worse."
Antifungal pessaries are small, solid, tablet-like medical devices that are inserted into the vagina to treat fungal infections, most commonly vaginal candidiasis. These pessaries contain antifungal medications that dissolve after insertion, releasing the active ingredient directly into the affected area to combat candida overgrowth.
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It is not true that antifungal pessaries make yeast infections worse.
According to the WHO, claims that pessaries make candidiasis worse may be based on a misunderstanding of the treatment process.
"There are several antifungal pessaries on the market; most are single-dose, but some are used for several days. For the pessary to dissolve optimally, it is important to insert it as far into the vagina as possible, preferably at bedtime, to avoid leakage ... Pessaries don't make symptoms worse, but leakage can be mistaken for aggravated discharge."
We asked Denning about the accuracy of the claim. He said: "This is false. The other common alternative is boric acid. Women who find that their vulvovaginal candidiasis gets worse with an antifungal pessary may have another condition."
These conditions include:
- Bacterial vaginosis
- Trichomonas
- Local allergy
- Inflammatory dermatological conditions of the vulva
In conclusion, navigating the plethora of candidiasis remedies on the internet requires caution. While some suggestions, such as wearing cotton underwear, are in line with medical advice, others, such as avoiding sugar, wheat, and dairy products, lack solid evidence.
Understanding the nuances between myth and reality is essential to making informed health decisions.
The claim was also posted here, here, here, here, here and here.
