Monthly Archives: June 2013

When we think of yeast…

Typically, we think of yeast when we think of baking. Sometimes we think of it with respect to beer.

On a human level, we tend to think of yeast infections in connection with women, because seemingly, women are more prone to them. However, such is not necessarily the case.

Before I continue, I will be discussing candidiasis (yeast infection) – and while I know that it can be transmitted sexually, and it can result from taking antibiotics, etc…I will be talking about manifestation of candidiasis without any other seeming origin…such as in non-sexually active, circumcised men (who often seem surprised they’ve got yeast)…or in children.

I received a question from a woman with two young daughters a few weeks ago about one of her daughters (age 6), wondering about her daughter’s itch “down there.” I asked if her daughter takes bubble baths (yes) and a few other pertinent questions. I told the woman that the only way to diagnose for sure was to take her daughter to a physician (recommended a gynecologist), but that the likely culprit was yeast. Just plain ol’ yeast. She seemed to be surprised (“but in a child?”) — and I suspect strongly that her greater concern was that someone might have touched her daughter sexually.

Of course, that is a possible concern, but given that her daughter approached her very plainly with no shame and told her that her vaginal area was itching, and mom noted the redness…and the daughter denied any inappropriate touching “down there” — my first thought was that a child who has been touched inappropriately has often been warned to not tell anyone, which would make talking about anything “down there” off-limits — the likelihood was that she hadn’t been harmed.

She was also surprised that children can (and do!) get yeast infections. Most moms (and some dads) know that babies get yeast (in the form of thrush), but that usual “blame” for that is passage through the vaginal canal during birth (it’s not really blame, per se, but yeah…vaginal birth is often seen as the “culprit”, which doesn’t seem to explain C-section babies who get thrush…but anyway…). The fact is, we all have yeast in our bodies. Most of us have it in very small amounts, but it is just a part of us.

Certain factors for yeast growth make overgrowth (leading to itchiness and infection) more common in adult women. Interestingly, you don’t hear too often about men getting candidiasis (yeast infection (at least not who are willing to openly talk about it)…and even the medical literature says that it’s “more common” for men to get a yeast infection if they’re not circumcised. I suspect that, given that the majority of adult men in the United States are circumcised (since that was a matter of course at birth for a very long time), the seeming lack of proper genital hygiene taught to young boys contributed to the wrong idea that boys and men are not susceptible to something like yeast. Which is, of course, frustrating.

Men (circumcised or not) are prone to yeast in the same way that women are…and for the same reasons…though the yeast infection may not manifest quite in the same way, or with the same likelihood as in women. To grow, yeast simply needs a warm moist place. For girls and women, well, no need to state the obvious. That growth might be more common in adult women is not surprising, either, since many adult females are sexually active, which adds more moisture. And…of course…even with that, some women never experience a yeast infection. Men (or at least many men) have been taught that if they’re circumcised and if they “keep their dicks clean,” they’ll never-ever-ever have aaaaaaaaaany problems like “that”…which is a load of hooey.

And…which is why you will find (if you look) men’s online forums discussing exactly this topic with surprised comments like, “But I’m circumcised!” or “But it’s on my nutsack, not on the tip of my dick!” Which makes me sigh.

An ill-informed mom (or dad) might completely freak out if her toddler son (circumcised or not) suddenly has redness at the base of his penis and on his scrotum that seems to smart at the touch and is itchy to the child.

Again, we human beings have yeast in our bodies…and all that’s needed for growth is warmth and moisture. The genital area (in men as well as women) is prone to moisture, particularly in hot and humid climates.

In cases like these…while I would encourage men and parents of young boys to certainly have a physician examine them if they aren’t completely certain…but my first (very educated) guess would be -simply- yeast. Go to a store and buy some Monistat cream. Apply it to the red, itchy areas. It is the same over-the-counter cream that women who get yeast infections use to get rid of their own. Just the topical cream, though, guys. We women do have a couple of other things we get because our anatomy is slightly different from yours. 

Of course, keep everything “down there” clean and dry as much as possible. For you parents out there with uncircumcised boys…(and for folks whose sons are circumcised)…yes, your little boys can get yeast infections. As best you’re able, keep their genitals clean and dry…and teach them how to keep clean and dry as they become old enough to understand. Note to parents of uncircumcised sons…do not attempt to retract your son’s foreskin (it will do that all on its own when the time comes…usually during puberty) — but you can clean the entire penis thoroughly (plain soap and water and soft pat-dry without pulling the foreskin back). For my sons, I have long preferred a gentle powder. I know there are folks who discourage this, but I prefer it, particularly on the scrotum, which can get moist due to simple sweat under the scrotum (the perineum) and on the rest of the scrotal area, including the inner thighs. And…I am teaching him how to do this for himself as he gets older.

For parents of young girls…yes, prepubescent girls can and do get yeast infections. Back when I worked as a medical assistant in a pediatric clinic, we had many young girls who were brought in by concerned parents…and one of the biggest culprits was bubble baths. This is not to suggest never giving your daughters bubble baths…far from it. However, be aware that the vagina is not a vacuum, and even in very young girls, liquid irritants can get in and wreak minor havoc. Also, when you’re teaching your daughter how to clean herself after using the bathroom (and I cannot stress this one enough), front to back. For my daughter, I’ve taught her that this is important both in the bath/shower and on the toilet after using the bathroom, so that it is an ingrained habit of front to back. Also, ensuring that all those folds and in-between all those folds are thoroughly cleaned and dried.

I have long suspected (and continue to suspect) that one reason women seem more prone to yeast infections is that we’re not taught the importance of thorough cleaning and gentle drying of everything — and again front to back. We’re just told “keep it clean” without any specific instructions. I remember the first time I read the instructions for a “clean catch“, I remember thinking…why weren’t we taught to clean like this as children? (Instructions for both men and women are in that link…and this is how we should be cleaning our genitals when we bathe, not just for a “clean catch” urine sample.) I know, too, that nobody ever told me that this is doubly important after I indulge in a bubble bath (one of my rare indulgences) because of the different potential irritants in the bubble bath itself.

Anyway, I hope this has been informative, and that you find it useful.

Dr. Weird