Should I be concerned about Candida? Can it cause my acne? And if so, what I can do about it. In this post I’ll see what science has to say about these questions.
What is Candida overgrowth syndrome?
Candida is yeast that almost all of carry in the skin and the digestive track. While it’s normally harmless when the opportunity rises it can turn pathogenic. The proponents of the Candida overgrowth syndrome say that under certain conditions it can overwhelm the probiotic bacteria in the gut and take over.
Toxins produces by Candida corrode the gut wall, and this leads to development of leaky gut syndrome. The yeast can then leaks into the bloodstream and spread all over the body. This is called system Candida infection.
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The claim goes that Candida, and the toxins it produces, causes a wide range of symptoms. These can include tiredness, skin problems, muscle pain, memory problems, irritability and many, many other things.
Though you see these claims repeated on tens of thousands of health websites, they are unlikely to be true. For the simple reason that most people with systemic Candida infection are dead.
Systemic Candida infection has 50% mortality rate
Many alt-med practitioners charge that doctors and skeptics are uneducated and ignorant of the problems Candida causes. This isn’t exactly true. Modern medicine is very familiar with systemic Candida infections, a condition called candidiasis.
The reason most doctors ignore the alt-med claims is that systemic Candida infections are very rare. They usually occur only in people with severely compromised immune systems (such as HIV patients or people undergoing chemotherapy). Systemic Candida infections have a horrific mortality rate, up to 50%. And people often die within a week of being infected.
Studies find no evidence for Candida syndrome
Some people claims that a milder, subclinical form of systemic Candida infection exists. Yet others claim that the wide range of problems is caused by Candida toxins leaking out of the gut. Sometimes these are referred as Candida syndrome or hypersensitivity.
Contrary to claims from alt-med practitioners this has been studies. I found two papers that reviewed the relevant studies. Here are conclusions.
The indications most closely linked to Candida colonization are irritable bowel syndrome and certain allergic reactions, although an association has been proven. There is no epidemiological or interventional evidence for the existence of a general and clinically demonstrable Candida hypersensitivity syndrome.
The role of intestinal colonization by Candida in Candida-associated vulvovaginitis and IgE-mediated disorders remains contradictory. Nevertheless, neither epidemiological nor therapeutic studies provide evidence for the existence of the so-called “Candida-syndrome” or “Candida-hypersensitivity-syndrome”.
So to date we have no good reason to believe any undiagnosed Candida epidemics exist.
Candida and acne
Just because Candida epidemic is more hype than reality doesn’t mean it couldn’t cause skin problems. There’s a good reason to believe Candida may aggravate acne, eczema, psoriasis and atopic dermatitis.
Studies have compared the prevalence on Candida between people with skin conditions and those with healthy skin. The overall picture is that Candida in the gut and mouth is more prevalent in people with skin conditions.
There are two ways Candida can cause skin problems.
There’s a clear link between gut and skin health. And we have a good reason to believe Candida overgrowth causes or aggravates gut problems.
- Candida seems to aggravate inflammatory bowel syndrome. This means it can disrupt the bacterial balance in the gut.
- People with skin conditions have higher levels of Candida antibodies in the blood. This suggests leakage from the gut, and this probably increases chronic inflammation.
- Treatment with oral antifungals often helps the skin. This happens even when the drug only targets the digestive system.
Overreaction by the skin immune system
Candida can cause acne and skin problems even in a more direct way. Some studies show that skin patients have stronger inflammatory response against the yeast. It’s like that immune system is primed against Candida and reacts violently when it gets a whiff of it. This initial inflammation can then trigger the acne formation process or aggravate existing acne.
Neither of these points are an absolute proof that Candida causes acne (or other skin conditions). But, I believe, it’s a reason enough to investigate the possibility.
Candida is simple to diagnose and treat
I want to inject a bit of realism here. One problem with natural health discussion of Candida is that they rely on unproven (and essentially useless) self-tests and diagnoses. This can really confuse people.
If you suspect Candida is behind your acne, please talk to your doctors. There are simple and reliable tests for diagnosing it. Sometimes a doctor can even diagnose it visually, but even if not it can be reliably done in a lab.
The same goes for treatments. Effective antifungal treatments exist. You don’t need crazy diets or take herbs months on end.
The point is that there’s nothing fuzzy or ambiguous about Candida. It can be diagnosed and treated quickly and effectively.
It’s still OK to improve your diet and lifestyle
I’ve written about controversial topics on other websites, and experience shows I need to add this preemptive bit. Because sooner or later the true believers will descend here they will draw false conclusions and make straw man arguments. For example, when I pointed out that the spit-test for Candida is dubious (at best), some people accused me of stealing hope from people. How did they reach that conclusion eludes me to this day.
But I digress. None of this means you shouldn’t improve your diet. Many of the diet and lifestyle suggestions Candida proponents make are sensible. It’s a good idea to eat less sugar and refined carbohydrates for example. But you don’t have to make these changes in the name of treating (probably nonexistent) Candida infection.
You can make these changes because they stabilize blood sugar and lower insulin levels. These things are very good for your skin, and overall health too.
Extraordinary claims require extraordinary proof. The proponents of Candida overgrowth syndrome make many extraordinary claims, yet they fall hopelessly short on evidence. To date no convincing evidence exists to support the claim that undiagnosed Candida overgrowth is an epidemic and causes a wide range of symptoms.
The same can’t be said about the connection between Candida and acne. Candida is more prevalent in people with acne and other skin conditions. It can cause problems in the gut, and thus aggravate acne through the gut-skin axis. Similarly immune system in problem skin may react to Candida too aggressively. This causes local inflammation in the skin and possibly triggers the acne formation process.
If you suspect Candida, there are simple and reliable tests for it. And it can be effectively treated with antifungal medications. There’s no reason to resort to dubious self-tests and unproven and restrictive treatments.
- Yeasts in the Gut: From Commensals to Infectious Agents.
- Epidemiology of Candidemia in Brazil: a Nationwide Sentinel Surveillance of Candidemia in Eleven Medical Centers.
- Epidemiology and Outcomes of Candidemia in 2019 Patients: Data from the Prospective Antifungal Therapy Alliance Registry.
- Invasive candidiasis: an overview from Taiwan.
- Epidemiology of Candidemia in Finland. (PDF)
- Effectiveness of nystatin in polysymptomatic patients. A randomized, double-blind trial with nystatin versus placebo in general practice.
- A Randomized, Double-Blind Trial of Nystatin Therapy for the Candidiasis Hypersensitivity Syndrome.
- Inflammation and gastrointestinal Candida colonization.
- Gastrointestinal Candida colonisation promotes sensitisation against food antigens by affecting the mucosal barrier in mice.
- The Microbiota and Allergies/Asthma.
- An assessment of the role of Candida albicans antigen in atopic dermatitis.
- Serum levels of antibodies for IgG, IgA, and IgM against the fungi antigen in psoriasis vulgaris.
- Role of Candida allergen in atopic dermatitis and efficacy of oral therapy with various antifungal agents.
- The pathogenetic significance of intestinal Candida colonization–a systematic review from an interdisciplinary and environmental medical point of view.
- Atopic Dermatitis and Fungi
- Anti-Candida antibody levels in psoriasis vulgaris.
- Fungal flora of human faeces in psoriasis and atopic dermatitis.
- Incidence of Candida in psoriasis–a study on the fungal flora of psoriatic patients.
- Candida in dermatology.
- Prevalence of Candida on the tongue and intertriginous areas of psoriatic and atopic dermatitis patients.
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