Thrush

What is thrush?

Thrush is a fungal (yeast) infection that can grow in your mouth, throat and other parts of your body. With oral thrush (oral candidiasis), you may develop white, raised, cottage cheese-like lesions (spots) on your tongue and cheeks. Thrush can quickly become irritated and cause mouth pain and redness.

Thrush happens when there’s an overgrowth of Candida, a type of fungus. Another name for thrush in your mouth or throat is oropharyngeal candidiasis.

Healthcare providers treat thrush with antifungal medication. If your immune system is healthy, thrush is a minor problem that goes away a couple of weeks after you start treatment.

Who can get thrush?

While thrush can affect anyone, some people are more at risk, including:

• Babies under 1 month old.
• Toddlers.
• Adults aged 65 or over.
• People with weakened immune systems (where symptoms are harder to control).

What are the symptoms of thrush?

Thrush usually develops suddenly. A common sign is the presence of creamy white, slightly raised lesions in your mouth — usually on your tongue or inner cheeks. You may also have lesions on the roof of your mouth, gums, tonsils or back of your throat.

Other symptoms may include:

• Redness and soreness inside and at the corners of your mouth.
• Loss of sense of taste (ageusia).
• Cottony feeling in your mouth.

The lesions can hurt and may bleed a little when you scrape them or brush your teeth. In severe cases, the lesions can spread into your esophagus and cause:

• Pain or difficulty swallowing.
• A feeling that food gets stuck in your throat or mid-chest area.
• Fever, if the infection spreads beyond your esophagus.

Thrush can spread to other parts of your body, including your lungs, liver and skin. This happens more often in people with cancer, HIV or other conditions that weaken the immune system.

What causes thrush?

Most people have small amounts of the Candida fungus in their mouth, digestive tract and skin. When illnesses, stress or medications disturb this balance, the fungus grows out of control and causes thrush.

Medications that can make yeast flourish and cause infection include:

• Corticosteroids.
• Antibiotics.
• Birth control pills.

Is thrush contagious?

Thrush can be contagious to those at risk (like people with weakened immune systems or who take certain medications). In people with healthy immune systems, it’s unusual to pass thrush through kissing or other close contact. In most cases, thrush isn’t particularly contagious (meaning, it doesn’t spread from person to person), but it is transmittable (meaning, you can catch it in other ways).

If you’re worried about getting thrush from another person who has it, avoid coming into contact with their saliva (spit). It’s smart to wash your hands as often as possible if you’re near someone who has thrush.

What are the risk factors for thrush?

Candida infection is more likely to develop in babies and people with:

• Diabetes.
• Anemia.
• HIV/AIDS (thrush in your esophagus — or swallowing tube — is common in this group).
• Cancer.
• Dry mouth (xerostomia).
• Pregnancy (due to the hormonal changes that occur).
• Smoking.
• Ill-fitting dentures.

What are the complications of thrush?

Thrush rarely causes complications in people with healthy immune systems. But if you have a weakened immune system, Candida can enter your bloodstream and spread to other areas of your body, such as your eyes, brain or heart. This type of infection is serious and may lead to septic shock, a life-threatening condition.

How is thrush diagnosed?

A healthcare provider can usually tell right away if you have thrush by looking for the distinctive white lesions on your mouth, tongue or cheeks. Lightly brushing the lesions away reveals a reddened, tender area that may bleed slightly. A microscopic exam of tissue from a lesion can confirm whether or not you have thrush.

If thrush extends into your esophagus, your healthcare provider might:

• Take a throat culture (swab the back of your throat with sterile cotton and study the microorganisms under a microscope).
• Perform an endoscopy of your esophagus, stomach and small intestine (examine the lining of these areas with a lighted camera mounted on the tip of a flexible tube).
• Take X-rays of your esophagus.

How is thrush treated?

The typical treatment for thrush is antifungal medications:

Antifungal medications

Healthcare providers usually prescribe antifungals (like nystatin) to treat thrush. These medicines are available in tablets, lozenges or liquids that are “swished” around in your mouth before swallowing. Usually, you need to take these medications for 10 to 14 days. Your healthcare provider will recommend specific treatment based on your age and the cause of the infection.

Kids and adults with healthy immune systems typically respond well to antifungal treatment. But thrush symptoms may be more severe and harder to treat in those with weakened immune systems.

How soon after treatment will I feel better?

Antifungals can clear up thrush in one to two weeks. You may need to continue the medication for a few more days to kill any fungus that’s left behind.

How can I lower my risk for thrush?

You can do these things to reduce your risk for thrush:

• Practice good oral hygiene. Brush your teeth at least twice a day and floss at least once a day.
• Avoid certain mouthwashes or sprays. Some of these products can destroy the normal balance of microorganisms in your mouth. Talk to your dentist or doctor about which ones are safe to use.
• See your dentist regularly. This is especially important if you have diabetes or wear dentures.
• Limit the amount of sugar and yeast-containing foods you eat. Foods such as bread, beer and wine encourage Candida growth.
• Avoid smoking and other tobacco use. Ask your healthcare provider about ways to help you quit smoking.

What can I expect if I have thrush?

With treatment, thrush usually goes away within one to two weeks. But if your symptoms linger or get worse, let your healthcare provider know.

When should I see my healthcare provider?

If you develop signs or symptoms of thrush — such as soreness, bleeding or raised white areas inside your mouth — schedule an appointment with a healthcare provider.

If you’ve already taken antifungals for thrush but your symptoms return, call your provider right away. It could indicate a more serious infection.

Are there any home remedies for oral thrush?

You’ll need antifungal medication to clear up thrush. But you might try some of these home remedies to ease your symptoms:

• Swish with warm saltwater.
• Take probiotics.
• Eat yogurt that contains healthy bacteria.

A note from Cleveland Clinic

Thrush is a fungal infection that affects your mouth, throat and other areas of your body. It’s an uncomfortable and inconvenient condition. But in people with healthy immune systems, it’s easily treatable with antifungal medications. People with compromised immune systems may have a more difficult time getting rid of thrush. If you develop thrush symptoms, contact your healthcare provider. Prompt treatment can get you back on track and feeling better.