What are the symptoms of thrush?

Thrush causes different symptoms depending on which body part is affected.

Oral thrush - affecting the mouth - causes:

• White patches in the mouth - which can be wiped off.

• A cottony feeling in the mouth.

• Irritation and discomfort in the mouth.

Thrush affecting the vulva and vagina (vulvovaginitis) causes:

• Itching and soreness of the vulva and vagina, including burning-type pain.

• Vaginal discharge - typically a thick white discharge that looks like cottage cheese.

• Redness and swelling of the vulva.

Thrush affecting the penis causes:

• Itchiness, soreness, and redness of the head of the penis and/or foreskin.

• Thick lumpy discharge under the foreskin.

Thrush (Candida infection) affecting the skin causes:

• Redness and itching of the skin.

• Typically, this occurs in skin folds (intertrigo) - for example, underneath the breasts.

Candida infection that's spread deeper in the body (invasive candidiasis) can cause a range of symptoms, and people with it can become seriously unwell. It's rare in most people, but is more common in people with severely reduced immune systems - such as people with AIDS.

The rest of this feature will take an in-depth look at the symptoms of thrush, as, at Patient, we know our readers sometimes want to have a deep dive into certain topics. Other articles in this series cover thrush causes, and thrush treatments.

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Thrush symptoms

Thrush can affect different body parts, and the symptoms differ depending on where the infection is.

Oral thrush symptoms

Oral thrush is most common in newborn babies, older people, and people with a weakened immune system.

There are a few different types of oral thrush, which can cause different patterns of symptoms:

• White or yellowish patches can appear in the mouth - such as in the cheeks, gums, or tongue. These can usually be scraped off, leaving behind a red base.

• The tongue and roof of the mouth can become sore and red, with the tongue becoming smooth.

• Thrush infection can affect dentures. This causes redness, and sometimes soreness, in the area where the dentures are.

• Cracks at the corners of the mouth (angular cheilitis) can be caused by thrush.

• Oral thrush can cause an unpleasant taste or sensation - such as a cottony feeling - in the mouth.

Vaginal thrush symptoms

Vaginal and vulval thrush is common in women after puberty - it's less common, but still happens, in women after menopause. Some health conditions, like diabetes and HIV, increase the risk of it happening. It's rare for vaginal yeast infections to happen in girls who haven't gone through puberty yet.

Thrush can affect the inside of the vagina, the skin around the vaginal entrance (the vulva), or both. Symptoms include:

• Itching, irritation, or soreness of the vagina and/or vulva.

• Vaginal discharge - typically white, thick (like cottage cheese) and not smelly.

• Redness of the vulva.

• Small cuts (fissures) of the vulva.

• Pain when having sex - usually near the vaginal entrance.

• Burning or stinging pain when weeing.

Thrush symptoms in men

Thrush infections are less common in men and boys, but can affect the head of the penis and foreskin (balanitis). Symptoms include:

• Soreness and itchiness of the head of the penis and/or foreskin.

• Swelling and redness of the head of the penis and/or foreskin.

• A thick discharge from underneath the foreskin.

• Pain when having sex.

• Burning or stinging pain when weeing.

Other thrush symptoms

Candida - the cause of thrush - can also cause skin infections. Typically, these affect areas where the skin is warm and moist, such as in skin folds, causing a condition called intertrigo. Symptoms of this include:

• Redness of the skin.

• Itchiness of the skin.

• Sometimes soreness of the skin.

Candida can also cause deeper infections. These are rare in people with normally-functioning immune systems, but are more commonly seen in people with a severely weakened immune system, such as people on some types of chemotherapy, or people with AIDS. Examples of these infections include Candida infection of the oesophagus (food pipe), which can cause:

• Difficulty swallowing - such as a sensation of food stuck in your throat, or lower down in the chest.

• Painful swallowing.

• Chest pain, typically behind the breastbone.

Other types of deep Candida infection are possible - people with these might become very unwell, for example with fever and symptoms of sepsis.

When to see a doctor for thrush symptoms

Many cases of thrush can be treated with medicines that you can get from a pharmacy. Speak to a pharmacist if you think you have thrush, and they can recommend treatment.

You should speak to a doctor if:

• You're not sure if you have thrush, or something else.

• You've tried treatment, and it hasn't worked.

• Thrush symptoms keep coming back (recurrent thrush) - for example more than four times in 12 months.

• You're pregnant or breastfeeding.

You can seek advice from a doctor or nurse in a GP surgery, or at a sexual health clinic. Thrush isn't a sexually transmitted infection, but some of the symptoms of genital thrush can be similar to other infections, and sexual health clinics are familiar with treating thrush as well.

How is thrush diagnosed?

Thrush affecting the mouth, vagina or vulva, skin, or penis can usually be diagnosed on the basis of typical symptoms, and examining the affected area. Tests aren't needed if the diagnosis is clear. This also means there doesn't need to be a delay in starting treatment from waiting for swab results.

Thrush can be tested for on swab tests - for example, swabs of the mouth, the penis, the vagina and vulva, or skin. Swab tests use a kind of cotton bud to pick up samples of organisms. Swab tests have to be interpreted carefully, because Candida is a normal organism that lives on most of us without causing any problems - it only needs to be treated if it causes an infection.

Swab tests can't tell between Candida that is simply living in the body, and Candida that is causing an infection - information about symptoms and examination findings is needed to tell between the two. Swab tests for Candida are usually requested if the diagnosis isn't clear, or if thrush treatment hasn't worked.

Tests for other conditions which might be offered include:

• Swab or urine tests for Chlamydia and Gonorrhoea might be recommended to look for other causes of vaginal or penile discharge.

• Blood tests may be recommended to look for causes of recurrent thrush, in people who have repeated episodes of thrush. This might include an HIV test, and a test for diabetes.

Tests for deep Candida infections vary depending on where the infection is. For example, oesophageal candidiasis is diagnosed on endoscopy.