Antifungal
Skincare


An antifungal medication, also known as an antimycotic medication, is a pharmaceutical fungicide or fungistatic used to treat and prevent mycoses such as athlete’s foot, ringworm, candidiasis (thrush), serious systemic infections such as cryptococcal meningitis, and others. A doctor’s prescription usually obtains such drugs, but a few are available over the counter (OTC). Antifungal medications typically work either by killing the fungal cells or stopping them from growing and multiplying.

Antifungal drugs target parts of the cell including the fungal cell membrane and the fungal cell wall. These are both protective parts of the cell that can cause the cell to leak and die when damaged. Human bodies do not have these structures, meaning antifungal drugs can target the fungi without harming the body’s cells.

Types of antifungal drugs

Antifungal drugs come in many forms depending on many factors. Specific drugs come in different forms. The type of infection a person has will impact how they receive the drugs.

There are four main types of antifungal drugs. These are:

Polyenes

Azoles

Allylamines

Echinocandins

Polyenes

These work by altering the wall of the fungal cells to be more porous, thus making them more likely to burst. A polyene is a molecule with multiple conjugated double bonds. A polyene antifungal is a macrocyclic polyene with a heavily hydroxylated region on the ring opposite the conjugated system. This makes polyene antifungal amphiphilic. The polyene antimycotics bind with sterols in the fungal cell membrane, principally ergosterol. This changes the cell membrane’s transition temperature (Tg), thereby placing the membrane in a less fluid, more crystalline state. (In ordinary circumstances, membrane sterols increase the packing of the phospholipid bilayer, making the plasma membrane denser.) As a result, the cell’s contents, including monovalent ions (K+, Na+, H+, and Cl−) and small organic molecules, leak, which is regarded as one of the primary ways a cell dies. Animal cells contain cholesterol instead of ergosterol, so they are much less susceptible.

Examples of polyenes and the fungal conditions they treat include:

Nystatin: A topical and oral antifungal that treats Candida infections involving the mouth or skin.

Amphotericin B: Treats many fungal conditions, including invasive aspergillosis, blastomycosis, candidiasis, coccidioidomycosis, cryptococcal meningitis, cryptococcosis, histoplasmosis, mucormycosis, sporotrichosis, and others.

Azoles

Azoles are some of the most commonly used antifungal. They interfere with an essential enzyme for creating the fungal cell membrane. Because of this, the cell membrane becomes unstable and can leak, eventually leading to cell death. There are two sub-categories within the azole antifungal medication: imidazoles and triazoles.

Some examples of imidazoles and the fungal conditions they treat include:

Clotrimazole: Skin, oral, and vaginal Candida infections.

Ketoconazole: Systemic fungal infections due to Candida, blastomycosis, coccidioidomycosis, histoplasmosis, chromomycosis, and paracoccidioidomycosis.

Miconazole: Vaginal, skin, and nail infections.

Some examples of triazoles and the fungal conditions they treat include:

Fluconazole: Used to treat fungal infections due to Candida and Cryptococcus.

Isavuconazole: Treatment of invasive aspergillosis and mucormycosis infections.

Itraconazole: Blastomycosis, aspergillosis, histoplasmosis, candidiasis, and various superficial mycoses.

Posaconazole: Treats invasive fungal infections due to aspergillosis and candida.

Voriconazole: Aspergillosis and Candida.

Allylamines

Allylamines work by inhibiting an enzyme that the cell membrane requires to operate correctly. Without this membrane, the cell is likely to be unable to function. Like the azole antifungal, allylamines interfere with an enzyme involved in creating the fungal cell membrane. One example of allylamine is terbinafine, which is often used to treat fungal infections of the skin. An example of allylamine is terbinafine, which treats fungal skin infections.

Echinocandins

These interfere with an enzyme involved in creating the fungal cell wall. Some examples of echinocandins and the fungal conditions they treat include:

Anidulafungin: Treats esophageal candidiasis and invasive candidiasis.

Caspofungin: Aspergillosis, esophageal candidiasis, and invasive candidiasis.

Micafungin: Esophageal candidiasis and invasive candidiasis.

Types of Fungal infections

The most common types of fungal infection are:

Ringworm: People also know ringworm as tinea or dermatophytosis. It is a common skin infection caused by any of around 40 different species of fungi. It can occur on the scalp, feet, or anywhere else on the skin.

Oral thrush: Caused by a yeast called Candida, this infection occurs when something affects the environment inside the mouth, throat, or esophagus.

Vaginal Yeast Infection: The yeast that usually lives in the body and on the skin causes this infection. If something disrupts the environment inside the vagina, the yeast can multiply and cause an infection.

Onychomycosis: Fungal nail infections can occur on the hands but most commonly occur on the toenails. Fungi cause these infections when they enter the nail through small cracks in the nail or skin around it.

Coccidioidomycosis: A fungus that lives in the southwestern United States soil causes coccidioidomycosis, also known as valley fever.

There are some more severe infections that fungi can cause, and these include:

Aspergillosis

Blastomycosis

Cryptococcus gattii infection

Fungal meningitis

Fungal pneumonia

Histoplasmosis

Mucormycosis

Paracoccidioidomycosis

Talaromycosis

These are much rarer but can be a lot more serious.

Symptoms of a Fungal infection

Ringworm: This presents with a ring-shaped rash and itchy, red, scaly, and cracked skin. Depending on its location, ringworm may cause a person to experience hair loss.

Oral thrush: White patches may cover the inside of the mouth and throat, including on the tongue. There may also be redness present. A person may experience pain while swallowing or eating.

Jock itch: People with jock itch may notice scaly, itchy, red spots, usually on the inner sides of the skin folds of their thigh.

Athlete’s foot: A person with an athlete’s foot may notice that they have red, swollen, itchy, and sometimes peeling skin between their toes.

Vaginal Yeast Infection: Symptoms may include abnormal vaginal discharge, vaginal itchiness, soreness, pain during penetrative sex, and pain when urinating.

Onychomycosis: Hands or feet with fungal infections often have thick, yellow, brown, white, or otherwise discolored nails. They may also be fragile or cracked.

Coccidioidomycosis: Valley fever causes a person to experience fatigue, headache, and shortness of breath, night sweats, and muscle ache. They may also have a cough and notice a rash.

WHAT ARE ANTIFUNGAL MEDICINES, AND HOW DO THEY WORK?

There are several types of antifungal medicines. They come as creams, sprays, solutions, tablets designed to go into the vagina (pessaries), shampoos, medications to take by mouth, and injections—most work by damaging the cell wall of the fungus, which causes the fungal cell to die.Antifungal creams, liquids, or sprays (also called topical antifungal) are used to treat fungal infections of the skin, scalp, and nails. They include clotrimazole, econazole, ketoconazole, miconazole, tioconazole, terbinafine, and amorolfine. They come in various brand names. Sometimes an antifungal cream is combined with other creams when two actions are required. For example, an antifungal cream is often combined with a mild steroid cream, such as hydrocortisone to treat certain rashes. The antifungal cream clears the infection, and the mild steroid cream reduces the inflammation caused by the infection.

Antifungal Shampoo

A shampoo that contains ketoconazole is sometimes used to help treat scalp fungal infections and certain skin conditions.

Antifungal Pessaries

Pessaries are tablets that are designed to be put into the vagina. Some antifungal medicines are used as pessaries to treat vaginal thrush, particularly clotrimazole, econazole, miconazole, and fenticonazole.

Antifungal Injections

These may be used if you have a severe fungal infection within the body. Amphotericin, flucytosine, itraconazole, voriconazole, anidulafungin, caspofungin, and micafungin are sometimes used in this way. The one chosen depends on the type of fungus causing the infection. These are specialist medications used for people who are usually quite ill in hospital.

Antifungal medicines are different from antibiotics, which are antibacterial medicines. Antibiotics do not kill fungi - they kill other germs (called bacteria). You are more prone to getting a fungal infection if you take antibiotics. For example, many women develop thrush after taking a course of antibiotics. This is because the antibiotic may kill the normal harmless bacteria that live on your skin or vagina and make it easier for fungi to flourish.

Side effects of Antifungal medication

It will help if you read the information leaflet with your particular brand for a complete list of cautions and possible side-effects. As a general rule:

Antifungal Creams, Sprays, Liquids, And Shampoos: These usually cause no side effects and are easy to use. Occasionally some people get a little bit of itch, burning, or redness where the antifungal preparation has been applied. If this is severe, you should stop using it. Occasionally, some women develop irritation around the vagina after applying vaginal antifungal products.

Antifungal Medicines by Mouth: The most widely used are terbinafine for nail infections, miconazole and nystatin for oral thrush, and fluconazole for vaginal thrush. These usually cause no side effects. You can even buy fluconazole without a prescription at pharmacies, as it is considered a medicine that is unlikely to cause problems. Some antifungal preparations cause liver problems or more severe side effects in a small number of people. A few common possible side-effects of some of the more widely used antifungal medicines are as follows:

Terbinafine sometimes causes tummy aches, loss of appetite, feeling sick (nausea), tummy upsets, diarrhea, headache, and rash, taste disturbance, and muscle or joint pains.

Fluconazole may cause nausea, tummy ache, diarrhea, wind, headache, or a rash.

Miconazole may cause nausea or sickness (vomiting) or a rash.

Nystatin may cause soreness of the mouth.

Antifungal Injections: These have more risk of causing side effects and sometimes serious problems. However, these are used to treat serious fungal infections, and the risk of side effects needs to be balanced against the need for treatment.


Natural Antifungal remedies

1. Yogurt and probiotics

The vagina is home to numerous beneficial microbes, which keep disease-causing microbes, such as Candida, in check. The yeasts grow out of control when something like antibiotics or hormones disrupts that delicate balance. Using yogurt or probiotic foods, such as kombucha, has become a common natural remedy for vaginal yeast infections to restore the vagina’s population of friendly bacteria.

2. Garlic

Numerous studies have shown that garlic benefits include its antifungal properties. Some women promote placing garlic cloves in the vagina at night. Still, even though this treatment is unlikely to cause any significant damage, there’s no scientific evidence to show it works. 

Instead, garlic has been proven to be even more effective against athlete’s foot than prescription medicines like Lamisil. A compound in garlic known as “ajoene” is especially effective against the fungus that causes the athlete’s foot. 

3. Oregano essential oil

Oregano oil is a powerful plant-based antibiotic. The Journal of Medicinal Food published a study that evaluated essential oregano oil and its effect on fungus caused by bacteria — it showed significant antibacterial properties against five species of harmful bacteria.

Oregano oil contains 71 percent of the antiseptic compounds known as phenols, including thymol and carvacrol. While oregano is a super powerful natural antibiotic, use caution. It can cause a burning sensation and is heavily diluted with a carrier oil. Also, I would not recommend applying it to sensitive areas of the body.

4. Tea Tree oil

Tea tree oils are effective against various Candida in numerous studies. Tea tree oil was studied using a micro broth method. The same preparation was tested in an experimental vaginal infection using fluconazole–itraconazole-susceptible or -resistant strains of C. Albicans (Candida).

Tea tree oil was shown to be active in vitro against all tested strains and was highly successful in accelerating the elimination of Candida from the experimentally infected rat vagina. Continued studies brought about resolution of the infection regardless of whether the infecting C. Albicans strain was susceptible or resistant to fluconazole. 

5. Coconut oil

Coconut oil is known for its health-supporting and immune-enhancing properties. In the case of fungus within the body, coconut oil can provide significant benefits. Yeast and fungus exist in all mucous membranes of your body, particularly the intestines, but rarely cause problems unless they become overgrown. This is when a natural antibiotic, like coconut oil, may be beneficial. Because excessive sugar intake, stress, or general weakness of the immune system can cause fungal growth, a fungal nail represents just one potential manifestation of this fungal overgrowth and may accompany a systemic fungal infection.

Coconut oil contains medium-chain fatty acids that have a fungus-killing action. These special fats exhibit potent antiviral, antibacterial and antifungal effects which can kill the fungus, which is why it should be considered for toenail fungus treatment and beyond. Both oral consumption and topical application can benefit. 

6. Dill oil

Dill oil has been used in Ayurvedic medicine since ancient times. Dill has been reported to possess antibacterial properties, making it a potential source of an eco-friendly antifungal drug.

The essential oil extracted from the seeds of dill (Anethum graveolens L.) was demonstrated in a study showing its ability to disrupt the permeability barrier of the plasma membrane, which can help eliminate fungus-causing bacteria.

7. Eliminate sugar and moldy foods

Reducing sugar and refined carbohydrates can significantly curtail infection from fungal. This is because yeast feeds on sugar, fermenting it to produce alcohol in the form of ethanol and an even more toxic chemical, acetaldehyde. When you stop a potential sugar addiction and reduce the amount of sugar in your diet, you reduce the amount available to the yeast in your intestines.

Yeast overgrowth, which leads to a leaky gut syndrome, can result in immune reactions. It’s best to avoid processed foods and sugars of all types, cheese, alcoholic beverages, mushrooms, and processed meats. Eat grains and high carbohydrate vegetables in moderation. Focus more on raw or lightly steamed vegetables and lean meats.

8. Caprylic acid

Caprylic acid contains antibacterial, antiviral, and antifungal properties. It can boost the immune system and is commonly used as topical fungicides. Caprylic acid helps naturally reduce yeast growth within the gastrointestinal tract so that beneficial bacteria can thrive. Taken orally, it is entirely natural, helping prevent an imbalance between various bacteria.

9. Boric acid

Boric acid has antibacterial properties, making it an excellent, affordable home remedy for fungus. Research shows that boric acid suppository capsules appear to be very effective against yeast infections, particularly those caused by Candida. However, boric acid can occasionally cause vaginal burning, should be diluted or used with the guidance of a doctor, is toxic when swallowed, and shouldn’t be used frequently or when pregnant. 

10. Apple cider vinegar

Apple cider vinegar (or ACV for short) is one natural remedy that I shout quite a lot about here at A. Vogel Talks Fungal Skin Infections, and that’s for a good reason. It’s antibacterial and antifungal, so it’s ideal for combating a fungal overgrowth, whether it’s internally or externally. It also helps that these benefits are backed up by research.  You can take apple cider vinegar in various ways: some people prefer to swallow a small amount each day; some would rather dilute it with water and apply it to the affected area.

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