Inflammatory skin conditions plague millions of people, with candida often being a major underlying cause. Aesthetic professionals are in an opportune position to help clients recognize candida. Understanding the nature, causes, and treatment of this condition can help you to recognize it in clients and make appropriate referrals, so they can get the help they need to end their suffering.

WHAT IS CANDIDA?
Candida is a yeast and fungal infection usually created by an overgrowth of candida albicans. There are dozens of strains of candida, but C. albicans is the most prevalent. This species is present on healthy skin and in the gut and is part of a balanced system that helps the body digest food and maintain good health. Under normal, healthy conditions, friendly bacteria keep candida in its place and everything is in balance. What happens when balance gets out of kilter? Inflammation – on the skin and in the digestive system. The clients that you meet in the treatment room will likely be suffering from skin rashes, sensitivity, and inflammatory skin conditions.

You might be wondering what the gut (like the gastrointestinal tract or digestive system) has to do with skin. Over the past several years, scientists have finally begun to unravel this mystery. There is now a concept known as the The Gut-Brain-Skin Axis.¹ The work behind this concept began over 70 years ago, when dermatologists John Stokes and Donald Pillsbury made the connection between acne, depression and anxiety, altered gut microbiome, and systemic inflammation. Since then, many researchers took a deep dive into the various components of this theory and have proven the links. These researchers connected emotional states – depression, worry, and anxiety – to altered gastrointestinal tract function (changes that cause alterations to the microbial flora), which they theorized promotes local and systemic inflammation: The Gut-Brain-Skin Axis! Finally, what we have always suspected was found to be true – gut health is reflected in the skin and our stress level can trigger flares. This research also led to the concept of leaky skin. Perhaps you have heard of leaky gut? Leaky skin is similar. Substance P, a neuropeptide produced in the gut, brain, and skin, plays a role in inflammatory skin conditions. Poor gut bacteria promotes the release of substance P. Probiotics have been shown to help modulate Substance P.²

MORE ABOUT CANDIDA
As mentioned earlier, our bodies are teeming with bacteria, both beneficial and harmful. In fact, a typical, healthy adult caries around 500 strains of bacteria and as many as 100 trillion individual bacteria.³ Many of these bacteria play important roles in digesting food and in maintaining a healthy immune system. Candida is a bacteria that falls on the more harmful side, but typically only when it grows too abundantly.

There are two forms of candida: yeast, which survives well in acidic conditions, and fungal, which thrives in a neutral or alkaline pH. As the conditions in the intestines change, candida is able to switch between these two forms and survive dramatic alterations in its environment. As it does so, it releases up to 79 byproducts, including uric acid and acetaldehyde, a neurotoxin that promotes free radical activity in the body. Free radicals damage cells. As you can see, these bugs are very smart and they learn to adapt to survive.

WHAT CAUSES CANDIDA?
There are some lifestyle and other conditions that can cause the overgrowth of candida in people. The following are some of the main stimulating factors.

Antibiotic Use from Food or Prescriptions: Yes, from the antibiotic drugs given to meat and dairy, too. Buying organic really helps limit this exposure.

High Sugar Diet: Yeast loves sugar. They grow and thrive on it. A high sugar diet also suppresses the immune system making it harder for the body to fight off the candida overgrowth.

Chronic Stress: Stress increases cortisol, which suppresses the immune system and elevates blood sugar. And, as we learned in the Gut-Brain-Skin Axis research, psychological stress alters gut microbiota, making it easier for invaders to take up residence.

Birth Control Pills: Hormone balance and intestinal balance are delicately related. Estrogen has been shown to increase yeast, so certain oral contraceptives can contribute to candida.

Toxic Chemical Exposure: This can come from just about anywhere – from mercury fillings, chlorine, and fluoride in the water to airborne pollutants.

Diabetes: Again, high blood sugar feeds the candida and diabetics usually have impaired immunity, as well, making it harder to fight off the invading yeast.

Genetic Predisposition: There are over 100 known snps (gene alterations) that increase the chances of a person getting candida, making some people genetically predisposed.

SYMPTOMS OF CANDIDA
How can you recognize candida in yourself and clients? The symptoms vary widely, but there are a few that are pretty consistent. The leaky gut that follows a candida overgrowth expands the damage and symptoms greatly. Catching and treating candida early can limit the long-term damage. Skin rashes, food sensitivities and new allergies, oral thrush (white coated tongue) and vaginal yeast infections, and digestive discomforts like gas and bloating are among the most commonly seen symptoms of candida. Other symptoms include:

• weight gain
• headaches
• fatigue
• brain fog
• altered mood
• joint pain

TREATMENT APPROACHES
When discussing treatment, once again, I will reiterate that candida needs sugar to survive, so diet is the key intervention in the treatment protocol. Specifically, candida utilizes glucose, fructose, and sucrose. It uses the sugar to build its cell walls, which are made of 80% carbohydrate (sugar). It also uses the sugar to create protective biofilms to hide from the body’s immune system. Isn’t it crazy how smart bacteria are? These biofilms are made of 32% glucose.

There are a few diet options, but all are sugar-free and low carb during the kill-off phase, which normally lasts four to six weeks. Depending on personal factors, low-carbohydrate diets, like Atkins and ketogenic, are good choices. For some people, those are too restrictive and they can’t comply. For these clients, more liberal diet plan may be needed. After a very strict kill-off phase, a reintroduction can be done, adding one food at a time (there is a list and method), noting any reaction. This will indicate if it is the right time to move into this phase. Please note, a client should be referred to a highly qualified certified nutrition specialist or registered dietitian (if they have training in this specialty) for monitoring during this diet. It is not in the scope of practice of an aesthetician to make dietary or supplement recommendations.

Speaking of supplements, there are some that can significantly help make the treatment protocol more successful. It is critical to start out slowly with these medications or supplements because some people experience some flu-like symptoms during the die-off phase.

The anti-fungals and anti-microbials which I have found to be effective are:

• oil of oregano
• berberine
• grapefruit seed extract
• caprylic acid (from coconut)
• garlic
• tea tree oil
• Nystatin, Diflucan, Sporanox, and Nizoral (available by prescription from a doctor only)

Additionally, a high fiber diet (35 grams or more per day) during treatment to help clear the bacteria as it is being killed is recommended. A charcoal or clay binder is also suggested for the right individual.

A person would not take all of these supplements at once. These are just options. A qualified nutritionist will be able to look at each person’s medical history and other factors and create a program that is personalized for each individual.

Restoring flora is critical and good pro- and prebiotic supplements are needed. Things to consider when choosing a probiotic:

• 250 million to 100 billion CFU’s (colony forming units)
• should take with food, separate from antifungals and antimicrobials
• switch them up every 30 days, so you don’t over-grow any one strain
• S. boulardi, lactobacillus acidophilus, and bifidobacteria bifidum are shown in research studies to help prevent candida regrowth

Prebiotics are the food for the probiotics. Prebiotics are found in certain foods that contain starch, especially a form called resistant starch. Without good food, the probiotic supplement will not colonize, so including these foods in the diet are very important. Some of the best foods to feed bacteria include asparagus, leeks, onion, garlic, Jerusalem artichoke, jicima, chicory root, dandelion greens, bananas, and sour cream. When trying to add resistant starch to a diet (which, by the way, is really important to support a healthy weight, too), focus on eating the following: oats, cooked and cooled rice, legumes, raw potato starch, cooked and cooled potatoes, and green bananas. Keep in mind that these foods are not to be added during the initial kill-off phase, as they are starches, which turn to sugar.

Clearing the body of candida is not an easy fix and some people are genetically predisposed to get yeast infections. It is important to know that everyone is unique and understanding your particular biochemistry is critical. Working with a qualified clinical nutritionist, a specially trained registered dietician, or integrative health doctor will help improve outcomes. They can do special testing, such as organic acid tests, stool analysis, skin scraping analysis, or DNA tests, to look for the 147 gene snps that are indicated in candida. This information helps to create a personalized nutrition and supplement treatment plan. In addition, hiring a health coach for the first four to six weeks is a great tool to help stay motivated and on-program.

Always work within your scope of practice. Notice and refer – do not try to offer nutritional advice or recommend supplements. Aesthetic professionals are in the perfect position to help individuals identify and get help with treating this complicated condition, so create a referral network for clients.

References
1 Bowe, Whitney P. and Alan C. Logan. “Acne vulgaris, probiotics and the gut-brain-skin axis –
back to the future?” Gut Pathogens 3, no. 1 (2011).
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3038963.
2 Mijouin, Lily, Mélanie Hillion, Yasmina Ramdani, Thomas Jaouen, Cécile Duclairoir-Poc,
Marie-Laure Follet-Gueye, Elian Lati, Florent Yvergnaux, Azzedine Driouich, Luc Lefeuvre,
et al. “Effects of a Skin Neuropeptide (Substance P) on Cutaneous Microflora.” PLoS One 8,
no. 11 (2013). https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3826737.
3 “Human microbiota.” Wikipedia. https://en.wikipedia.org/wiki/Human_microbiota.

Ginger Downey, MS, CNS, holds a bachelor’s degree in foods and nutrition and a master’s degree in nutrition. She is also a certified nutrition specialist (CNS). Her strong science background overlays a ten-year career in human resources. In her work as a nutritionist, Downey worked in corporate wellness, where she developed nutrition and behavioral modification protocols and programming. Since 2011, she has been the co-owner of DermaMed Solutions, LLC, where her focus is on researching the latest scientific advances in skin care and incorporating them into DermaMed’s holistic approach. Additionally, Downey works with patients in private clinical practice, incorporating her most recent training in nutrigenomics, utilizing individual DNA data to create personalized nutritional programs for her clients. This email address is being protected from spambots. You need JavaScript enabled to view it.