Yeast Infection Under the Breast: How to Identify the Rash

A yeast infection under the breast usually looks like a raised, shiny, reddish-brown rash where the skin folds under the breast. The rash can be itchy or painful and cause tiny blisters that ooze and crust over. It may also give off a bad odor.

The shape of the rash will often look the same on each side of the skin fold, This is because the fungus that causes most yeast infections, called Candida, thrives in moist environments. In areas like the breasts where skin-to-skin contact creates excess moisture, the rash underneath the breast will often be a mirror image of the rash on the breast itself.

This article explains the causes and risk factors of a yeast infection under the breasts. It also describes how the infection is treated and prevented.

Causes and Risk Factors

Candida is a fungus that lives both inside and outside of your body. It can be found in the digestive tract, mouth, vagina, and on your skin. Candida albicans is by far the most common type, but there are other Candida species that can also cause yeast infections.

Under normal circumstances, Candida is but one of many microorganisms that reside on the skin as part of the body's natural flora. When the natural flora is in balance, Candida is kept in check and doesn’t cause any problems.

When the balance is disrupted, Candida can suddenly overgrow and establish an infection. When this occurs on the skin, it is known as cutaneous candidiasis.

A yeast infection can develop under the breasts due to a common inflammatory skin condition called intertrigo. This is where skin-to-skin friction combined with trapped moisture disrupts the integrity of the skin. The trapped moisture also causes surfaces of the skin to stick together in skin folds such as the breasts and armpits.

These factors not only promote the overgrowth of Candida but also allow the fungus to infiltrate damaged tissues. The resulting infection is known as candidal intertrigo.

There are other factors that can contribute to yeast infections under the breasts:

Diabetes

When you have uncontrolled diabetes, high blood sugar (hyperglycemia) can fuel the growth of the fungus. On top of this, uncontrolled hyperglycemia can damage blood vessels in the skin, decreasing circulation and making it harder to fight skin infections.

Large Breasts

Large, heavy breasts—especially those not well-supported with a bra—are more likely to rub against the skin of the upper torso. The skin under large breasts may also be harder to keep dry and well-ventilated. This can cause intertrigo which, in turn, can lead to a yeast infection.

Tight clothing can also promote the overgrowth of the fungus by blocking air circulation and allowing heat and moisture to accumulate.

Obesity

People with obesity typically have deep skin folds, including those under the breasts. They may also sweat more due to thicker layers of fat (adipose tissues) under the skin.

Moreover, obesity places the body under constant inflammation, which in and of itself increases the likelihood of intertrigo.

Together, these factors not only increase the risk of candidal intertrigo but make it more likely for the infection to recur even with effective treatment.

Climate

Skin can get and stay excessively moist in hot, humid environments. This gives Candida ample opportunity to multiply and spread.

This is evidenced in part by research in which new strains of Candida have emerged as a result of climate change. This includes a species called Candida auris, which is increasingly seen in healthcare settings and is surprisingly resistant to antifungal drugs.

Health Problems

People with certain health conditions are at greater risk of candida intertrigo and are more likely to have recurrent and hard-to-treat episodes.

This is due in large part to the suppression of the body's natural immune response. In short, when your immune defenses are down, Candida has the opportunity to overgrow.

Conditions associated with an increased risk of candidal intertrigo include:

• HIV and other forms of immunosuppression
• Hypothyroidism (low thyroid function)
• Iron deficiency
• Pregnancy
• Menstruation
• Smoking
• The use of broad-spectrum antibiotics
• The use of corticosteroids (steroids)
• The use of estrogen-based birth control
• Vitamin B deficiency

How to Treat a Yeast Infection Under the Breasts

Cutaneous yeast infections are most commonly treated with topical antifungal creams, ointments, and sprays that you apply to the skin. Some are available over the counter (OTC). In severe cases, your healthcare provider may recommend a prescription option.

Some of the topical antifungals used to treat candidal intertrigo include:

• Ecoza (econazole)
• Lamisil (terbinafine)
• Lotramim (clotrimazole)
• Monistat-Derm (miconazole)
• Nizoral (ketoconazole)
• Nyata (nystatin)
  

With twice daily application, most people will see improvement within a week or so.

Prevention

When it comes to cutaneous yeast infections, the best defense is a good offense. Here are some tips that can help:

• Practice good hygiene: Keep the skin under your breasts clean, washing morning and night with gentle soap. Dry under the breasts thoroughly after bathing. Never clean with an alcohol-based hand sanitizer as it can dry and damage the skin.
• Choose the right bra: Wear a support bra made of cotton, which is more breathable and absorbent. You can even try wearing a cotton T-shirt underneath your bra if you are prone to sweating.
• Ventilate the skin: Wear loose-fitting clothes and avoid tight tops (particularly those made of unbreathable fabrics like nylon, acrylic, viscose, or leather). You can even opt to go shirtless when in private.
• Keep the skin dry: If you get sweaty during the day, take the time to excuse yourself and dry underneath the breasts. An antiperspirant or a moisture-absorbing powder like Gold Bond can also help keep you dry.
• Lose weight: A healthy diet paired with routine exercise can reduce the density of adipose tissues in skin folds. It can also improve your overall fitness and reduce the level of perspiration that might occur with everyday activities.

Summary

Yeast infections can develop in skin folds where moisture gets trapped, such as under the breasts. The rash usually looks red or reddish-brown and may cause blisters or crusting. It may also be painful, itchy, or emit a bad smell.

Obesity, smoking, certain health conditions like diabetes, and simply having large breasts can increase the risk of yeast infections under the breasts.

These types of infections are treated with topical antifungal drugs. They can also be prevented by practicing good hygiene, wearing a cotton support bra, and keeping the skin dry and well-ventilated throughout the day. Weight loss also helps.