Candida is a genus of yeast, most commonly Candida albicans, that naturally lives on and inside the human body. When the microbiome balance is disrupted, this fungus can multiply uncontrollably, leading to candidiasis or Candida overgrowth. Symptoms range from localized skin rashes to systemic infections, depending on the location. Because of this wide range of severity, the medical professional best suited to treat the condition varies considerably. The decision about which doctor to see is determined by the specific symptoms, the infection’s location, and whether it is recurrent or invasive.
Initial Assessment by Primary Care
A Primary Care Physician (PCP), including General Practitioners (GPs) and Family Doctors, is the appropriate first point of contact for suspected Candida overgrowth. PCPs manage the majority of common, localized fungal infections in healthy individuals. Infections such as oral thrush, which manifests as white patches on the tongue and inner cheeks, are often diagnosed and treated at this level.
PCPs also commonly treat mild skin folds infections (intertrigo) and initial, uncomplicated vaginal yeast infections. The initial assessment involves a visual examination and a review of the patient’s history, noting recent antibiotic use or underlying conditions like diabetes. Diagnosis is often confirmed quickly through a simple visual inspection or a basic test, such as a potassium hydroxide (KOH) wet mount or a quick swab.
Treatment for these localized infections involves a short course of topical antifungal medications (creams or lozenges) or a brief oral antifungal regimen. If the infection fails to respond to this initial treatment, or if the symptoms are severe and suggest a deeper issue, the PCP will then refer the patient to a medical specialist.
Specialists for Systemic or Recurrent Infections
When Candida infections become severe, chronic, or spread beyond their initial site, specialized medical professionals are required for proper diagnosis and management. The specific specialist needed is determined by the body system most affected by the persistent overgrowth.
A Gastroenterologist (GI) is the appropriate specialist when the primary concern is chronic intestinal overgrowth or gut dysbiosis. These doctors use advanced diagnostic tools like comprehensive stool analyses to evaluate the balance of the gut flora, which includes the presence and quantity of Candida. Management by a GI specialist involves targeted prescription antifungals like nystatin or fluconazole, alongside strategies to restore beneficial bacterial populations.
For severe or life-threatening cases of invasive candidiasis, an Infectious Disease (ID) specialist must be consulted. This situation, often called candidemia when the fungus enters the bloodstream, typically occurs in immunocompromised individuals or hospital patients. The ID specialist manages the systemic spread to organs like the heart, kidneys, or eyes, relying on blood cultures and susceptibility testing to guide treatment. This level of infection often requires high-dose intravenous antifungal medications, such as echinocandins, to clear the fungus from the body.
A Gynecologist is the specialist who manages severe or Recurrent Vulvovaginal Candidiasis (RVVC), often defined as four or more symptomatic episodes within a year. Beyond confirming the diagnosis with laboratory tests, the gynecologist investigates underlying factors like hormonal changes or persistent immune dysfunction. Treatment for RVVC often involves a prolonged maintenance course of oral fluconazole to suppress the yeast and prevent recurrence.
When the skin or nails are chronically affected, a Dermatologist is the suitable specialist for persistent nail fungus (onychomycosis) or skin infections that do not clear with standard topical care. A dermatologist may perform a deeper tissue biopsy or culture to identify the exact fungal species and determine its resistance profile. This allows them to prescribe stronger, longer-duration oral antifungals that can penetrate the nail bed or deeper layers of the skin.
The Role of Integrative and Functional Medicine
Beyond conventional specialists, some patients seek care from practitioners of Integrative and Functional Medicine, including Naturopathic Doctors (NDs) or medical doctors (MDs/DOs) who practice functionally. These professionals focus on identifying the underlying root cause of chronic or recurrent Candida symptoms, rather than simply suppressing the infection.
The approach centers heavily on the connection between gut health, diet, and immune function. Practitioners in this field may utilize advanced testing, such as organic acid urine tests or specialized stool tests, to gain a detailed understanding of the patient’s internal environment. Based on these results, they create comprehensive, individualized plans designed to restore balance to the body’s systems.
Treatment protocols frequently involve significant dietary changes, such as implementing a low-sugar, anti-Candida diet to deprive the yeast of its primary fuel source. This is often combined with targeted supplements, including high-dose probiotics and natural antifungal agents like caprylic acid or oil of oregano. This approach manages chronic overgrowth and identifies predisposing factors, but it is not for treating acute, invasive, or systemic candidiasis, which remains the domain of conventional medical specialists.