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Jock itch is an itchy rash of the groin that results from a superficial fungal infection of your skin. Men and women encounter the disease worldwide, although it is seen more often in the humid tropics. The rash may affect only your groin, but it may spread to include your inner thighs, genitals, and areas around your anus, rectum, or vagina.
Several organisms have been identified as causing the rash.
Risk factors include the following:
Heat
Humidity
Tight clothing
Damp skin folds as may occur with obesity or excessive sweating
Weakened immune systems
Jock itch must be distinguished from these skin problems:
Chronic irritation of skin folds
Psoriasis
Contact dermatitis
Erythrasma - A reddish brown rash
Eczema
Occasionally, bacterial organisms may cause infection on top of the fungal infection of jock itch. This new infection may become chronic if left untreated and may keep coming back in certain people.
Jock Itch Causes
A variety of fungi called tinea may cause jock itch, and the rash may occur in anyone, not just athletes or just men.
People taking broad-spectrum antibiotics, with weakened immune systems, or who have diabetes are more at risk to develop the rash.
The moisture, warmth, and presence of friction between skin folds make the groin area particularly open to fungal infection.
Wearing tight clothes or athletic supporters can aggravate the problem further.
Intimate contact or contact with objects that harbor the fungus invites the fungi. The fungus is spread by contact with the spores, which may survive on dead skin cells or objects for a long time.
If you have another fungal infection, such as athlete's foot , the same tinea organism may cause a rash in your groin.
Infections caused by Candida albicans are relatively "wet" (the skin is moist or weeping) and may involve the penis. This infection is seen more often in people with diabetes.
Epidermophyton floccosum may be responsible for the epidemic infections in dormitories, barracks, and similar situations in which people live close together and in which towels, sheets, blankets, and other items may harbor a fungus for years.
Trichophyton mentagrophytes is associated with an aggressive pustular infection and has been isolated from animal dander. You may have a severe inflammatory reaction with this infection, and the inflammation may spread rapidly over your trunk and legs.
Symptoms
The acute infection begins with an itchy area of redness about a half-inch across. The area may enlarge, and other sores may develop in no particular pattern. The rash appears as raised red plaques (platelike areas) with sharp borders. The border may exhibit tiny pimples or even pustules with central areas that are reddish and dry with small scales.
If you become infected with candidal organisms, the rash tends to be redder and wetter. The skin of your penis may be involved, whereas other organisms spare the penis. Women who also have vaginal infection experience vaginal itching and white, thick, cottage cheese – like discharge with candidiasis .
You may have other fungal skin rashes such as athlete's foot or ringworm on other body parts.
In long-standing infections, the rash becomes less itchy and less red, and the plaques may fuse together.
The rash becomes irritating with time and may, in severe cases, feature breakdown of the skin that is quite uncomfortable.
When to call the doctor
The appearance of a red itchy rash in your groin or genital area should prompt a visit to your doctor.
Once you have been diagnosed, go back to the doctor if the rash does any of these things:
Spreads or changes appearance
Becomes increasingly uncomfortable
Develops lumps or swelling of the affected areas
Does not improve after 2 weeks of treatment
Does not go away completely or comes back frequently despite proper prevention
When to go to the hospital
Go to a hospital's emergency department if you develop symptoms beyond the rash:
Fever
Weakness
Vomiting
Rapid spread of the rash
Swollen glands
Lumps in the groin
Drainage of pus
Open sores or ulcers
Boils
Rash that involves your penis or vaginal area
Difficulty urinating
Rash that spreads to your trunk
Self-Care at Home
If you have some itching and redness in the groin area, try to keep the area dry, exposed to air as much as possible, and avoid tight clothes on the area. These measures may relieve the problem.
Many antifungal medications are available without prescription. They come in cream, liquid spray, ointment, and powder forms. Some people may develop an allergic reaction to the medication, so stop using them if your rash seems worse.
Tolnaftate (Tinactin, Aftate) and undecylenate (Cruex, Desenex) are well-known, effective medications. The powder form is also useful as a drying agent. These medications are not effective against candidal infections.
Clotrimazole (Fungoid, Lotrimin, Mycelex) and miconazole (Micatin, Monistat Derm) are also available over-the-counter and are effective against all fungi.
If these medications help, be sure to use them for 2-4 weeks to completely clear the infection.
Keeping the affected area clean and bone dry helps to clear the infection.
You may use the medications to prevent relapses as well.
Medications
The doctor will prescribe antifungal medication based on your history and physical examination.
Skin creams will be the first line.
Prescription medications to clear the fungus may come in the form of a cream, powder, gel, or spray. A topical medication often prescribed is terbinafine (Lamisil, Daskil, Dermgel). Lamisil is now available in nonprescription form.
Keep the area dry and cool between applications.
Some medications may cause skin irritation, so stop using it and call your doctor if the area seems to get worse.
Some topical (ointment) therapies are available over-the-counter. Miconazole (Micatin, Monistat Derm), tolnaftate (Aftate, Ting, Tinactin), and clotrimazole (Lotrimin, Mycelex) are some examples.
Oral medications have a greater risk for side effects.
They will be reserved for extensive, severe, or chronic infections.
They may also be prescribed if topical therapy does not work. Commonly prescribed medications are itraconazole (Sporanox) and fluconazole (Diflucan)
You will use the medication for 1 to several weeks because fungal infections can take a long time to clear.
Occasionally, your doctor may prescribe combination therapy in which a steroid or antibiotic is added to the antifungal medication.
Follow-up
Use any medication the way it is prescribed and for the length of time prescribed. Do not stop because the rash goes away quickly.
If instructed to do so, follow up with your doctor to be re-checked even if the rash has completely gone away.
Prevention
To prevent jock itch, try to keep your groin area clean and dry.
Use cornstarch, powders, even antifungal powder such as Desenex or Cruex in the various skin folds.
It is best to wear loose-fitting cotton underwear.
From a public health perspective, sterilizing linens by washing in hot soapy water with bleach can help in situations of communal bedding and bath linens.
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