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The fungal jungle in your pants - (7/23/2019)

By Dr. Ron Gasbarro

Wayne walked into the pharmacy fanning himself with his newspaper. “Look at me, doc,” Wayne said, “I’m sweatin’ like an SOB!” Then, Wayne whispered to the pharmacist, “I got a terrible rash between my legs that will not go away. Is there anything I can use?” The pharmacist told Wayne that he likely has a case of tinea cruris. Tinea cruris is the medical term for a fungal skin infection of the groin region. The average Joe might know this as, jock itch, crotch rot, or ringworm. The term ringworm is a misnomer as a fungus is not the same organism as a parasitic worm. However, the fact that the common skin fungi (dermatophytes) cause a red ring-like rash has earned it the name “ringworm.”

While both genders can get the oft-painful itchy tinea, males tend to acquire it more frequently. Tinea cruris affects the groin area, inner thighs, and buttocks – places where the skin is warm and moist. Yes, the areas where you do NOT want them to set up shop, especially on hot, humid days. Affected areas may appear red, tan, or brown, with flaking, rippling, peeling, iridescence, or cracking skin. The acute infection begins with an area in the groin fold usually on both sides. The area may enlarge, and other sores may develop. The rash has sharply defined borders that may blister and ooze. 

This groin fungus is often spread from one person to another, usually through sharing personal items like towels. Another route of transmission is from the feet to the groin. The same fungi that cause athlete’s foot (tinea pedis) also cause tinea cruris. The fungi are easily spread on the hands when a person with athlete’s foot scratches their feet and then touches the groin region. Or if one practices yoga or is an amateur contortionist, the fungus can be transmitted directly from foot to crotch. 

The pharmacist explained to Wayne that treating jock itch can be challenging and has two endpoints: Make the fungus disappear and keep the area dry. There are over-the-counter antifungal creams and ointments that should be able to arrest the infection. Miconazole, clotrimazole, terbinafine, and tolnaftate are among them. Use the product twice a day for 10 to 14 days. If the area is inflamed, triamcinolone cream (TAC) 0.1% can be used. After showering and thoroughly drying the area with a fresh towel, liberally apply a drying powder such as Zeasorb® or Gold Bond®. If you tend to get jock itch, continue to apply antifungal or drying powders after bathing, even when you do not have jock itch. If your jock itch clears, keep using the antifungal cream for another 7 to 10 days to kill any fungus that lurks below the skin surface. Wear boxers, not briefs. Launder your athletic supporter frequently. 

Natural remedies for tinea cruris are also available. Apple cider vinegar, because it is a mild acid helps eliminate the fungus and stop the infection from spreading. Also, it helps draw out extra moisture from the infected area, which in turn speeds up the healing process. Tea tree oil has antifungal and antibacterial properties that relieve itching when applied to the infected areas. The full-strength formulation may irritate so find a gel or cream if possible. Bathing in a tub of cool saltwater for 30 minutes, twice a day for a month may help. Alternatively, find a quiet nude beach where you can stand in the ocean without your trunks on. Just don’t let the jellyfish nip at your naughty bits!

The pharmacist directed Wayne to the antifungal section and picked out a drying powder for him. Wayne then said to the pharmacist, “And I know of a secluded little beach where I can let the waves wash over my entire body,” he said with a wink. 

Ron Gasbarro, PharmD, is a registered pharmacist, medical writer, and principal at Rx-Press.com. Read more at www.rx-press.com 

 


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