Dermatology/Jock Itch

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Question
Dr. Fisher,

I really hope you can answer my questions. I have been suffering from jock itch in the groin area for five years. In the first year, I did not get it medically treated because I did not know what it was. I just treated it with an over the counter itch cream. In the second year, I went to my gynocologist, and she prescribed me fluconazole, which I had to take once a day for two weeks. It worked to a point. It use to be intensely itchy, but after I was given the pill, the itch subsided. I could feel a lingering feeling of being itchy, but not to the point where I was so itchy it was hard to concentrate on anything. The itch did not completely go away, but it became manageable. My gynocologist also gave me clotrimazole cream. In the third and fourth year, it was still manageable. Now, in the fifth year, I am starting to exercise, and it started to get worse again, but this time it was only in the right side of my groin. I went to another gynocologist. She did not think it was jock itch, but after I told her about how itchy it was, she prescribed me fluconazole. It has been three weeks since I have completely finished all the pills. But the itch remains. It is usually worse when I am exercising, hot or sweaty. I do not have diabetes. I do have polycystic ovarian syndrome. My questions are:

-Do I go to a dermatologist or another gynocologist?
-Can I completely get rid of this, I am sick and tired of feeling itchy like this?  or am I a lost cause, I am starting to lose hope of ever being cured of this itch?

Thank you, I am sorry that this is very long.

Answer
You have a condition called intertrigo.


Intertrigo is inflammation of the skin. It tends to occur in warm, moist areas of the body where two skin surfaces rub or press against each other. Such areas are called "skin folds."

Causes
Intertrigo affects the top layers of skin. It is caused by moisture, bacteria, yeast, or fungus in the folds of the skin. The affected areas of skin are usually pink to brown. If the skin is very moist, it may begin to break down. In severe cases, there may be a bad odor.
Intertrigo is common in warm, moist climates.


Other things you can do are:

Keep areas of folded skin open with dry towels.
Blowing a fan across moist areas.
Wear loose clothing.
Use a powder ion your groin like OTC season AF to keep the moisture down
When to Contact a Medical Professional
Call your health care provider if:

The condition does not go away, even with good home care.
The area of affected skin spreads beyond a skin fold.
What to Expect at Your Office Visit
Your health care provider can tell if you have the condition by looking at your skin.

Other tests may include:

A skin scraping and KOH examination to rule out a fungal infection
A Wood's lamp to rule out a bacterial infection called erythrasma
Rarely, a skin biopsy to confirm the diagnosis
Treatment options for intertrigo include:

Antibiotic or antifungal cream applied to the skin
Drying medication such as Domeboro soaks
Low-dose steroid cream
Creams that protect the skin
I like the prescription Vytone Cream 1% which is a prescription. It has an iodine derivative which kills yeast, fungus and bacteria and a mild cortisone to help with inflammation. However, the most important thing to do is to keep the groin dry.  

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Michael S. Fisher, <B>Ph.D., M.D.</B>

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