Suggest Treatment For Dermatitis

Posted on Wed, 26 Feb 2014

Question: Dear Dr Kakkar, I have finally worked out how to write to you directly! I wanted to follow up with you but I didn't manage last time, so I spoke to Dr XXXXXXX when I had symptoms again. Anyway, the hydrocortisone and clotrimazole were not sufficient and the itch started again. I visited my GP to ask for the prescription bethametasone. He suggested betamethasone with clioquinol, just in case I have developed a sensitivity to clotrimazole. So I have been using the new cream twice a day for a week. Now, in the second week, I am using it only once a day. The itch has gone, there is no discharge or dead skin. However, the area is very dry when the ointment is not on. My plan is to complete this week with the cream once a day. What do you think? For a series of other circumstanes, I have also got to suspect a giardiatis from a recent trip to subsaharan Africa (which I mentioned to Dr Geetika). A treatment with Tinidazole seems to have cleared it. Could that have been a cause of the reoccurring Candida? So bottom line, your diagnosis of dermatitis was correct, as the cure you suggested. Have you got any suggestions on how to avoid this in the future? Is there any cream, ointment or other product - not as strong as corticosteroid - that you would recommend ? Many many thanks XXXX

Answered by Dr. Dr. Kakkar (1 hour later)

Brief Answer: Nice to get in touch again Detailed Answer: Hi. Nice to get in touch with you again. As I had previously mentioned in our previous conversation that Hydrocortisone is a very mild steroid (therefore sometimes insufficient). Hydrocortisone is however safe even if it is used for a bit longer on the delicate genital mucosa. If you can refer back to my previous answer, I actually wanted you to use beclomethasone, which is a moderately potent steroid, even though I finally agreed on Canesten-HC(clotrimazole+hydrocortisone) Betamethasone on the other hand, is a very potent steroid (therefore shows faster results). It is generally avoided on the delicate genital mucosa but since you have used it for just a week, so that's not too long. Always practice plain lukewarm water cleansing in that area and always avoid soaps, antiseptics over there. Giardiasis is totally unrelated to this. Getting a blood sugar test would be logical over here. Since it has resolved, nothing needs to applied as a preventive measure except attention to general precautions Practice safe sex always using a condom regards

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Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar