
What Causes Itching Sensation And Discomfort Feeling On Groin Area?

Tinea cruris; antifungals (oral+topical)
Detailed Answer:
Hello. Thank you writing to us at healthcaremagic
I am Dr. Kakkar. I have gone through your query.
You seem to have Fungal Infection of the groin folds (Tinea Cruris). Groin folds provide an ideal environment for the fungus to proliferate because of the moist, humid conditions that prevail in the folds, specially in hot and humid weather of summers.
Itching is usually bothersome in Tinea cruris and can be embarassing.
If I was the treating doctor I would have started you on oral antifungals e.g either fluconazole or terbinafine.
Oral antifungals are faster acting and control the infection much better when used in combination with topical antifungal creams. Topical creams alone are sometimes not totally effective if the area of involvement is extensive.
In addition to oral antifungals, I usually ask my patients to use a topical plain antifungal e.g either clotrimazole, which is available OTC Or one of the prescription antifungal e.g Sertaconazole, Luliconazole, Bifonazole etc. They need to be used regularly, twice daily for 4-6 weeks.
You have already been using a plain antifungal, irregularly though, for past 2 weeks and I would suggest that you stick to that. Use it regularly, twice daily for 4-6 weeks.
I usually avoid combinations (with steroid content) that you have mentioned in your query because of the danger of local steroid related side effects, if overused by patients, like skin thinning, stretch marks/striae.
As itching is bothersome in fungal infections, therefore, I also ask my patients to take an OTC oral antihistamine e.g cetrizine 10 mg once daily.
Fungal infections can recur, if the conditions favorable for fungal proliferation start to exist again.
Therefore, an antifungal dusting powder e.g clotrimazole dusting powder is usually part of maintenance regime in my patients, once the condition has resolved with oral+topical antifungals.
Antifungal dusting powder keeps the folds dry as well as is inhibitory to fungal growth.
I would suggest that you visit a dermatologist in your region. Your dermatologist after examination might prescribe you an oral antifungal, if he or she feels that your condition is quite extensive to be treated by topical creams alone.
Regards
Take care


I am having discomfort and itching since one month using candid ointment irregularly
Now I am having
Discomfort
Occasional itching
Sofned area around 2-3 cm in one area near Scrotal fold
Since I have previous experience of similar complaint with hyperpigmentation I am not able to differentiate discolouration of the affected area
Occasional painful sensation/burning sensation of the affected area
Uploaded some images to have more information..
I need more advices..
One
Since I was using clotrimazole is it a good thinking to change from clotrimazole to other topicals.. Like miconazole or sertaconazole as you mentioned..
If it is so which one is the better...
Two
U advised oral antifungal like fluconazole.. Right now as you have more information of images of my situation as well so what you advice
Dose
Frequency
Duration of fluconazole should I use
Third
I have been going through the Internet regarding tinea cruris these days information says that if we have inflammatory signs we can consider steroids.. Can I think that some sort of burning sensation as sign of inflammation..
Since 3 days I have been applying candid twice daily..
Itching reduced a little bit but abnormal sensation /grating /foreign body sensation is there..
Waiting for your valuable opinion...
Antifungal treatment; visit a dermatologist
Detailed Answer:
Hi.
I have gone through the images. You may continue with clotrimazole. Use it regularly, twice daily for 4 weeks.
After going through the Images, I can see there is discoloration on both inner thighs, probably due to past episodes.
I can also see a dry, slightly scaly, light coloured patch on the right inner thigh area, which is probably active Tinea. Therefore, I am of the view that you require oral antifungals. I would suggest that you visit a nearby dermatologist for a confirmatory diagnosis.
Fluconazole is given orally as a weekly dose. Some skin specialists may also give it as twice weekly dose (e.g on Wednesdays/Saturdays Or on Mondays/Thursdays) for 4-6 weeks.
Oral fluconazole is available in 150 mg and 200 mg strengths. Your doctor will decide on the duration of treatment depending on the response. Usually it is 4-6 weeks.
Antifungal steroids combinations can be considered for inflammatory Tinea (those associated with bothersome itching and burning). However, they should be used strictly under the supervision of a dermatologist and never to be used for more than 2-4 weeks.
Since in my clinical practice I find a lot of patients landing up with steroid related side effects due to topical steroid abuse, therefore I am personally not in favour of antifungal+steroid combinations. I prefer just plain antifungals. The itching part can be taken care by oral antihistamines like cetrizine.
However, if used for the prescribed duration and under the supervision of a dermatologist, an antifungal+steroid combination is ok to use.
Regards


Thanks for the update
Detailed Answer:
Hi.
Ok. Good. What all did your dermatologist told you to use?
Regards


Surfaz cream for 4-6 weeks twice daily
Onecan tablet 150 mg once weekly
Sir what should be the result after 10 days.. How should I feel..
Itching Decreased
But still burning sensation is there in Scrotal folds and around that area intermittently..
Previously I told soft patches like areas,.. U told active lesion.. Should that become normalize by now That is after 2 weeks of regular application or still it takes time......
After how many days that soft area or so called active lesion comes down to normal skin..
Still rough sensation is there intermittently.
After the end of 1 week It was nice seems Decreased a bit but in second week it seems stand still not able to explain whether Decreased or not.. Some times feel good that healing is there some times feel that still problem is there..
Confused whether healing is there or not...
I can go to doctor but there even without properly seeing,, prescribing some ointment and medications.
1.Confused whether healing is there or not..
2.how do you talk to your patient..
3. What information would you like take from your patient to situation.. So that I will give you to assess..
Guide me... Thanks
Fungal infection; striae
Detailed Answer:
Hello.
Since your symptoms have definitely improved therefore you just need to stick to the treatment for a total duration of 4-6 weeks.
Symptomatic improvement is the most important criteria whether the treatment is effective or not. Usually 2 weeks is good enough time to bring about a significant symptomatic improvement but treatment must still be continued for the prescribed duration to prevent a relapse.
Thereafter you may continue with an antifungal dusting powder to prevent recurrence.
On reviewing the photographs I can also see that there are a few "striae" in the upper inner thigh area, which you probably refer to as soft area. This is most likely due to previous topical steroid use in this area (probably steroid in combination with antifungal) since you have a past history of fungal infections too.
Striae are a side effect of steroid abuse as I have mentioned in my previous reply. This is exactly the reason why I am against steroid+antifungal combination and therefore I asked you to use plain antifungal.
Striae are permanent. They wont go completely.
I can understand your frustration in dealing with this recurring problem but with regular use of the prescribed medicines you can overcome it.
Regards


I am not sure whether I have significant symptomatic improvement or not..
PAPER LIKE /GRATING sensation is still there not only in the Scrotal fold but also a bit distance to fold, around edges of pigmentation (you might have seen my images..
Still burning sensation is there especially immediately after application of candid ointment.. Here and there.. On and off...
Occasional itching is there..
Approximately 3 weeks of regular application..
Do I stick to the treatment or do I need change in the treatment..
After going through the Internet a thought of resistance to candid is sane or insane thought..
Looking for an expert opinion..
Antifungal treatment
Detailed Answer:
Hi.
Ok. You may use an antifungal+steroid combination for 2 weeks, it will provide you better symptomatic relief.
The steroid that is advisable for use at this site should be a "mild" steroid i.e beclomethasone propionate 0.05% in combination with clotrimazole. This is the only steroid that is permissible for use at this site.
You can use this combination of clotrimazole+beclomethasone propionate for a few days and thereafter change it back to plain topical antifungal (clotrimazole cream).
Clotrimazole 1% +Beclomethasone propionate 0.025% combination cream is a prescription product and you must also discuss this with your treating doctor. You must visit your doctor for a review of the skin condition.
After examining, If your doctor too feels that this combination would be better you may ask for a prescription for the same.
Rest of the treatment should be continued as before.
Regards


At one point you told 0.05% beclomethasone other place 0.025 % beclomethasone
Is it 0.05 or 0.025??
Is it beclomethasone propionate or di propionate??
As I am already using candid cream can I go for candid b cream??
Antifungal cream
Detailed Answer:
Hi
It is 0.025% Beclomethasone dipropionate. It is a mild steroid and is available in combination with Clotrimazole 1%.
I can only tell you the generic names via this forum. We cannot give a prescription online.
Please go through the disclaimer at the bottom of this page.
Regards

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