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Jock Itch

What is Jock Itch?

Jock itch is a common type of groin and upper thigh infection caused by fungi. It belongs in the group of fungal skin infections, which is also called as Tinea [1]. This condition was given the term, jock itch, because it usually occurs to people who sweat a lot, just like the jocks or athletes [2]. It is also referred to as Tinea Cruris (Tinea, a name of fungus, and cruris, the Latin term used for leg) [3].

 

Jock Itch Causes

Most people have microscopic bacteria and fungi present on the body. Dermatophytes belong to a group of fungi which live on the dead tissues of the nails, hair, and skin. These fungi group lives on a warm and moist environment, such as the inner portion of the thighs. When the groin or inguinal area sweats and is not dried off in the right way, this facilitates the growth and multiplication of fungi [1]. The other parts of the body where the fungi also grow and flourish include buttocks, armpits, underneath the breasts, upper and inner thighs [3].

 

Specific causes of jock itch include the following:

1. Wearing certain types of clothes or personal items

  • Friction caused by tight clothes for prolonged time (bathing suits, workout clothes)
  • Contaminated or unwashed clothing
  • Sharing clothes or towels with other people
  • Using damp towels [1, 2, 4]

2. Use of public places such as:

  • Locker rooms
  • Steamy rooms
  • Public Showers
  • Rooms with wet floors [4]

3. Weather

  • Humid and Hot weather conditions [1]

4. Direct contact

  • Direct contact with contaminated clothes or towel
  • Direct skin to skin contact with infected area
  • Sexual intercourse with a person who has the infection [2,5]

5. Health conditions

  • Diabetes Mellitus
  • Obesity
  • Skin Conditions: Athlete’s foot, Psoriasis, Allergic contact dermatitis, dandruff
  • Weak immune system
  • Patients who are taking broad-spectrum antibiotics [1, 7, 8]

 

Jock Itch Symptoms

Jock itch can usually lasts for several weeks, if it is treated, but there are chances that it may reoccur as well [3]. Also, this type of infection is less severe when compared to other infections caused by tinea [1]. The symptoms of jock itch are as follows:

  • Burning or itching sensation felt at the groin, anus, or thigh skin folds. Areas such as genitals, perineum, and inner thighs may be included as well.
  • Areas affected have the appearance of peeling, flaking, chaffing, or cracking skin
  • Discoloration of the affected skin areas to tan, brown, or red
  • The rash appears as a circular pattern with edges that are elevated or raised
  • Enlargement or soreness of the areas affected
  • When the rash spreads to other locations, it goes down to the thigh. The edge which spreads appears redder and more elevated. It looks scaly and well distinguished.
  • Borders may also show pimples or pustules [1,7]

 

Jock Itch Pictures

Here are some pictures of jock itch (tinea cruris):

 Jock Itch-Location

Picture 1: Jock itch’s most common location, the groin area

 Jock Itch-rashes

Picture 2: Pink colored rash related to jock itch

 Jock Itch-Raised Appearance

Picture 3: Jock Itch Appearance (Raised edges and reddish in color)

 Jock Itch-Ring shaped rashed

Picture 4: Brown and red rashes covering the skin which are ring-shaped

(Jock Itch Picture source:  atlasdermatologico.com.br)

 

Jock Itch Diagnosis

Medical History

The doctor may ask the patient certain questions which are related to the occurrence of jock itch. Some of the questions that might be asked during the gathering of patient history include:

1. Presence of medical conditions

  • Diabetes
  • Psoriasis
  • Allergic Contact Dermatitis

2. Presence of any symptoms

  • Fever
  • Onset of rashes appearance
  • Previous rashes or infections
  • Excessive Thirst (Polyphagia)
  • Excessive Urination (Polyuria)

3. Medication/treatment

  • Includes past and current medications taken
  • Any home remedies tried

4. Social/Travel History

  • Sexual history, including HIV status
  • Owning of pets
  • Going to gym or playing sports
  • Use of public whirlpool or pool
  • Past and current travels (includes camping activities, military training, vacations) [8]

Physical Examination

Diagnosis by the physician can be made by just looking at the condition of the patient’s skin [5]. A thorough assessment of the following may be done:

1. Vital signs

  • Pulse, respiration, temperature, blood pressure

2. Skin areas examination

  • Feet
  • Armpits
  • Underneath the breast
  • Vagina (for women) [8]

Laboratory Tests

1. Potassium Hydroxide (KOH) Test

  • Involves scraping of skin samples coming from affected areas.
  • Examined under the microscope

2. Skin culture

  • Done by scraping of the skin
  • Fungal Culture: Sent to the laboratory to see if this will grow fungi [2]

3. Wood’s lamp Exam

  • This is the examination of the skin with the use of a wood lamp. It is an equipment which gives source of long wavelength ultraviolet lights.

4. Other lab tests

  • Blood glucose monitoring
  • Full blood count [8]

 

Jock Itch Treatment

Usually, jock itch can resolve within a couple of weeks with self-care. Simple remedies for jock itch include:

1. Wear the right choice of clothes

  • Avoid clothes that cause friction and irritation to the affected area. [5]

2. Maintain good hygiene

  • Always keep the skin dry and clean.
  • Wash the infected area with soap and water [4, 5]

3. Over-the-counter topical antifungal creams or drying powders

  • Products which contain terbinafine, miconazole, naftifine can be bought at the pharmacy without the doctor’s prescription.
  • Try buying products with brandnames such as Canesten, Micatin, or Monistat-Derm.
  • Always remember to read the directions indicated on the package. Follow those instructions.
  • Avoid suddenly stopping the use of the medicine. Use it as indicated in the package.
  • 1% hydrocortisone cream and zinc oxide ointment are also beneficial in relieving jock itch [4, 8]

 

On the other hand, if the infection still persists longer than 2 weeks, became severe, or reoccurs frequently, ask for the help of a physician. After the check-up, the doctor may prescribe some medications which may be stronger to treat the infected areas [5]. These medications may involve:

 

Skin lotions or creams

It is the first choice of therapy of jock itch. Its prescription will depend on the diagnosis made by the physician.

1. Prescription topical antifungal medications

  • These are available in many forms such as gel, spray, powder, or cream.
  • Topical medications are for application on the skin.
  • Example of a topical antifungal medication is Oxistat. This includes contents such as oxiconazole and ecoazole.

2. Oral or topical antibiotics

  • Erythromycin is very effective in groin infections caused by bacteria.

Oral Medications

  • Recommended for jock itch cases that are more severe, chronic, or extensive.
  • Includes prescribed medications like fluconazole (Diflucan), and itraconazole (Sporanox)
  • Advised to be taken for one to several weeks due to lengthy time it takes before fungal infections resolve. [8]

 

Jock Itch Prevention

1. Have a healthy lifestyle.

  • Staying healthy through proper diet, exercise, and rest.

2. Exercise and Athletic Activity rituals

  • Immediate shower after doing athletic activities.
  • Clean equipment used before and after exercise.
  • Remember to wear sandals when showering at public pools and gym.

3.  Wear it right.

  • Choose the right clothing. It should be loose as much as much as possible.
  • Wash clothing items after use. Do not wear unwashed or contaminated clothes.
  • Change underwear at least once a day or more if necessary.
  • For those who have athlete’s foot, put on socks before wearing underwear. This is necessary to prevent the fungus spread from feet to groin area.

4. Maintain proper hygiene

  • Bathe daily or as needed. It is recommended to shower after activities that will cause excessive sweating.
  • Wash hands frequently.
  • Keep the groin area dry and clean. If needed, put powder at the groin area to prevent it from producing moisture.
  • No sharing of personal items. [2, 3, 4]

 

Prognosis

Jock itch usually goes away with self-care treatment. It may resolve quickly, depending on the case of infection. In some people, there may be reoccurring of the infection. The people who are most likely to have reoccurring jock itch are:

  • Jocks/Athletes
  • People who have present fungal infection located at the other parts of the body, such as in the case of Athlete’s foot.
  • Immunocompromised people or those who have weakened immune systems.
  • People who wears tight fitting clothes. [3, 8]

 

References:

1. http://kidshealth.org/teen/diseases_conditions/skin/jock_itch.html

2. http://www.mayoclinic.com/health/jock-itch/DS00490

3. http://www.intelihealth.com/IH/ihtIH/WSIH/9339/10214.html?b=

4. http://www.healthlinkbc.ca/kb/content/special/aa45969spec.html

5. http://www.nlm.nih.gov/medlineplus/ency/article/000876.htm

6. http://www.umm.edu/ency/article/000876.htm

7. http://en.wikipedia.org/wiki/Tinea_cruris

8. http://www.emedicinehealth.com/jock_itch/article_em.htm



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