Tinea Cruris: AKA Jock Itch
As many as three-quarters of the adult male population will suffer the pain and inconvenience of jock itch at some time during their lives. The itchy, scabby feeling in the groin is painful enough to wake you at night. The good news? Jock itch can be treated, usually inexpensively and at home, and some basic preventive maintenance can keep it from coming back.
What's So Itchy?
It's unexpected and considerably more painful than you'd think possible. One day you're walking around pain-free, and the next day you notice an irritation in your groin, a little redness, perhaps, or a touch of scaliness. You don't pay any attention to it, chalking it up to a rash or some minor discomfort. The next thing you know, you've called your dermatologist begging for relief from what feels like an atomic-level burning sensation between your thighs.
It's jock itch, the scourge of all too many men past adolescence.
"I think it's safe to say that there is no way most men can avoid it," says David Biro, MD, an assistant clinical professor of dermatology at SUNY Health Science Center in Brooklyn, NY. "The key is to recognize the symptoms and to do something about it."
Who Is Most Likely to Get It?
Jock itch shows up in post-adolescent men and rarely in women, though why is something of a mystery. Even if you get jock itch, a woman you are intimate with won't get it.
Research indicates that hormonal changes during puberty and heredity each play a role (if your father had jock itch, you probably will). So does lifestyle. More active men or overweight men, who sweat more in the groin area, are more likely to get jock itch, as are men who frequent public places like locker rooms and gyms. That's why your dad warned you not to go barefoot in the shower room.
There also seems to be a correlation between jock itch and it's fungal cousin, athlete's foot. If you have athlete's foot, your chances of getting jock itch are that much better. In addition, if you have a nail fungus, you have a greater chance of developing jock itch from scratching your groin area.
The fungus is one of those organisms that will probably outlive the human race, say doctors. It is ubiquitous, waiting in ambush and looking for a moist, warm groin to inhabit (which is why it likes summer better than winter).
"You're never going to be able to get rid of the fungus," says Kevin Pinski, MD, associate clinical professor of dermatology at Northwestern University Medical School in Chicago. "It's found throughout the environment, which makes it tough to go through life without coming into contact with the fungus."
This doesn't mean there aren't things you can do to keep the fungus in its place, and to deal with jock itch and athlete's foot if and when they show up.
What You Can Do
First, make sure you have what you think you have.
Jock itch is characterized by lesions, red skin, and a discernible border between the part of your thigh that's affected and the part that isn't. Jock itch almost never involves the scrotum or penis. But a couple of other conditions mimic jock itch and its symptoms.
One is a form of a yeast infection called intertrigo, a skin irritation caused when the body folds rub against each other. It becomes worse when you're hot and sweaty. Symptoms include redness and peeling. The second, though not nearly as common as intertrigo or jock itch, is a form of seborrhea that is related to dandruff and is marked by dry, cracking skin. Erythrasma and psoriasis are other common conditions that may mimic jock itch.
If you notice something reddening your groin, don't wait for it to get worse. It's much easier to treat in the early stages. Most forms of jock itch respond to over-the-counter products, which contain any of several basic ingredients: miconazole, tolnaftate, terbinafine, and clotrimazole are common generics sold without prescription. If the product is specifically for athlete's foot, be careful, as it may be too harsh for the groin area.
Terbinafine is more costly than some others but may be more effective and require somewhat shorter treatment times. Medications come in lotions, sprays, powders, and creams, and if the label says to use the product for two weeks, use it for two weeks. The fungus has a nasty habit of popping up when you let your guard down.
Keep your groin dry and clean. This denies the fungus a chance to reproduce. Wipe the area thoroughly after showering, and dry your feet after you dry your groin. There's some thought that you can carry jock itch fungus from your feet to your groin on clothing or a towel, especially if you shower in public places.
Dr. Pinski says it's not being obsessive to bring your own towel to the gym, since poorly washed towels can also carry the fungus. Also, wear cotton underwear, since it breathes, and if you're a brief man, consider boxers. The latter increase the flow of air to the groin, and promotes drying.
If your jock itch returns every summer, be prepared to powder or spray yourself everyday with an antifungal over-the-counter product. Stay away from powders with cornstarch, since yeast thrives on cornstarch, and that won't help clear anything up if you have a yeast infection.
Know When to Bring in the Big Guns
If you're in tremendous pain, and none of the above is working, it's time to see a dermatologist.
"If it's chronic, it's more difficult to treat, and you know it's going to come back year after year." says Dr. Pinski.
The good news is that doctors can treat even the most chronic cases. The bad news is that it involves expensive prescription medication that sometimes includes oral antifungals.
"You're not stuck with jock itch forever, because there are things you can do to get rid of it and things you can do to prevent recurrence," says Dr. Biro. "But you have to see it coming, and you have to be proactive about treating it. It's not going to go away on its own."
American Academy of Family Physicians
American Academy of Dermatology.
BC Health Guide
Last reviewed May 2008 by Ross Zeltser, MD, FAAD
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