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Diagnosed genital candidiasis. Penis looks reddish and have rashes on it. Prescribed flucanozole and topical clotrimazole. Help?

DOCTOR OF THE MONTH - Dec 2013
Dec 2013
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Dermatologist
Practicing since : 2002
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Question
Hello Doctor,in 2008 i was diagnosed with genital candidiasis(whitish discharge from penis,reddish rashes on glans penis,burning sensation while urinating and severe itching)i was prescribed with flucanozole-150mg weekly once for 4 weeks and topical clotrimazole.i was cured then.
again this year from month of august(after sexual session)i am experiencing same sympotoms like rashes on glans penis and slight itching and slight cloudy discharge but no pain during urination.i took the same treatment as before(fluconazole-150mg/week/4 weeks and topical antifungal lotion(clotrimazole).during the treatment all the symptoms are gone.i continued the topical clotrimazole for 1 more month.3 days back i stopped the topical lotion.today i noticed rashes are back on glans penis.i dont understand why this is happening and its really disturbing.please help me doctor.
Posted Sun, 20 Oct 2013 in Sexually Transmitted Diseases
 
 
Answered by Dr. Sanjay Kumar Kanodia 2 hours later
Brief Answer:
Kindly see the detailed answer

Detailed Answer:
Hi,

Welcome and thanks for posting your query to Healthcare Magic.

I can understand your concern for the present situation.

After reading your complete query with diligence I can make out that you are suffering from recurrent candidal (fungal) infection of the glans penis area.

Before I proceed to your condition, let you understand some medical facts- Fungal infections are common type of infections which can affect anybody at any site. But more commonly it affects the areas which are moist areas (as in your case).

More specifically this is related to the hygiene especially in uncircumcised males. It is more common to find moist area at glans penis and frenulum (skin covering the glans penis) area which favors the growth of fungus. The fungus can be grown directly in an individual or can be more commonly because of infection from the partner.

So in case of unprotected sexual intercourse if the area is not washed properly or later on if the hygiene is not maintained properly anybody can get the infection again. So the same thing is in your case too.

Now more importantly you experienced the recurrence of infection as soon as you stopped the clotrimazole application. This shows that fungus is not completely eradicated.

For the management of the same kindly follow the suggestions below:

- Wash your penile area for two times in a day. You can use a mild soap to wash the area. Wash it very gently but properly. If you are uncircumcised then it is quite important to retract your skin fully backwards and then wash the area.

- After every sexual intercourse too, wash the area properly. I personally suggest you to use protection in form of condoms during every intercourse.

- It is quite very important to check for infection in your partner too. If your partner has white discharge then it is the most common cause of recurrent infection. In all the cases of candidal infection we always treat the partner. So get your partner treated for the same.

- Wear cotton undergarments. Change these two times a day. Do not wear any synthetic or tight garments.

- You can apply latest anti-fungal creams such as "Sertaconazole" or "Luliconazole" or "Amorolfine" and take latest anti-fungal tablets according to medical advise. Sometimes there is resistance to the clotrimazole, so the latest antifungals helps in completely eradicating the infection.

Overall it is nothing to be worried about. It is a common condition which we see quite often in our day to day practice. With complete treatment of self and partner and with good hygiene maintenance it can be cured very easily.

I hope this clears all your doubts. Tell me if you have any further quires.

Wish you good health
with regards,
Dr. Sanjay Kumar Kanodia
(MD - Skin & Sexually Transmitted Diseases)
Above answer was peer-reviewed by
 
Follow-up: Diagnosed genital candidiasis. Penis looks reddish and have rashes on it. Prescribed flucanozole and topical clotrimazole. Help? 5 minutes later
Hello Doctor,thanks for your valuable advice.can you suggest any latest anti-fungal tablets and their course of use?
Thank you.
 
 
Answered by Dr. Sanjay Kumar Kanodia 49 minutes later
Brief Answer:
Simple latest topical application is sufficient

Detailed Answer:
Hello Young man,

Welcome to the forum again and thanks for your prompt reply.

The latest oral antifungals are given only if the other of the measures told are not effective. So first try to meticulously do all the other measures told to you. Even the topical antifungals such as "Sertaconazole" or "Luliconazole" with fluconazole also give very good cure.

Even if by these measures the things are not getting right then only we use "Itraconazole" 200 mg twice daily for one day by mouth is sufficient. It is only a reserve drug when rest everything is failing. In most of the cases combination of latest topical antifungals are sufficient.

You try all the other measures including treatment of your partner and safe sex practice to avoid the recurrence.

I hope this helps you, if you have any further queries I will be happy to help or if you do not then can close the answer and rate the answer.

Wish you good health
with regards,
Dr. Sanjay Kumar Kanodia
(MD - Skin & Sexually Transmitted Diseases)
Above answer was peer-reviewed by
 
Follow-up: Diagnosed genital candidiasis. Penis looks reddish and have rashes on it. Prescribed flucanozole and topical clotrimazole. Help? 7 minutes later
Hello Doctor,
In which form is this SERTACONAZOLE and LULICONAZOLE should i use.(cream or lotion)and for how many times a day and how many days for complete recovery and to avoid reoccurance.
thank you
 
 
Answered by Dr. Sanjay Kumar Kanodia 20 minutes later
Brief Answer:
Apply least possible amount

Detailed Answer:
Hi,

Welcome to the forum again.

"Sertaconazole" or "Luliconazole" can be used in both cream as well as lotion form. It does not make any difference. The most important part is that it should be used in very very thin amount so that it should not be visible to the naked eye. Sometimes the over application is the reason for resistance as well as aggravation of the problem. A small dot on tip of finger is sufficient. It can be applied two times for 7 days and then can be tapered off to one time at night time for next 7 days. After that it can be used alternatively or off and on basis for next couple of days before stopping it completely.

Above and all maintain the hygiene at your best.

I hope it cleared all your doubts, if you have any further queries I will be happy to help or if you do not then can close the answer and rate the answer.

Wish you good health
with regards,
Dr. Sanjay Kumar Kanodia
(MD - Skin & Sexually Transmitted Diseases)
Above answer was peer-reviewed by
 
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