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Dr. Andrew Rynne

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Hi Doctor, This question is for Dr. Kakkar. Am suffering

Answered by
Dr.
Dr. Kakkar S.

Dermatologist

Practicing since :2002

Answered : 8811 Questions

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Posted on Fri, 22 Feb 2019 in Skin Hair and Nails
Question: Hi Doctor,

This question is for Dr. Kakkar.


Am suffering from Jock Itch(Groin Area, Hips area) from a good period of time(it's suppressing some time and coming back again). I have shown dermatologist for the same concern 6 months back for this as the condition got worsened(Reddish, Swollen, Itchy and Spread over multiple areas) and got the following medicines from the doctor.



1. Itraconozole 100mg

2. Grisovin FP

3. Hicope

4. Nizoclin Topical Cream



I have followed it for 20 days(i could see results in the 2nd day itself) as suggested by the doctor and stopped it. After 2-3 weeks of stopping the medicines, I could see it recurring again with the same signs. Again I continued it for the same period and stopped and this cycle is repeating again and again. I see it getting suppressed and recurring back after some days of stopping medicines.



It gets spread to my spouse as well, whenever I get she also gets it and both will follow the same medications and stop at the same time.



I have the following queries:



1. Is this recurring situation common in all cases?

2. Why do I see this behavior in spite of following the medications as suggested by the dermatologist and even after taking proper care of that area.

3. Is there any way we can completely cure this disease, as this is getting worsened because of its recurring nature.

4. Is this happening due to intercourse? If yes, whats the necessary precautions/medications which we need to take.



Thanks in Advance
doctor
Answered by Dr. Kakkar S. 1 hour later
Brief Answer:
Regarding fungal infection

Detailed Answer:
Hello and welcome to ask a doctor service. I have reviewed your query and here is my advice.

Recurrence is commonly due to either inadequate treatment, re-infection or resistance. Since your infection responds very well to the oral and topical treatment so its definitely not resistance in your case. Re-infection from fomites like used or shared clothes, towels etc is the most common cause of recurrence. You should bath daily and change your clothes (including undergarments) daily, wash them and let them dry in sun for at least 2 hours. Iron your clothes (even underwear) so as to kill the fungal spores. Avoid wearing tight clothes, particularly denim trousers, as most people don't wash denims just after sungle use. People usually wear denims 2-3 times before washing and that leads to autoinnoculation in the groin / upper thigh area with fungal spores from unwashed denims. Cut your nails short as scratching can lead to build up of fungal spores underneath nails which can get autoinnoculated further upon scratching leading to re-infection and recurrence. Quality of medication is also an important determinant of cure. Some substandard Itraconazole brands have either fewer or bigger sized pellets which means low levels of Itraconazole in blood. Apart from these general measures I suggest you to take a longer duration of treatment i.e 4 - 6 weeks of Itraconazole (Cap Ceastra XL or Cap. Sporonox). Topically I suggest you to use Amorolfine 0.025% cream (Fungicros), twice daily for at least 4 weeks, covering the entire affected area and also 2 cm of surrounding normal skin, and for 2 weeks after complete cure. You may also use an antifungal body wash e.g Dersil AF body wash or Nidos- AF body wash, daily.

Hope I have answered your query. Let me know if you need any more assistance.
Above answer was peer-reviewed by : Dr. Kampana
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