Our skin is swarming with microbes we can’t see. Most of them are beneficial, or at least not harmful. Occasionally, however, one species or another gets a bit out of hand. That’s what we think is happening with jock itch. Some type of fungus, perhaps a Trycophyton species, has gotten out of control and is causing an unpleasant reaction with redness, itching and inflammation. What can you do?
Underwear Is Important:
Q. My husband suffered from jock itch. The solution was clotrimazole cream, but the most important element was changing the type of underwear he wore!
The elastic in the legs of men’s briefs can be hugely irritating to skin. He switched to 100 percent cotton boxer briefs. I washed them in fragrance-free products. My husband also used fragrance free soap for showering.
I read that you should not use cornstarch as a talc replacement because it feeds the fungus. As a preventive, apply amber Listerine or witch hazel or even alcohol to the area after showering and drying.
Primer on Jock Itch:
A. Jock itch (tinea cruris) is caused by fungal infections of the skin. One of the most common culprits is Trichophyton rubrum. It flourishes in warm damp skin folds.
Your strategy to use an antifungal cream like clotrimazole (Lotrimin AF) or miconazole (Micatin, Zeasorb-AF) makes good sense. Creating an inhospitable fungal environment by wearing loose cotton briefs is also good practice.
Many readers of this column have also found that old-fashioned amber Listerine can be helpful. That is probably because it contains alcohol which can help dry the skin and discourage fungi. So can the antifungal herbal oils in Listerine: eucalyptol, menthol, methyl salicylate and thymol.
Some readers recommend using Cetaphil cleanser to wash the irritated area instead of soap and water. Others have found that using dandruff shampoo, especially Selsun Blue with selenium sulfide, can be helpful. Read on for more information on these.
Another reader emphasizes the importance of washing underwear in hot water. Although she was not diagnosed with a fungal infection, it solved her problem.
Hot Water to Wash Underwear:
Q. Years ago, I had infrequent stabbing pains around my genital area. This was unpredictable and very embarrassing.
My gynecologist gave me a long list of things to be careful of such as making sure I washed my hands after handling a newspaper, but nothing helped. Then I read that underwear should be washed in hot water. This was not on her list, but it definitely helped me. I haven’t had the problem since.
Many people use cold water for laundry now. I thought someone else might benefit.
A. We have no idea what was causing your pain. Washing underwear in hot water (140 degrees F), though, should get rid of most germs, whether bacterial or fungal. Thanks for the tip.
One Reader’s Approach to Controlling Jock Itch:
Q. I want to share with you how I have controlled jock itch. After showering, I towel dry completely, then apply cornstarch as dusting powder to the area. The secret is to keep the skin dry. I have used this method successfully for years.
A. Keeping the skin dry is the first step. Other readers have recommended the following approaches:
Use Cetaphil cleanser on the affected skin. It is gentle and has antifungal properties. (More details below.)
Avoid fragrance in soap or laundry detergent.
Apply athlete’s foot creams. Because they too fight fungus, they can often be helpful.
Give Listerine or dandruff shampoo a try.
If none of these works, see a dermatologist for a proper diagnosis. One specialist wrote us that contact dermatitis, psoriasis or seborrheic dermatitis might all be mistaken for jock itch and may not respond well to antifungal treatment. (See below “A Scary Warning.”)
Remedies for Jock Itch:
Q. I have a bad case of jock itch, for want of a better word. I’ve used Neosporin and Lotrimin Ultra and one other medication I can’t remember right now. I thought it was getting better, but while I was still using the medications, it came back. Nothing I used has helped at all.
I dry the area well after bathing and I use baby powder, but I am still having trouble. The skin has now reached the point of being dry, cracked and bleeding. Can you offer any suggestions?
A. Jock itch is normally caused by a fungal infection. Neosporin, which contains topical antibiotics, is not likely to cure a fungus.
Lotrimin Ultra contains butenafine, an antifungal ingredient, so it should have helped. You may want to alternate it with other OTC antifungal products such as clotrimazole (Lotrimin AF, Mycelex), miconazole (Micatin, Zeasorb-AF) or tolnaftate (Aftate, Tinactin). One standard treatment, terbinafine (Lamisil), may be losing its power against the usual organisms causing the problem (Mycoses, July 2018). Luliconazole (Luzu), available since 2013, may be effective (Gupta, Foley & Versteeg, Mycopathologia, Feb. 2017).
Non-Standard Treatments:
Other readers have offered some unusual remedies that they have found helpful. One person wrote that an ointment for diaper rash was especially effective.
Diaper Rash Ointment for Jock Itch:
Q. For several years, I had jock itch. When I tried the usual OTC remedies, I was disappointed. Finally, I tried Dr. Sheffield’s Diaper Rash Ointment. After a few applications, things cleared up and I have had no recurrence.
A. Like most diaper rash ointments, Dr. Sheffield’s contains zinc oxide. This functions as a moisture barrier. Zinc oxide also has antifungal activity. In addition, Dr. Sheffield’s contains cod liver oil, which has antibacterial properties (Marine Drugs, June 2016).
Should you get a recurrence, combining the antifungal drug miconazole with zinc oxide should be highly effective. You can buy both topical products separately in any pharmacy. This will save a lot of money compared to preformulated combination products.
Cetaphil Cleanser:
Many readers of this column report that a skin cleanser called Cetaphil can be very helpful against chronic jock itch. It is soothing and contains propylene glycol and cetyl alcohol, which both have antifungal activity. One young woman said it was as effective for her as for men.
Treating Jock Itch with Dandruff Shampoo:
Some people benefit from applying dandruff shampoo such as Selsun Blue to the area. Lather, let it stay on the affected zone for five minutes and then rinse. Selenium sulfide, the active ingredient, has antifungal activity.
Listerine or Vinegar:
Once the inflamed skin has healed, you may want to try applications of vinegar or original (amber) Listerine. Listerine contains herbal oils that fight fungus, while vinegar makes the skin too acidic to be hospitable to the fungus. Don’t apply either of these to irritated skin, as they are likely to cause significant discomfort.
Antiperspirant Against Jock Itch?
Antiperspirant on the groin area can help keep it dry and discourage fungus overgrowth as well. We get nervous about recommending antiperspirants on such sensitive tissue, however. By law, antiperspirants must contain aluminum salts, and we fear that some aluminum might get absorbed. If you can find another way to keep the skin dry, that would be preferable.
Are You Reacting to an Everyday Product?
Sometimes the products we use every day trigger a reaction that aggravates the problem.
A physician wrote to us to say that some people actually develop
“contact dermatitis to the baby powder they use for skin rashes. Baby powder is not benign and can likely cause additional contact dermatitis on top of jock itch.”
A reader confirmed this problem:
“I suffered what I thought was jock itch for years and years. I tried all kinds of treatments without success. My rash was not only in my groin area but actually anywhere clothing trapped heat or even rubbed on my skin, such as around my waist, stomach and under my arms. I was absolutely miserable most of the time until finally I had a lady at work 20 years ago advise me to change my bath soap (no perfumed soap of any kind).
“Within several days the misery had diminished significantly, but I still had problems. She then told me only use perfume-free detergents when washing my clothes. I just wanted to relay that the combination of only using Basis soap while bathing combined with washing my clothing only in perfume-free detergents has given me complete relief. Now I live a normal life without the ‘jock itch.’”
Is It Really Jock Itch?
A dermatologist shared this insight:
“Jock itch may actually be psoriasis, contact dermatitis, seborrheic dermatitis (perhaps why dandruff shampoo works in some cases), yeast infection or any of a variety of more unusual skin disorders, as well as fungus infection. Non-prescription antifungals are probably overused. In a situation where an individual has a poor response to these products, the best advice would be to consider seeing a dermatologist for proper diagnosis and treatment.”
A Scary Warning:
Finally, a reader warns that people
“who have persistent ‘jock itch’ may instead have a rare, pre-cancerous condition called EMPD (extramammary Paget disease). It can resemble a fungal infection. EMPD primarily affects women, though men can get it as well. Anyone who has an itchy rash in the groin area which doesn’t go away should be checked by a competent dermatologist. A biopsy will reveal if it’s EMPD.”
EMPD is extremely rare, but our reader’s advice is good. If jock itch doesn’t clear up after treatment with an antifungal drug or one of the fungus-discouraging home remedies, it makes sense to check with a dermatologist.
If you have had success, tell us about the remedy you have found most helpful against jock itch.
