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JOCK ITCH

Overview

Jock itch is a common fungal infection that usually occurs in athletes. The medical term for this condition is known as tinea cruris. It gets its name because it is frequently seen in athletes who wear a jockstrap. However, it may occur in other individuals as well, depending on certain physiological and environmental factors. Jock itch is often accompanied by fungal infections of other regions, such as athletes’ foot (tinea pedis), fungal nail infections, etc. Like most fungal infections, jock itch is contagious and can spread from one infected person to another by coming in contact with the affected region or sharing personal items. 

Causes

Jock itch may be caused by varying types of fungi that cause skin infections. The common ones include Trichophyton rubrum, Epidermophyton floccosum, Candida albicans, etc. These fungi may also cause athletes’ foot, which is usually present before or along with jock itch. Jock itch is caused due to a warm, humid environment because it supports fungal growth. This is why the groin and area behind the knees are the most commonly affected regions. Pre-existing fungal infection of another part of the skin can also lead to jock itch because the fungus may be transmitted from one part to another by touching with hands or clothes. Direct skin-to-skin contact with an infected person or sharing underwear, towels, etc., can also cause jock itch in an otherwise healthy individual. 

Risk Factors And Epidemiology

Athletes tend to develop jock itch because they have to wear jockstraps or fitted undergarments and sweat a lot due to excessive physical activity. Apart from athletes, males who work out or exercise a lot or wear fitted underwear or clothing items can develop jock itch. External factors such as increased temperature or high humidity may also contribute to flare up the symptoms of this condition. A weak immune system is a significant risk factor for all kinds of fungal infections, including jock itch. If you have diabetes, HIV, or any other immunocompromising disease or condition, you may develop a jock itch at some point. Patients using immunosuppressant medications and those undergoing chemotherapy or radiotherapy may also be at risk. Overweight individuals are also at risk of developing this fungal infection. 

Jock itch is predominant among males. It can occur at any age, but it is more common among teenage or adolescent males. It is frequently observed in countries with a hot or humid climates. 

Signs And Symptoms

Jock itch begins as a red rash that appears within the creases of the groin region. It spreads upwards towards the abdomen and lowers towards the inner thighs on either side. The rash may be slightly raised and has a distinctive outline. The affected skin region becomes itchy or tender and may have scales or flakes that increase upon itching. The borders of this rash may be lined by small vesicles that may burst open by itching or other factors. The rash may also spread to anal and perianal regions in severe cases. 

Diagnosis

Diagnosis of jock itch is usually made based on its clinical presentation. Your doctor may require a history of your symptoms, onset, duration, etc., along with certain details about your occupation or personal hygiene. Physical examination of the affected region is often sufficient to make a diagnosis. Rash around the groin region with distinctive borders is characteristic of jock itch. Suppose your doctor suspects any other skin infection. In that case, a conformational test may be done by taking a swab from the affected region and observing it under a microscope to check for the presence of causative fungi. 

Differential Diagnosis

The signs and symptoms of jock itch may resemble other skin infections or diseases. Therefore, it is important to differentiate it from other causes. Such conditions include contact dermatitis, seborrheic dermatitis, candida intertrigo, psoriasis, erythrasma, etc.

Treatment

Topical antifungal medications are the best treatment option for jock itch. These medications reduce the symptoms and cause the death of fungal organisms, causing this skin infection. These medications are available in a topical cream, lotion, spray, powder, or ointment form. The prescribed medication is applied to the groin region and other affected areas. If severe itching is present, your doctor may prescribe topical corticosteroids, but it is not often suggested. Wearing loose cotton underwear and keeping the area dry are recommended to reduce the severity of symptoms. Because this condition is contagious, it is also necessary to avoid sharing personal clothing items or used towels with another person to limit the spread of this infection from one person to another. Toilet seats should be cleaned after use because it may cause its spread. Athletes and sportspeople are suggested to keep individual towels and other personal hygiene items if they develop this infection

Medication

Antifungal medications used for the treatment of jock itch include clotrimazole, miconazole, butenafine, etc. These medications are available in various forms and are to be used in limited dosage are prescribed by your doctor. Topical corticosteroids such as dexamethasone are only given in very few cases along with anti-fungal medications to reduce severe itchiness. 

Prognosis

The overall prognosis of this fungal infection is good if it is treated well with anti-fungal medications. Lack of medical treatment can cause severe rash and itching, which causes extreme discomfort to the affected person. Severe itching of the affected skin area may also lead to secondary bacterial infections and other complications. 

Prevention

Jock itch can be prevented by maintaining personal hygiene, avoiding wearing jockstraps or fitted underwear, keeping the groin region dry, and avoiding direct contact with an infected person. If a member of your family or team gets infected, it is better to avoid sharing clothes, underwear, towels, etc., with them to prevent the spread of this infection. If another fungal infection such as athletes' foot is present, it is important to get it treated as soon as possible to avoid the spread of fungal organisms to the groin region.