This might be what actually killed Captain Hook
February 12, 2017 9:47 AM   Subscribe

I've apparently become infected with some kind of treatment-resistant jock itch. Anti-fungal creams work great temporarily, but the infection comes roaring back as soon as I stop applying the ointment.

I've had jock itch several times in the past, and it always responded well to routine over-the-counter treatments. But this time is different. I first noticed the problem (burning, itching, discoloration on my inner thighs) about two months ago. I didn't go to a doctor, but I recognized the symptoms based on past bouts.

I started treatment early, so I was confident that everything would be fine. And it was, at first. I used 1% terbinafine cream. My first round of treatment lasted about a week, and all seemed well (no more burning, discoloration, etc.). I thought I was done, but the symptoms returned after a couple of days. The second round of treatment was for two weeks. Same thing. Latest round was for over a month. I was hopeful that four-plus weeks of twice-daily antifungal cream would cure me – but, sadly, it has not.

I have a doctor's appointment in two weeks. I'd rather not take oral medication, if I can avoid it. My Google-fu hasn't turned up anything too promising that I can try in the meantime.

Anybody have any suggestions?
posted by alex1965 to Health & Fitness (25 answers total)
Have you considered good, old fashioned plain cultured yoghurt instead of antibiotics?
posted by parmanparman at 10:07 AM on February 12, 2017

I am not a doctor.

As long as it's not near mucus membranes I'd suggest a ten percent bleach solution applied to skin and allowed to dry. I've used it for ringworm and it works well.

The anti fungal pills are expensive but effective.
posted by answergrape at 10:08 AM on February 12, 2017

You need to take the oral medication, and you should probably go to urgent care and start now. Fungus gets systemic - you can't just treat the toenails or the jock or whatever once it becomes systemic. It can ruin your health once it gets into your sinuses or heart.

Take the medicine.
posted by Lyn Never at 10:08 AM on February 12, 2017 [10 favorites]

The oral medication will likely fix the problem.

You do have one other option, but it's pretty tough. You have an overgrowth of candida, the yeast that causes jock itch. The only way to get rid of it without medication is to starve it out. Yeasts feed on sugar, so you'll have to cut out ALL forms of sugar: sweeteners, all grains, cheese, fruits, and fermented products (including alcohol).

You can pretty much only eat meat, eggs, fats, and non-starchy vegetables (no potatoes, yams, cauliflower, etc). You'll need to do this without cheating for at least a month, while rebalancing your gut biome with probiotics like plain kefir and unsweetened live culture yogurt (no added sugar). You'll likely need to go easy on sugar, dairy, and carbs for several months after that to prevent a relapse while your gut health stabilizes. The GAPS diet is a good way to ease your body back into eating sugars without relapse.

There's a lot of misinformation about candida fasting online, mostly centered around getting you to buy 'cleansing supplements' that allow you to accomplish the fast in a few days. It's crap. You have to starve the yeast completely, and that simply takes time. There is no non-prescription 'magic bullet'.

It's a pretty tough regime to stick to, but if you really feel strongly about not taking pills, this is pretty much the only way to get rid of it. I've had at least 6 friends do this fast successfully, and they were all able to clear their candida permanently.
posted by ananci at 10:12 AM on February 12, 2017 [3 favorites]

There are a few over-the-counter anti-fungal active ingredients in the creams or sprays. I'd at least get one with a different active ingredient to see if that helps while you are waiting for your appointment. The pharmacist may be helpful in suggesting which product would be a good one to try next.
posted by RoadScholar at 10:18 AM on February 12, 2017

Man, don't mess around. Don't Clorox your dick. Yougurt is good but I guarantee you this will come back if you don't just take the meds. Seconding go to urgent care.
posted by kapers at 10:21 AM on February 12, 2017 [13 favorites]

Try Lotrimin Ultra Jock Itch Antifungal cream (1% Butenafine Hydrocholoride) till you can get in to see the doctor (and I hope the doctor is a dermatologist?)

Keep the area clean, and dry off well after bathing. Change/wash everything that touches that area (like underwear) daily. If you can, wash stuff like towels and underwear in hot water when you do the laundry. If you also have athlete's foot, be sure to treat that (and change socks daily). If you might have athlete's foot, try putting on socks before you put on underwear, to protect from spreading anything from your feet to your groin. Try wearing 100% cotton underwear that is not too tight, like boxer shorts.
posted by gudrun at 10:22 AM on February 12, 2017

If over-the-counter home remedies are not working, you need to see a doctor and take antifungal medication.
posted by My Dad at 10:23 AM on February 12, 2017 [2 favorites]

Also, if I'm reading you right, you don't know for certain what this actually is, so you can't treat what you can't diagnose. Dr. time.
posted by kapers at 10:26 AM on February 12, 2017 [2 favorites]

I've had success treating athlete's foot using a different OTC antifungal for the recurrence, but since you've gone several rounds with this already, it's doctor time.

Why do you want to avoid the oral antifungal?
posted by momus_window at 10:37 AM on February 12, 2017

I highly recommend showers with this: Anti-fungal bodywash.

I used it for three months straight because I had a fungal skin rash on my side/back. I haven't used it for nearly four months now and the rash hasn't returned.
posted by LOLAttorney2009 at 10:46 AM on February 12, 2017 [1 favorite]

I am not a dude but I have had yeast infections and I took an antifungal pill prescribed to me once when I needed to get it solved faster than those multi-day topical things and it was a miracle in a pill - symptoms gone in 24 hours. Just see a doctor, get the pill, and take it and be done. I've had the antifungal pill prescribed to me over the phone by a nurse hotline through my insurance company before, and I'm sure you can get it from urgent care or something too. Antifungals are not the same as antibiotics - if you dislike antibiotics, stop worrying about this.
posted by olinerd at 10:51 AM on February 12, 2017 [1 favorite]

The inner thigh location of this and speed of its return are making me think in terms of a urinary tract infection which is colonizing and recolonizing your skin.

In that case, it might not be a fungus, and your antifungal cream could be functioning merely as a barrier.

So it might be time to revisit your urologist, or even an endocrinologist since hyperparathyroidism can present as a recurrent UTI.
posted by jamjam at 11:22 AM on February 12, 2017

you may need a prescription anti-fungal cream....I had to go to the doctor for this kind of woe once and he prescribed something called, iirc, Spectrazole, which restored order pretty quickly
posted by thelonius at 11:28 AM on February 12, 2017

I've had good luck with Tinactin (tolnoftate 1%) for athlete's foot and jock itch.
posted by H21 at 1:10 PM on February 12, 2017

Someone I know recently had an intractable fungal infection and it turned out this person had developed an underlying problem that needed to be treated first. (In their case, it was developing type 1 diabetes, which meant higher blood sugars, which made them more prone to all kinds of infections. But there are other things that could cause increased susceptibility to infection, and they're all things you'd want to get tested and treated for.)
posted by LobsterMitten at 1:34 PM on February 12, 2017

Vinegar is an antifungal.
posted by brujita at 1:58 PM on February 12, 2017

Decolorized Iodine (Walgreens carries it), the excruciating pain means it's working.
posted by 445supermag at 8:29 PM on February 12, 2017

I'm not a doctor. Call your doctor, describe your symptoms again, describe what has worked in the past and explain that it's no longer working. Ask for your docs opinion on a prescription
for nystatin powder.
posted by pintapicasso at 3:51 AM on February 13, 2017

Also, this is basic but make sure you are keeping your skin dry. Use a towel to dry your genitals thoroughly after bathing. If you notice yourself getting sweaty during the day or night then dry yourself off.
posted by pintapicasso at 3:54 AM on February 13, 2017

I'm currently treating the same issue. It turns out that for me, avoiding all sugars and limiting carbs is critical, so that the tolnoftate / terbinafine treatments (I alternate every two weeks) can do their thing. And yes, good hygiene.

Also, regularly go swimming in a pool if you can. The pool water treatment also helps (I'm in the UK, so US pool treatments may differ).
posted by dowcrag at 5:01 AM on February 13, 2017

Thanks for all the tips. Here is my summary:

gudrun suggested trying a cream with 1% butenafine. A quick Google search suggests that this active ingredient may work better than the one I had been using (see "Studies on comparison of the efficacy of terbinafine 1% cream and butenafine 1% cream for the treatment of Tinea cruris").

A few other MeFites recommended trying creams with other active ingredients (such as tolnaftate). Those are worth a shot, if the butenafine doesn't work.

LOLAttorney2009 recommended PediFix FungaSoapLiquid with Tea Tree Oil. The Amazon reviews are excellent, so I ordered a bottle. I will start using it.

answergrape's suggestion for 10% Clorox sounds a bit risky, but I see that some people swear by it for treating athlete's foot. I don't think I'm going to try this option, though, unless everything else fails. And even then, I will have to be super-careful about it.

Thanks again.
posted by alex1965 at 6:18 AM on February 13, 2017

Why do you want to avoid the oral antifungal?
posted by momus_window at 13:37 on February 12 [+] [!]

I've been told anti-fungrals can really wreak havoc on ones liver. Be very careful, and for pity's sake, don't drink while your taking them.
posted by james33 at 8:03 AM on February 13, 2017

Gold bond powder constantly.
posted by TheRedArmy at 10:41 AM on February 13, 2017

Throw away all your underwear and buy brand new ones.
posted by KathrynT at 5:51 PM on February 13, 2017 [1 favorite]

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