Anything that enhances that environment puts the person at risk of getting jock itch. Therefore, wearing sweaty, wet clothing in the summertime or wearing several layers of clothing in the wintertime causes an increased incidence of jock itch.
What Is Jock Itch?
The fungus that most commonly causes jock itch is called Trichophyton rubrum. It also causes fungal infections of the toes and body.
Under the microscope, this fungus looks like translucent, branching, rod-shaped filaments or hyphae (a structure that looks like a tube). The width of the hyphae is uniform throughout, which helps distinguish it from hair, which tapers at the end. Some hyphae appear to have bubbles within their walls, which also distinguishes them from hair. Under most conditions, these fungi inhabit only the dead skin cells of the epidermis (the outermost layer of the skin).
Risk Factors
Jock itch is more common in men than women. Athletes are more likely to get jock itch and it is commonly passed around in locker rooms.
The fungus thrives in warm, moist environments, such as jockstraps and cups worn under sweaty sports uniforms. Jock itch is more common in the summer, though it can occur at any time of year.
People with diabetes or compromised immune systems are also at an increased risk for jock itch.
Signs and Symptoms of Jock Itch
A jock itch rash starts in the groin fold, usually on both sides.
If the rash grows in size, it usually advances down the inner thigh. The advancing edge is redder and more raised than areas that have been infected longer.
It is usually scaly and very easily distinguished or well demarcated. The skin within the border turns reddish-brown and loses much of its scale.
Jock itch can range from bothersome to painful and cause notable itchiness, or even a burning or stinging feeling.
Jock itch that’s caused by the T. rubrum fungus does not involve the scrotum or penis. If those areas are involved, you can most likely blame Candida albicans, the same type of yeast that causes vaginal yeast infections.
Similar Rashes
There are other rashes of the groin that can cause symptoms that are similar to jock itch. The first is called intertrigo, which is a red, macerated rash at the groin fold that’s not caused by a fungus.
Intertrigo commonly occurs in people who are obese and is caused by moist skin rubbing against other moist skin. The skin cracks and breaks down in lines called fissures, which can be very painful. These fissures can get secondarily infected with fungi or bacteria. The edge of the rash usually does not advance until much later in the life of the rash.
The other condition that mimics jock itch is called erythrasma. This is a bacterial infection that affects the groin and advances down the inner thigh. However, erythrasma’s rash is flat and brown throughout the affected area. It also does not have any scales or blisters.
Diagnosis
The best way to diagnose tinea cruris is to look for hyphae (those tube structures) under a microscope using a KOH test.
The skin is scraped with a scalpel or glass slide, causing dead skin cells to fall off onto a glass slide. A few drops of potassium hydroxide (KOH) are added to the slide and the slide is heated for a short time.
The KOH dissolves the material binding the skin cells together, releasing the hyphae, but it does not distort the cell or the hyphae. Special stains such as Chlorazol Fungal Stain, Swartz Lamkins Fungal Stain, or Parker’s blue ink can be used to help see the hyphae better.
Jock Itch Treatment
Jock itch is best treated with topical creams or ointments since the fungus affects only the top layer of skin (the epidermis). Many antifungal medications require a prescription, but there are three that can be bought over-the-counter (OTC). The OTC antifungals are:
Terbinafine (Lamisil) cream Tolnaftate (Tinactin)Clotrimazole (Lotrimin)Miconazole (Micatin)
Creams should be applied to the rash, itself, and also at least two finger widths beyond the rash. Many people with jock itch also have athlete’s foot and these same creams can be applied to the feet. However, treatment of athlete’s foot can take up to four weeks.
Home Remedies
In addition to over-the-counter treatments for jock itch, there are a few things you can do at home to manage fungal infections. It is important to keep the area clean and dry.
Wash and dry the area at least once a day and after activities that cause sweating, such as playing sports or working in the heat. Do not use the same towel to dry the area as the rest of your body. Reusing towels can cause the fungal infection to spread to other body parts.
Make sure you change your pants and underwear daily. If you are prone to sweating, try wearing underwear made from wearing moisture-wicking fabrics and promptly change out of damp bottoms.
Most importantly, keep applying the anti-fungal treatment as often and for as long as directed and treat any co-occurring fungal infections, such as athlete’s foot.
When to See a Healthcare Provider
If the condition does not improve after a week of over-the-counter jock itch treatments, see your healthcare provider for stronger medicine. You should also see a doctor if the rash develops blisters.
A severe case of jock itch may require treatment with steroids, such as hydrocortisone. Do not use steroids in the groin area except under medical supervision. Steroids can feed the fungus and make jock itch worse.
Prevention
To prevent jock itch from occurring or re-occurring, several measures may be taken.
Wear loose-fitting clothing made of cotton or synthetic materials designed to wick moisture away from the surface. Avoid sharing clothing and towels or washcloths. Allow the groin to dry completely after showering before putting on underwear and clothes. Antifungal powders or sprays may be used once a day to prevent infection.
In addition, if you wear a jockstrap for sports, always wash the strap and cup between uses. Most straps can be tossed in the washing machine. Refer to the manufacturer’s instructions for washing.
To wash an athletic cup, fill a sink with enough hot water to cover the cup. Add antibacterial soap and allow to soak until the water cools to room temperature. Next, use a clean cloth or sponge to scrub the cup. Rinse well with cool water and allow to air dry.
