Jock Itch Is Not Fun In The Philippines

Jock Itch Is Not Fun In The Philippines

Trichophyton Rubrum Microconidia by Medmyco licensed under CC0 1.0

Skip over the details and go right to the treatment regimen that worked for me.

Jock Itch For The First Time In The Philippines

Jock itch or tinea cruris is a fungal infection most often caused by the fungus Trichophyton Rubrum. I did not even know that I had it for a few days. I had been working in the hot, humid and rainy environment clearing weeds and grass. I noticed a tingly mild burning sensation a day or two into the work. A few days later and that feeling was still lingering, but most of the time I felt nothing at all. After about two weeks the discomfort level increased just enough to warrant an inspection. 

A Dark Red Rash 

The blotch was about 2 1/2 inches across with cauliflower lobed edges and an angry red, raised and well-defined border. It was on my inner thigh going toward the perineum. I had never seen such a terrible thing in my life. I made haste to get to the doctor where I was relieved to discover that what had afflicted me was a very common fungal infection. I have been using Ketoconazole cream for the past few days and it seems to be working well.

Prolonged Hot And Sweaty Conditions 

The heat and sweat combined with chaffing of the skin provided the perfect opportunity for a micro-organism to enter the skin.

I will be taking extra care in the future to prevent a recurrence. It is not possible to stay dry while working. Less than five minutes after beginning work I am already streaming sweat. The day-time temp averages 90F with humidity also in the 90% range. What I can do is shower mid-work and change into fresh work clothes. I will also be using sulfur soap. I do not know if the soap will work to help prevent jock itch, but it cannot hurt. The extra hassle will be worth it. 

Update 6-6-19 

Four days later and the Ketoconazole 2% is working well. I was advised that in order to prevent recurrence I must continue application of the drugs for 5-7 days beyond the point where the redness appears to clear up.

Update 6-16-19 

Previously I had written a post about the Tinea cruris (jock itch) that had taken me by surprise after a few days of working long hours in hot and rainy conditions. The tentative diagnosis was Trichophyton rubrum. 

I now have suspicions that a different microbe could be the culprit.

The reason I doubt the original diagnosis is twofold. First, I noticed the development of satellite lesions.  Satellite lesions are red bumps/blisters outside of the main patch of affected skin. The second tip-off that I was dealing with something different is the fact that the scrotal area became affected. That is not common with Trichophyton (though there is some argument).

I could be dealing with Intertrigo complicated by a Candida albicans super-infection. 

I will be visiting the doctor again soon to get their thoughts on the matter.

In  my last update I had written that the infection was retreating and I was doing well. That did not last. I took my recovery for granted and spent a day working and sweating only to find that the infection has become inflamed again and the angry red border had returned.

That episode shocked me into getting a lot more serious about beating the infection.

For the past five days I have sworn off working up a sweat and remained in the air conditioned room with the fan full blast on the affected area. 

I cannot stress enough the importance of positioning a fan to blow directly on the area. I do this throughout the day and while sleeping. The redness fades away and the blisters/bumps dry out where the skin is exposed to the blowing air. This is crucial, especially in a tropical environment.  

I have also been bathing with Dr. Wong’s Sulfur Soap each day. The instructions say that the soap can be used specifically for skin infections. You are supposed to apply the lather and allow it to stay on the affected skin for several minutes. I have been doing that and the area is clearing more every day.

In keeping with staying dry, I use a hair dryer to make sure that the area gets absolutely dry.

Two weeks on and though I suffered a setback a week ago the infection is definitely clearing up. The skin is much lighter in color now and the angry red border has been reduced to just a few patchy pinkish bumps.

Recovery Is Maddeningly Slow

Generally, the consensus seems to be right around six weeks.

And it is also very common for there to be re-occurrences. I would guess that this is due to losing patience with treatment. I have only been treating the infection for two weeks and it is a super drag to go to the proper extent necessary to assure complete healing.

It occurred to me that a bio-film could be the reason for such slow and incomplete healing.

A quick search of Google proved that my hunch was correct. Whether I have T. rubrum or C. albicans does not matter. Both fungi produce bio-film. 

What Is A Bio-Film And Why Does It Matter?

If you are familiar with the Philippines, then you probably know what nata de coco is. Nata de coco is bacterial cellulose produced by Acetobacter xylinum cultured in coconut water. Nata de coco is a bio-film. If you have ever eaten nata de coco, then you know that it is jelly-like, but also tough. I like to chew it. You will also note the faint scent and flavor of vinegar.

Bio-film matters to those of us with a skin infection because the bio-film insulates the fungal cells from our immune systems and also from being impacted by anti-fungal medications.

This is why fungal infections take so long to heal and why they come back with a vengeance. 

The logical next question that I asked Google was how do I disrupt the bio-film of a fungal skin infection, so it can be killed with medications?

There were many answers to that question, but I searched out the ones that I could easily apply to my problem right now…if any such solutions existed.

And one such solution does exist…possibly.

It is thought that a substance called cyclooxygenase is involved in the creation of bio-films. It is theorized that cyclooxygenase (COX) inhibiting drugs inhibit the ability of COX  to be used in synthesizing fungal prostaglandins (lipids) that form the structure of bio-films.

Basically, drugs like aspirin and Advil are thought to be capable of breaking down the bio-film of some fungal infections.

But since my recuperation is on track I don't think I want to experiment much, though I might mention it to the doctor.

The bio-film can set up in as little as 24-72 hours.

I doubt that there would be any symptoms within that time frame. And if there are symptoms, then I would imagine that it would be a minor and intermittent itch, like I experienced.

By the time you experience any real symptom that gets your attention and makes you check out the problem you already have a serious infection dug in and shielded with a bio-film.

The best way to beat that situation is to never get into it in the first place.

Intertrigo and other groin infections get their start with help from an insider: US.

By not taking care of our bodies when we are working in dirty, hot and humid environments we are playing number one advocate on the side of the disease.

Once I have the victory over this illness, I intend to continue bathing with sulfur soap and using the hair dryer as an added precaution.

I will be a lot more cognizant of what is going on where skin meets skin and no more working in the rain or dragging my work day too long without a shower break to wash away the sweat and grime.

Update 8-10-19

OK, finally, after months of dealing with this PLAGUE, at long last every single red dot is gone. Because of the climate and my active lifestyle AND the location of the affected area it was very difficult to get the condition completely resolved. 

I am tentatively relieved and happy to say that it seems for the last week that I have completely recovered.

Many times it seemed that I had recovered and then I would do some traveling or spend the day working in the yard only to find that the condition had returned, albeit it just a tiny red dot. But that is how this entire ordeal began - with a tiny red dot. Or there would be the tell tale itch with no visible sign and then the sign would appear.

My Treatment 

This is what worked for me. What works for you is up to you and your doctor.
  • Ketoconazole is a life saver - use as directed. Some people may be allergic. **You MUST continue to apply the medication for a MINIMUM of 7 days after all visible signs of infection have disappeared.
  • Run a fan on the affected area as much as possible. This helps to keep it dry.
  • Sleeping in the buff also helps keep the area dry. 
  • Reduce or eliminate sugar. Excess sugar, in my opinion, seems to make the infection worse. 
  • Maintain a healthy diet to keep your immune system up.
  • Get plenty of sleep. Lack of sleep negatively impacts immunity. Most of the time these infections remain in the keratin and beyond the reach of the immune system, but lack of sleep and poor diet may contribute to creating conditions that the microbes can take advantage of to invade the body.
  • Sulfur soap seems to have helped. 
  • Dandruff shampoo on jock itch - Don't do it. It irritates the skin. 
  • Do not allow the area to remain hot and sweat covered for longer than absolutely necessary.
  • Shower immediately after workouts etc.
  • After showering pat dry and or blow dry the affected skin - not too hot.
  • Allow 4-8 weeks for the infection to heal completely. 
Maybe you are thinking that it just goes away without any treatment after 4-8 weeks, but that might be a mistake. If you do not take care of it and keep up treatment the infection may never go away and it might get much worse and spread. 

Update 8-31-19

** Just because you cannot see the infection and it seems to be healed does mean that you are cleared of the infection. Fungal colonies may still be present and those that remain will be the strongest of all, so if you stop treatment prematurely it will be these strongest and most resistant fungi that survive and they will multiply and become an infection that will be much more difficult to beat. For this reason you must continue to apply the antifungal cream for a minimum of seven days beyond the point that no visible infection remains. Personally, I went 14 days beyond being visibly clear.

No comments:

Post a Comment

If you have comments, corrections or questions we would be happy to hear from you. Do not bother leaving your email address, as we do not contact people outside of this site. Any response will be found here in the comment section.