What Causes Jock Itch?

What Causes Jock Itch?

Jock Itch is a fungal infection that both men and women develop in the warm and moist environs of their groin, especially the junction between their thighs and waist. The infection is characterized by wavy reddish-brown rashes that appear raised and inflamed at the center, gradually tapering away to a blistered and scaly edge. The rashes itch terribly, and in extreme cases spread to adjacent areas in the groin if they are left untreated. 

It is a form of ringworm of the skin. It is highly contagious. It is a type of skin infection called tinea cruris. Jock itch is caused by various types of fungus. Since this fungus resides in warm and moist places people who are overweight or those who sweat a lot or those who have eczema have a tendency to get jock itch.  Jock itch appears as a rash with patches. These patches may be red or peeling or they may have bumps at the edges which may look like blisters. The rash can spread quickly and cause itching. Jock itch is common problem for male athletes. But even people not playing sports may get it. However, girls and women can get it too.

Jock Itch – Debunking Common Myths

• Jock Itch is not a condition which is exclusive to men. It affects both men and women.
• Jock Itch is not as extensive in coverage as other skin disorders and is mostly confined to the groin, thighs, and folds of the buttocks.
• It is not exclusive to the athletic community, and can affect anyone.
• It is very different from other skin conditions and is treatable using potent anti-fungal lotions, creams, and shampoos.
• Jock Itch does not penetrate beneath the skin. It is purely a surface infection of fungi feeding on the dead keratin flaking off nails, skin, and hair.

Causative Factors

1. The Fungal Origins of Jock Itch

The primary cause of Jock Itch is a fungus. It belongs to the dermatophyte family of fungi and is further split into three groups, the Microsporum, the Trichophyton, and the Epidermophyton. These fungi thrive in warm and moist environments. The perpetually warm and sweaty surface of the groin provides ideal conditions for the fungi to spread infection and multiply.

Physical factors facilitating fungal infection of the groin are:

• A warm environment in the groin with very little air circulation.
• Excessive sweat trapped in these areas following moderate to extreme exercise and sporting activity.
• Tight-fitting garments of the synthetic type that do not allow the skin aeration. Often people active in sports activities wear tight body hugging sportswear, swimwear and genital cups. This prevents aeration in the groin. Due to the constant friction between the skin on skin and the rubbing of synthetic fabrics creates an ideal condition for the growth of the fungus and fungal infections. This further causes inflammation of the skin and unbearable itching.
• Re-wearing clothes, changing underwear infrequently.
• Lack of hygiene, sporadic cleaning or a nonexistent showering routine.

2. Yeast

Equally capable of creating a full blown Jock Itch is the common yeast, Candida Albicans. Yeast infections are common for women in their genital area, but can also affect men.  

3. Family History

In many instances, we may end up inheriting a defective pair of genes. They severely handicap the skin and make it difficult for the skin to ward off microbial threats. If the body is immune deficient then there is a risk of acquiring skin allergies, inflammation and fungal infections. Allergic rhinitis triggers skin eruptions, itching and chronic inflammation. This causes the outer layers of the skin to open up naturally for fungal infections.

4. Athlete’s Foot

It is widely observed that people already grappling with an athlete’s foot infection are prone to develop a fungal infection in the groin. This happens for a simple reason. The fungus that causes athlete’s foot is the same that causes Jock Itch. The infection finds it easier to travel northward from foot to groin through infected hands (that earlier scratched the feet) and the act of donning underwear. The blisters and sores in foot infection if untreated worsen the inflammation of the skin and quickly spread the infection. Spores may even travel via the hand and undergarment to the groin region. Hence people diagnosed with jock itch are first checked for athlete’s foot to check for any cross contamination.

5. Public Restrooms

Jock Itch is definitely contagious. Using public restrooms (infected towels) and commodes, and using shared items in swimming pools can sometimes lead to contact infection and transmission of Jock Itch. In public places use of public swimming pools, locker rooms, and toilets of public places, saunas, spas, gyms and showers can spread the infection. Also sharing of clothes of an infected person may spread the infection.  Contact with a contaminated toilet seat or a locker room bench may cause the fungus Candida, Epidermophyton or Trichophyton to spread from person to person.  Sharing infected towels or soaps may increase the chances of infection.

6. Predisposing Factors

• Obesity – An excessive body mass creates folds of skin tissue that are more likely to trap warmth and moisture that attracts fungal infection. The creases and folds make a suitable breeding ground for the fungus which results into rashes like jock itch. It results in redness and breaks in the skin. The skin also becomes itchy. The person may become more prone to yeast infection.  Overhanging the pubic region if there are skin folds then through friction it creates more surface area for bruising skin. This created blisters which provokes fungal infections. The skin - overload in obese people also burden the immune system which then find its difficult to fight against the aggressive fungal infections.

• Diabetes – High blood glucose levels predispose people to drier skin. The reason is that the body tries to eliminate excess glucose through frequent urination. This dehydrates the skin. Dry and itchy skin can trigger a host of bacterial and fungal infections in diabetics. Dry skin can also be caused by affecting the nerves that control the sweat glands. There is absence or decrease in sweating which leads to cracked, dry skin. Bathing in hot water and cold, dry air aggravates the dryness of the skin. Dryness leads to skin problems such as cracking, peeling and itching. Fungal infections can occur which results in red to brownish lesions that cover the groin.

• Overuse of certain medications – Excessive use of corticosteroids interferes with the body’s immune response making the individual sensitive to fungal attacks. People with conditions such as arthritis, allergic reactions, asthma and autoimmune diseases such as lupus, sarcoidosis or inflammatory bowel disease may need to take corticosteroids medications with side effects that can weaken immune system and put the person at a risk of fungal infection. People with compromised immune system such as from HIV/AID, chronic illness, cancer, hepatitis, systemic chemotherapy, immunosupprosive drugs such as prednisone, biologic-immune –system-modifying drugs such as infliximab (Remicade) or etanercept (Enbrel) are more susceptible to jock itch.

• Hereditary diseases – Disorders like allergic retinitis and eczema are inherited. These conditions compromise the body’s immune response. This makes the body incapable of effectively thwarting aggressive microbial attacks. Atopic dermatitis is a chronic inherited skin disease; the disease is characterized by itchy inflamed skin. The barrier in the skin that usually protects the skin from fungal infections becomes weak or compromised. Thus people with this inherited disease are more susceptible to jock itch.

7. Heat and moisture

 Heavy rains followed by intermittent sunshine increases the humidity in the air, People tend to sweat a lot. If their clothes are drenched in sweat for longer duration it could encourage the growth of fungi. Same applies for people who work out in gym for long.

8. Sweat caked groin- some people seat profusely. The salt and other substances excreted mix with the dead skin cells create a breeding ground for the fungi. The groin gets very little oxygen since it is tightly wrapped under multiple layers of clothes. This encourages the growth of the fungus.

9. Lack of personal hygiene- the risk of fungal infection increases if the groin and genitals are not washed regularly. The fungi are always present in a dormant state on the surface of the skin and activate skin eruptions, if the hygiene is poor.

Symptoms

• Common symptoms are itching and pain.
• Rash appears on the groin, skin folds, inner thighs or buttocks.
• Edge of the rash may have bump which look like blisters or may be scaly.
• Center of the rash may be reddish brown in color.
• The skin may be cracking, flaking or peeling.

Diagnosis

A person who had jock itch before may be able to recognize its symptoms. After asking questions about your symptoms or by looking at the rash you doctor will be able to confirm whether you have jock itch. The doctor may take a sample of the skin rash place it on a glass slide and observe under the microscope. However, this might not be needed.

Treatment

If left untreated it can last for months. Antifungal are available over- the -counter which help to clear the jock itch in few weeks. These medicines are available in the form of creams, sprays and powders. If it does not improve then you may need a stronger medicine. Incase of no improvement consult your doctor.

To fasten the healing process follows these steps:

• Wash the area keep it dry and clean. Beyond the edge of the rash apply antifungal cream.
• Antifungal cream or powder that contains terbinafine, miconazole or clotimazole should be used. These creams or powders are available without prescription such as Lamisil, Micatin, Lotrimin and Monistat.
• Use a different towel for the rest of your body
• Apply the medicine as directed on the label.
• Use as per recommended. If you stop using it then the infection might recur.
• Use compresses such as Burow’s compress incase if your ringworm causes larger areas of blisters. This helps to soothe and dry out the blisters. Once the skin is dried out use unprescribed antifungal creams.

Prevention

• After athletic activities shower immediately
• Wear loose clothes. Do not share your clothes or towels and wash them frequently.

Both men and women can get affected but this condition. It is more common in men. Those who perspire heavily are more at risk.

Classic jock itch does not affect the genitals but only the inner thighs, groin and lower buttocks.

If untreated then jock itch can cause problems such as ulcers, cellulites which is a potentially life threatening skin infection, Open sores, abscesses. The jock itch may spread to the genitals and women may develop yeast infections.  Jock itch can stay for six months if not treated.