Jock Itch

By Dr. Loretta Lanphier, ND, CN, HHP, CH

What is Jock Itch?

Jock itch is a type of fungal infection that affects warm, moist, and dark areas of the body such as the groin, inner thighs, genitals, buttocks, and anus. In general, this particular fungal infection is said to be found mainly where the legs meet the pelvis. Fungal infections are usually named based on their location. Jock itch is officially known as Tinea cruris, taken from the Latin cruris, which means “leg.” The literal translation is “vermin of the crotch.”

Jock itch is most often found in men, but does occur in both sexes. It is estimated that approximately 20% of individuals will experience this type of fungal infection at some point in their lives. The title “jock itch” is due to the tendency of people who sweat a lot, such as athletes, to get this disease. This infection has a myriad of nicknames, including “ringworm of the groin,” “crotch itch,” “crotch rot,” and “crack fungus,” as well as others that I will spare you from that are a bit crude and could be classified as locker room slang. Suffice it to say, jock itch is a quite common malady that is usually no more than a troublesome annoyance for most sufferers. However, it can lead to more serious complications, especially in folks with a compromised immune system. Jock itch is contagious, and can be spread from person to person and/or from one body part to another. It is often caused by the same species of fungus that is responsible for athlete’s foot and ringworm of the scalp.

What Are the Symptoms of Jock Itch?

Jock itch appears as a rash that is often ring-shaped. Its most common signs include:

  • Itching in the groin, folds of the skin, genital area, buttocks, or anus. Jock itch rarely affects the penis or scrotum in males.
  • Jock itch often starts in the folds of the groin, and will commonly spread down the skin of the inner thighs.
  • Red, scaly patches that may include “pustules” or blisters that can break open and ooze. Affected areas are often redder on the outside with more normal looking skin on the inside, creating the appearance of a ring.
  • Raised appearance, which also may contribute to the term “ringworm,” as it sometimes looks like a worm underneath the skin. However, there is no worm associated with jock itch or its kissing cousin ringworm.
  • Burning and stinging at the site of infection, often quite intense.
  • Dry, cracked skin which tends to peel.

What Are the Causes of Jock Itch?

Jock itch is caused by a variety of microscopic fungi known as dermatophytes. These and other fungi are normally found in the skin of all humans and as well as other creatures such as farm animals, dogs, and cats. But this type of fungus is classified as an opportunistic organism, which means that when given the right conditions, it will grow beyond normal bounds and become a problem. These conditions can be environmental, such as the groin area that encourages jock itch, or due to a weakness in the body, such as an immune system problem. There does seem to be a genetic tendency in some folks to develop jock itch as well. In rare cases, jock itch can also be the result of a bacterial infection or be spawned by a chemical sensitivity to clothing. Certain allergic reactions, such as to a medicine you are taking, can also trigger jock itch.

Most jock itch is caused by a fungus called Trichophyton rubrum. This is often the same bug that produces athlete’s foot and other fungal infections throughout the body. Jock itch can be spread from person to person via direct skin contact with an infected person, such as through intimate relations. However, it is much more common for the infection to be spread from one body part to another. An example is transferring the infection from the feet to the groin while dressing. Another common way jock itch is spread is through towels that are improperly laundered, especially in a public setting like a health club or a locker room. You can also spread it on your body by drying an infected area, and then drying other body parts.

Warm, humid settings that cause you and others to perspire are great breeding grounds for the fungi that cause jock itch. Sweating washes away oils that are naturally found on our skin that have anti-fungal properties. In addition, when we sweat our pores are open, making it easier for the skin to absorb infectious agents. I would be careful about using public showers, and would definitely recommend wearing shower shoes. Jock itch can often start out as an athlete’s foot infection. Also be careful about sitting on public exercise equipment that has not been properly cleaned between users. Another way to reduce your risk is to wash your workout clothes promptly after each use. Damp clothing in a dark locker or gym bag is a very attractive place for fungi to hang out and multiple.

Given the opportunistic characteristics of fungal infections, be especially careful to take preventative measures if your immune system is at all compromised. HIV or diabetes patients are good examples of this. Another condition known as atopic dermatitis can also increase your risk for jock itch and other skin infections. This inherited disorder weakens the natural barriers normally found in the skin that protect us from many types of infectious agents, such as bacterial, viral, and fungal. Again, this effect is only increased if your immune system is not functioning up to par.

Are There Any Possible Complications From Jock Itch?

Normally, jock itch is not a serious condition. Most individuals will not experience infections that cause any permanent scarring or move deeper into the body, beyond the surface of the skin. Occasionally this does happen, and these infections can cause critical illnesses due to more advanced infections. This is most likely to occur only if your immune system is not able to fight off the infection normally. In situations like this, jock itch often becomes a prolonged infection that is difficult to get rid of. This can lead to other opportunistic infections in a patient with HIV, for example.

The most common complication from jock itch is the spread of the infection to other body parts. Fungal infections are very prone to do this. Typical locations where the infection might spread include:

  1. The head (Tinea capitis, ringworm of the head): This produces itchy, scaly skin that often leads to hair loss.
  2. The feet (Tinea pedis, athlete’s foot): Commonly starts between the toes.
  3. The toenails (Tinea unglum): Causing the toenails to become abnormally thick and brittle.
  4. The torso (Tinea corporis): Usually affecting the arms, legs, or chest.

How Do I Know If I Have Jock Itch?

The diagnosis for jock itch is not a difficult one. Often a simple exam by a health care practitioner who is familiar enough with the disease to visually identify it is sufficient. However, there are several skin conditions that can look similar in appearance to jock itch. The two most common are:

  1. Erythrasma:  This is a bacterial skin infection that often occurs in the groin area. Sometimes mistaken for jock itch, upon closer inspection it can be noted that it is usually not ring-like, as is jock itch, and it does not normally produce blisters or pustules.
  2. Intertrigo:  This rash is typically found in the skin folds of obese individuals. It is thought to be caused by the friction of sweaty skin rubbing against itself, and enables the skin to crack and form fissures, which make it more susceptible to fungal and bacterial infections.

If there is any doubt during diagnosis, a sample of the skin can be taken and examined in the lab under a microscope. This fairly definitive procedure is called a KOH Test. It can accurately tell if your infection is of fungal, bacterial, or viral origin. A more advanced test involving a skin culture can give more information about the exact variety of the infectious agent.

What Treatments Are Available for Jock Itch?

Mainstream medical treatments focus almost entirely on anti-fungal medications. While these are often effective, and may be appropriate at times, as with any medications there are side effects you should be aware of. You know your own body and medical conditions better than anyone, or at least you should. Some of the oral medications prescribed for jock itch can be particularly dangerous if you have any kind of liver dysfunction. They can bring on abnormal liver function in otherwise healthy people, and definitely aggravate existing liver issues. They also tend to interfere with the function of other medicines. A good example is warfarin, which is used as an anticoagulant to reduce the risk of blood clots. If you are on warfarin and taking oral prescription drugs for jock itch, be careful of possible serious consequences. One drug, called griseofulvin, can stimulate a drop in your white blood cell count. This is especially important for folks to know if they are immune system compromised.

The other main type of drugs are topical antifungal medications. These are available both over- the-counter, and by prescription.

The best way to treat any disease, including jock itch, is to prevent it from developing in the first place. Here are some practical tips to avoid jock itch:

  1. Wear loose-fitting clothing:  Clothing that is too tight, especially underclothing, can greatly increase your risk for jock itch. Try boxers instead of briefs, and don’t wear anything tight while working out or in an environment where you may be perspiring.
  2. Stay clean:  Bathing often, especially after sweating, will also help. Make sure you dry thoroughly as well. Also, make sure to wash clothes promptly and put on clean underwear every day. Washing hands on a regular basis can also prevent the spread of infections, including fungal ones such as jock itch.
  3. If you have other fungal infections, such as athlete’s foot, make sure you treat them promptly as they can easily lead to jock itch. Putting on socks first before your underwear can help stop the spread of athlete’s foot to the groin area.
  4. Public settings:  Use common sense whenever you use a public workout or showering facility. Never share towels or personal items with others.

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