Ayurvedic treatment for Jock itch

Ayurvedic Treatment for Jock Itch addresses the root cause of the disease and design the line of treatment on the basis of individuals affected. Jock itch(Tinea cruris) is an itchy skin rash in the groin, found mostly in men. It causes severe itching and sometimes inflamed skin rashes in the groin. Starting in the groin, it can spread to inner thighs, genitals (including penis, scrotum, labia, and vaginal opening), and anus. Jock itch causes reddish discoloration on the skin on the sides of the groin folds. It can cause dry skin rash with definite margins or a collection of small, pinpoint red bumps in hair follicles. This form of eruption is often called ring worm because of its well-defined red edge with central clearing. Although it is not a fatal/serious disease, it is very much uncomfortable and irritating. Recurrent and unyielding cases of Jock itch can cause immense stress and it can lead to depression.

When Jock itch is frequently noted in otherwise healthy people, there are chances of diabetes and/or obesity present. Possible causes include irritation from tight-fitting or abrasive underwear, excess moisture& sweating, skin rubbing or friction, fungal, Candida (yeast) or bacterial infection.

Signs & symptoms

Mild and frequent itching in the groin, unbearable itching in some cases.

Pain and foul smell in the groin in some cases.

Pink or red, dry and scaly skin rashes with well-marked margins in the folds of groin.Sometimes, inflamed pustules with oozing.

In chronic cases, the infection may spread to inner thighs, genitals and anus.

White or thick vaginal discharge in women.

Causes

  • Warmth, moisture, skin friction & irritation.
  • Tight undergarments and clothes that do not allow enough air circulation. Sweat facilitates bacterial growth.
  • Infections caused by fungus and yeasts: Candida (yeast), Trichophyton, and Epidermophyton (fungal)
  • Infections by certain types of bacteria
  • obesity
  • excess exercise & sweating,
  • weakened immune system.

Pathophysiology

The most common etiologic agents for jock itch (tinea cruris) are, Trichophyton rubrum and Epidermophyton floccosum. At times, T. mentagrophytes and T. verrucosum also cause the problem. These causative agents reach the patients, body from unhygienic towels or undergarments and they produce keratinases, which allow invasion of the cornified layer of epidermis. It causes large patches of erythema with central clearing, with oozing in the early stages. Chronic infection makes the area scaly and dry. Severe itching present.

Diagnosis

Jock itch is diagnosed mostly by a direct physical examination.

Microscopic examination of skin scrapings is done in the lab to check for causative organisms of infection. Also, skin swab or culture will be needed in infectious jock itch. A fungal or bacterial culture may be useful to detect the causative organism.

Very rarely, a skin biopsy is performed.

Other medical conditions can mimic jock itch. Some possible mimics include

  • ring worm, also called tinea,
  • contact dermatitis,
  • erythema,
  • impetigo,
  • diaper rash,
  • heat rash,
  • pemphigus.

Treatments

Jock itch due to excess moisture:

General measures to keep the groin clean and dry along with the use of zinc oxide ointment.

Fungal/Yeast:

Mild:

  • washing the groin twice daily with an antifungal shampoo like Ketoconazole (Nizoral shampoo) or selenium sulphide (Selsun blue shampoo).

Moderate:

  • washing the groin twice daily with an antifungal shampoo like ketoconazole or selenium sulphide; and
  • using a topical antifungal cream like Miconazole (Monistat, Micatin), clotrimazole (Lotrimin, Mycelex), or terbinafine (Lamisil).

Severe:

  • washing groin twice daily with an antifungal shampoo like ketoconazole or selenium sulphide;
  • using a topical antifungal cream like miconazole, clotrimazole, or terbinafine; and
  • taking an antifungal pill like fluconazole (Diflucan), itraconazole (sporanox), or terbinafine
 

Bacterial:

Mild:

  • antibacterial skin washes like Lever 2000 soap and a neomycin -containing ointment.

Moderate:

  • antibacterial skin washes like chlorhexidine soap twice daily; and
  • twice-daily application of a topical antibiotic like erythromycin lotion or metronidazolelotion.

Severe:

  • antibacterial skin washes like chlorhexidine soap twice daily and
  • a 5- to 14-day course of an oral antibiotic like cephalexin, dicloxacillin, doxycycline, minocycline (Dynacin, Minocin), or erythromycin.

Management of itching:

If the condition is not caused by an infectious agent,

  • Use a short five- to seven-day course of a mild to medium potency, topical steroid cream like prescription triamcinolone 0.025% once or twice a day for inflamed or itchy areas.
  • Use a short five- to seven-day course of a mild over-the-counter topical steroid cream like 1% hydrocortisone (Cortaid) one to three times a day for itching.

Prevention

  • Wash groin and buttocks with soap and water after exercise and sweating.
  • Wash workout clothes, underwear, and swimwear after each use.
  • Minimize groin moisture by using white cotton underwear.
  • Change underwear frequently and especially after sweating.
  • It may be useful to apply petroleum jelly or zinc oxide ointment liberally to the groin creases prior to physical exercise to minimize friction skin damage.
  • Wash clothes, undergarments, and towels in hot soapy water.
  • Use loose-fitting cotton underwear and clothing.
  • Avoid undergarments with polyesters, nylon, or synthetic fibres.
  • Use an antifungal powder to keep the groin dry.
  • Avoid perfumed creams, powders, sprays, or lotions on the groin.
  • Do not go barefoot, especially at gyms, schools, and public pools.
  • Treat athlete’s foot if you have it.
  • Cover your feet with socks before you put on your underwear and pants.

Prognosis

Jock itch has an excellent prognosis. It is a mild, benign, usually noncontagious, and self-limited skin condition. In most cases, it can be cured easily.

Complications

Complications are rare since jock itch is usually a mild and self-limited skin condition. Residual skin discoloration is present in many of the cases.

But widespread, atypical cases of jock itch may be embarrassing, chronically disfiguring, and psychologically distressing.

Severe cases may be very uncomfortable and develop secondary complications such as breaks in the skin, open sores, ulcers, and rarely cellulitis.

Rarely, the rash may spread past the groin onto the thighs and genitals. Secondary skin infections from scratching or rubbing can uncommonly deepen, causing cellulitis or abscess formation.

Another potential complication includes temporary skin discoloration called post-inflammatory hypo or hyperpigmentation. This altered skin colour may occur after the rash has improved or after a temporary flare. Permanent scarring is uncommon.

Disease & Ayurveda

Jock itch         – Mandalakushtha

Nidana

Unwholesome diet with opposite potency

Improper routine and behaviour

Teasing and humiliating other good people

Theft

Bad deeds which cause emotional stress factors like repentance/fear/anxiety

Kaphadoshakopanidana                   – causes for vitiation of all the kapha dosha  

Purvaaroopa

Absence of sweating

Loss of tactile sensation

Samprapti

Due to the causative factors, vitiated doshas (mainly kapha) vitiate rasadhatu and reaches skin. It settles near groin area and develop into itchy rashes.

Lakshana

Chronic moist & heavy lesions of skin, continuous to each other.

Severe itching

Painless skin rashes with redness or whitish discolouration

Divisions

Not mentioned

Prognosis

Sukhasadhya if not inflamed

Kricchrasaadhya if inflamed

Chikithsa

Samana

kshalana – washing with kashayas like aragwadhadikwatha or triphalakwatha

lepana – applying external medicines like vilwadi gulika, rasothamadi lepa, thulaseepatrakalka, etc.

Sodhana

        Virechana with erandatailam, avipathi choornam etc

Commonly used medicines

        Aragwadhadi kwatham

Amrutavrishapatoladi kwatham

Manjishtadi Kashayam

Panchathiktakam Kashayam

Mahathikthakam ghrutham

Avipathi choornam

Nimbamruthadi erandam

Arogya Vardhini Vati

Gandhak Rasayan

Triphala Guggulu

Kaisore Guggulu

Rasothamadi Lepam

Thudhamalaharam

Brands available

AVS Kottakal

SNA Oushadhasala

Vaidyaratnam oushadhasala

AVP Coimbatore

Home remedies

Home remedy for mild jock itch includes the following:

  • Wash the groin skin two to three times a day.
  • Keep the groin area dry.
  • Avoid excess groin skin irritation by wearing 100% cotton underwear.
  • Avoid fabric softeners, bleaches, or harsh laundry detergents.
  • Apply a mix of over-the-counter hydrocortisone cream and clotrimazole (Lotrimin, Mycelex) cream one to two times a day to the affected area and covering this liberally with zinc oxide ointment.

Holistic (nonmedicated) home remedy options for jock itch include

  • soaking the affected area daily with a washcloth dipped in dilute white vinegar (1part of vinegar to 4 parts of water) and drying the skin; and
  • soaking in a bathtub daily or every other day with very dilute Clorox bleach (1 quarter cup of Clorox bleach in a bathtub full of water) and drying the skin.

 Diet

Do’s

Light meals and easily digestible foods

Green gram, soups, buttermilk boiled with ginger, turmeric, curry leaves etc.

Freshly cooked and warm food processed with cumin seeds, ginger, ajwain etc

Maintain a regular food and sleep schedule.

Don’ts

Heavy meals and difficult to digest foods – cause indigestion.

Junk foods- cause disturbance in digestion and reduces the bioavailability of the medicine

Carbonated drinks – makes the stomach more acidic and disturbed digestion

Refrigerated and frozen foods – causes weak and sluggish digestion by weakening Agni (digestive fire)

Milk and milk products other than buttermilk- Cause indigestion, increase Kaphadosha, can lead to obstruction in channels and respiratory problems.

Curd – causes vidaaha and thereby many other diseases

Red chilli and other pungent, hot and spicy food items.

Better to avoid exposure to excessive sunlight wind rain or dust.

Avoid stress.

Avoid sedentary lifestyle as it is one of the main causes of rheumatoid arthritis.

Avoid holding or forcing the urges like urine, faeces, cough, sneeze etc.

Yoga

Salabhasana

vajrasana

Nadisudhi pranayama

Bhujangasana

All the exercises and physical exertions must be decided and done under the supervision of a medical expert only.

Research articles

https://www.ncbi.nlm.nih.gov/books/NBK554602/

https://pubmed.ncbi.nlm.nih.gov/25090020/

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