Bad reaction to Nystatin/Triamcinolone?

Hi Dr. Rockoff,

I'm a 39 year old male. I had a fungal infection, most likely Candida, in my groin area (scrotum, penis, & some in inner thighs). I used an over-the-counter medicine, Micatin (Miconazole nitrate 2%), for jock itch. It started to sting and burn my skin, so I stopped using it after just two days. I went to a doctor (not a Dermatologist) and he prescribed a cream, Nystatin (100,000 USP) & Triamcinolone (1 mg). After using it for four days, I began to notice that it also had a stinging effect and caused skin distortion (especially the penis head and inner forskin). Worst of all, it seems I have lost all sensation and significant numbness to those areas. I believe the damage is permanent. I'm also now worried that the cream, especially the steroid (Triamcin.), may have been absorbed thru my scrotum and into my system, because it feels as if my testicles somewhat burns.

Did this Doctor prescribe a wrong medication? Is the steroid too strong? and can Nystat. & Triamcin. cream actually do such damage?

Thanks!

[Alan Rockoff, MD]

No, it can't.  Triamcinolone is a medium-potent steroid that shouldn't be used in the groin long-term, but long-term means months, and any changes it causes are in any case reversible, not permanent damage.

So first of all, please don't worry that you have permanently damaged your skin.  Second, I advise your seeing a dermatologist.  Red scrotum is rarely anything serious, but clearing it up can be quite tricky.  

Frankly, I have a sense that you tend to over-interpret symptoms.  Micatin, for instance, is a perfectly safe and respectable anti-yeast/antifungal.  That you stopped after two days because it, "started to sting and burn my skin," suggests to me that you are at risk of worrying yourself needlessly and talk yourself out of using things that may help you.  When you see the dermatologist, I advise you to get the information and reassurance you need to avoid this tendency.

Best.

Dr. Rockoff