Groin Rash ongoing

[crocushillrunner]

OK here it goes.  here is a link to my post in June the first time I EVER had a groin issue http://www.medhelp.org/posts/Dermatology/Rash-in-groin-Yeast--irritation--chaffing/show/1262892

I had a groin rash in June, Dr. said it was yeast. Applied econozole, went away after 2 weeks. Said that things like this can reoccur. Consumed with thoughts that the yeast infection was a sign of something sinister tested for everything, all results negative,HIV, diabetes, blood pressure etc. I am a little bit overweight and my thighs do touch.

The rash has come back a few times. A former Derm on here has always seemed very skeptical about yeasts, since groin rashes call all look similar. Anyway 3 weeks ago I ran on the treadmill, 3 days later I got the rash again, only on my scrotum, went back to dr. she said it was yeast again and to you econazole, since using econazole on the rash and one inch around, my groin crease has gotten red patches and small little red dots, which can look like a yeast border, but say red dots can be a side effect from the econazole.
Below are my concerns I would like addressed if possible.
1 I have completely stopped exercising out of fear that it will get worse, even if it is yeast or irritation, would it be OK to work out as long as I shower right away and continue using the cream. Chubby thighs gone would prob help a ton anyway.
2 Is it OK to use the econazole for 8 weeks? To make sure everything is dead.  Or should I ask for an oral one?
3 Should I have it scraped to confirm what it is?
4 Is reoccurane in healthy guys normal?
I shower daily, gently wash with just water, dry it good, apply econazole, baby powder, loose unders. Change in to open shorts when home. Anything else?

I have only seen my GP not a derm on this, would a derm be better suited for it? I have read a lot of misdiagnoses from GP regarding groin rashes. I have a pic if that helps!

Thanks so much!!

[Jasmina Jankicevic, MD, MSc, CCRP]

Welcome to the Dermatology Expert Forum! Thank you for your question.

Answers are:

1. Yes, exercising is not contraindicated; as long as you maintain areas clean and dry, and prevent friction (appropriate cotton underwear could help).

2. If yeast is the cause, and all risk/aggravating factors are removed (sweat, friction, synthetic fabrics, etc.) you will not need to use econazole that long.

3. Yes, it is recommended to have results of the KOH test and culture first. Once therapy is initiated, performing those tests can give false-negative results. However, in cases like yours, if therapy is discontinued for a while (for example, two weeks), mentioned diagnostic tools will become reliable again.

4. If friction is present continually, as well as sweating, skin becomes damaged and therefore an excellent entering point for fungus/yeast. In such a situation, infection can reoccur multiple times. The goal is to eliminate all risk factors.

Well, if you are using both cream and then powder, you need to be more thorough in order to wash off old layers of products. Soap might be needed (but no tough rubbing). The powder you mentioned in earlier post has menthol and zinc-oxide in it. It might be better to use prescription one with antifungal medicine in it.

Wishing You Optimal Health and Happy Holidays,
Dr Jasmina Jankicevic

[crocushillrunner]

Thank you so much for responding to jumble of words considered a question:)

I have just one more question, if you are able to still answer any...

Could use hydrocortisone or vaseline or diaper ointment over top of it, to help with friction?

Thanks so so so so much. You answer nailed all of my concerns.
Best,
Travis