How can I manage my genital itching effectively at 29?

Question

Hi doctor,

I am 29 years old. I have been suffering from itching genitalia for over five to six years, and the severity would range from low to medium. It is mostly due to sweating in that area. I used to apply an itch guard for a few days, and it used to get fine. Now, over four to five months, I have severe itching on my genitals that is in the penis, testicles, and also the area below. I am using Candiderma powder frequently. But when the problem increases, I apply Quadriderm ointment at night for two to three days. There is also a lot of flaking and cracking of the skin. I have attached pictures of it. I usually end up itching while sleeping, too. Please tell me,

What can be the problem?
What medication and precautions should I take?

Please help.

Answer 1

Hi,

Welcome to icliniq.com.

I have reviewed the attached images (attachment removed to protect the patient's identity). Your problem seems to have lingered on to become a chronic hyperkeratotic scrotal eczema. This is a result of your hyperallergenic tendency, constant scratching, sweat-induced maceration, and intermittent but incomplete treatments with suboptimal medicines.

Do you have a history of generalized dry skin that worsens in winter?
Did you have childhood eczema, sinusitis, or childhood asthma?
Does your occupation entail a lot of sweating in the groin area? What kind of fabric do you use for undergarments?
Are you using either pure cotton and loose ones or tight synthetic fabric ones?

Till you revert with the answers, I advise you to wash that area twice a day with a moisturizing, non-medicated soap. Removal of sweat by regular washing is important. I prefer loose cotton undergarments and wearing cotton shorts once you reach home to allow aeration of that area. Start applying a cream named Tenovate-M (Clobetasol propionate) twice a day over the affected part after bath for seven days, and then shift to using Onabet-B or Sertacide-B (Sertaconazole nitrate) cream twice a day for five days. Then start with Lulifin cream (Luliconazole) just once at night for two weeks. If your general health is good, then you must take an oral antifungal as well. Take tablet Terbicip 250 mg (Terbinafine hydrochloride) twice a day for the first week, then once a day for the next three weeks, and complete a course of four weeks. To reduce itching, you may take a tablet of Levosiz 5 mg (Levocetirizine) or Teczine (Levocetirizine hydrochloride), one tablet at night for 5-10 days.

As of now, answer a few questions of mine. Are you a known diabetic? If not, then please get it tested.

I hope this helps you.

Thank you.