How to manage rashes on my buttocks which get worse with pads?

Hello,

Welcome to icliniq.com.

I understand your concern.

Based on the history you provided and the picture (the attachments were removed to protect the patient’s identity), I can see red circular rashes on both buttocks that are round, red, and scaly. This appearance suggests a superficial fungal infection of the skin (tinea corporis or dermatophyte infection).

These infections commonly appear as circular or ring-shaped red patches with itching and scaling.

The fact that the rash worsened with Hydrocortisone is also an important clue, as topical steroids can suppress the skin’s immune response and allow fungal infections to spread or become more inflamed.

Your partial improvement with antifungal medications such as Fluconazole and Clotrimazole further supports this possibility.

Moisture and friction are significant contributing factors in your case. Because the rash began during a period of coughing-related incontinence and tends to worsen when wearing pads, the warm and moist environment created by pads can encourage fungal growth and slow healing.

Additionally, skin folds and areas with prolonged moisture, particularly in individuals with higher body weight, are more prone to fungal infections and irritation.

For management, please start topical antifungal treatment along with measures to keep the area dry.

Applying a topical antifungal cream such as Clotrimazole or Bifonazole one percent twice daily to the affected areas, extending slightly beyond the visible rash, is typically recommended for at least three to four weeks.

Treatment should be continued even if the rash appears to improve earlier, as stopping too soon can allow the infection to recur. For itching, an oral antihistamine such as Cetirizine 10 mg at bedtime may help reduce discomfort and prevent scratching.

It is also important to focus on local skin care. Try to keep the buttock area clean and dry, change pads frequently if needed, and consider using breathable cotton underwear.

After washing, gently pat the skin dry rather than rubbing it. Wearing loose clothing and allowing the area some air exposure when possible can also help reduce moisture buildup. In some cases, using a mild antifungal powder during the day may help keep the area dry.

With proper antifungal therapy and good moisture control, most fungal infections in this area gradually improve over several weeks.

I hope this has helped you.

Please feel free to reach out to me again if you have further queries.

Thank you.