HomeAnswersDermatologyvulvovaginitisI have fungal infection in the vulvar and groin region. Please help.

How to get relieved from vulvovaginal itching?

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The following is an actual conversation between an iCliniq user and a doctor that has been reviewed and published as a Premium Q&A.

Answered by

Dr. Shama Naaz

Medically reviewed by

Dr. Sneha Kannan

Published At May 1, 2021
Reviewed AtApril 23, 2024

Patient's Query

Hi doctor,

I am a 24-year-old female. I am not diagnosed with any pre-existing condition. I have been suffering from a fungal infection in my vulvar and groin region for almost two months. Initially, it only affected the vulvar region, but now it spread to the inner thighs and connected buttock area. I have been receiving treatment for almost seven weeks now, and it has reduced my itching and scarring drastically. The last prescribed dosage by my doctor was Sebifin tablet in the morning (250 mg), Sizon tablet (10 mg) at night, Fungicros topical cream twice a day, and Fluconazole tablet (2 pills once a week). I have completed this course for a month. I will attach the previous prescription of my treatment. Currently, the affected area is extremely dry and red and sometimes peels off. Should I continue the above treatment? I cannot reach my doctor because of lockdown in my region and thus would like your advice. If photos would help, please let me know. I have attached my prescription for the past seven weeks here. Thank you.

Answered by Dr. Shama Naaz

Hello,

Welcome to icliniq.com.

Please send a picture of the affected area if possible. Also, mention if there is any vaginal discharge?

Patient's Query

Hi doctor,

I have attached the photos here. Sometimes the area near the vaginal opening becomes itchy. And so does the area just below the mons pubis. Discharge is not different from my normal discharge. I am not sure if you can see the photos correctly. Please let me know. I can try to send a PDF.

Answered by Dr. Shama Naaz

Hello,

Welcome back to icliniq.com.

I have seen the pictures (attachments removed to protect the patient's identity). Some areas are still active. You should continue the medications for one month. And get an LFT (liver function test) done as routine investigations because you are on antifungal treatment. Also add cream containing Oxiconazole. Use Amorolfine and Phenoxyethanol cream in the morning. And use Oxiconazole cream at night time. It would help if you kept the area dry because moisture predisposes to fungal infections. Use a moisturizing soap for bathing to relieve dry skin. You can apply a moisturizer to relieve dryness in the afternoon because morning and evening are scheduled for antifungal cream. Avoid wearing tight clothes like jeans. Sweat can exacerbate the infection. Avoid eggs, meat, and hot beverages. I hope this has helped you. Kindly follow up if you have more doubts.

Thank you.

Patient's Query

Thank you doctor,

I have been using Dettol skincare. Should I switch to the soap you have mentioned? Also, since hospitals are pretty busy due to COVID-19, can I get the LFT done after a week? Should I wash the area at night also with soap before applying cream? Also, doctor, does fungal infection take this much time to cure? This has never happened before, and since it is taking so long, I am worried. There is also itching and irritation under my arms. This happened before as well, so the doctor had suggested applying the cream. But the area under the arms is not as itchy or red as before. I will attach a photo, but I am not sure if anything will be visible. I am currently trying to keep the area dry and apply Nycil powder thoroughly after the bath in the morning.

Answered by Dr. Shama Naaz

Hi,

Welcome back to icliniq.com.

The soap you are using causes irritation over the sensitive areas, so you should switch. Yes, you can get your LFT done after a week. There is no need to wash with soap at night time because too much water or moisture will make the area macerated. Yes, it takes time to treat fungal infections. And there is a fixed duration of treatment for fungal infection (comparable to the antibiotic course of bacterial infection, but in fungal infection, the duration is more prolonged from two to three months). Satisfactory treatment is when the raised red areas start to turn dark or, in some cases, turn lighter and become flat. Then only we can say that the site is healing. In your pictures, there are red raised areas that show active fungal infection. That is why you should continue taking medicines. I hope this has helped you. Kindly follow up if you have more doubts.

Thank you.

Patient's Query

Thanks for the reply doctor,

I will continue the treatment as suggested by you. For itching in the labia area (as mentioned above), I applied cream containing Clobetasone and Miconazole last night, which gave relief. But the site is itching again. Should I use this cream in that region? Kindly suggest.

Answered by Dr. Shama Naaz

Hi,

Welcome back to icliniq.com.

I read your query and understood your concern. I suggest you do not use cream containing Clobetasol and Miconazole as it contains a very potent steroid that should never be applied over the genital area. It will cause dryness, increase the infection, and makes the skin thin. Steroids are only used in specific disorders like psoriasis, eczema, autoimmune disorders but never in fungal or bacterial infections. I hope this has helped you. Kindly follow up if you have more doubts.

Thank you.

Patient's Query

Thank you doctor,

So should I use cream containing Amorolfin in that area as well for itching? Also, can you please let me know about the itching underarms? I have already given the information above. Kindly suggest.

Answered by Dr. Shama Naaz

Hi,

Welcome back to icliniq.com.

I read your query and understood your concern. Yes, you should apply cream containing Amorolfin in that area for itching. For underarms, if there is itching, you should apply antifungal cream. Because we cannot appreciate redness in that area as it is darker than the rest of the body. I hope this has helped you. Kindly follow up if you have more doubts.

Thank you.

Patient's Query

Thank you doctor,

I will apply the same cream. Also, with food, is there anything I should avoid or consume more at the moment? I am currently not consuming any meat or eggs, but I drink coffee or tea twice a day. I will try to visit my doctor as soon as possible. But for now, I will continue the treatment as suggested by you. I was anxious about how to go about this, especially since there is a lockdown, but after consulting you, I am confident to continue this treatment. Thank you so much.

Answered by Dr. Shama Naaz

Hi,

Welcome back to icliniq.com.

I read your query and understood your concern.. I suggest you reduce the frequency of tea or coffee intake to once a day. And also decrease sugar and carbohydrate intake. Feel free to ask if you have more queries. Thank you.

Patient's Query

Hi doctor,

I do not consume much-added sugar, but I consume lots of fruits around lunchtime, which tend to be sweet. I will reduce the number of carbohydrates, but my diet is not much as it is. Also, I will reduce hot beverages to once a day. I applied the cream under the labia, but there is itching around the clitoris and vaginal opening. And it gets intense at some times leading me to scratch it. Should I apply something else also there or a different cream?

Answered by Dr. Shama Naaz

Hi,

Welcome back to icliniq.com.

I read your query and understood your concern. You can apply cream containing Fusidic acid and Sertaconazole cream. I hope this has helped you. Kindly follow up if you have more doubts.

Thank you.

Patient's Query

Hi doctor,

When should I use all three creams containing Amorolfin ,Oxiconazole, and Sertaconazole? And also advise on which area should I use them.

Answered by Dr. Shama Naaz

Hi,

Welcome back to icliniq.com.

I read your query and understood your concern. If you are not getting relief from cream containing Amorolfin, then I suggest you change to Oxiconazole cream, a new generation antifungal cream. Sertaconazole cream is for itching in and around the vaginal area. I hope this has helped you. Kindly follow up if you have more doubts.

Thank you.

Patient's Query

Hi doctor,

Amorolfin cream has given relief except around the vaginal area. For that, I will use Sertaconazole . How long is the application of Sertaconazole (at a stretch) considered safe? I do not want to become dependent on it in the long run. Kindly suggest.

Answered by Dr. Shama Naaz

Hi,

Welcome back to icliniq.com.

I read your query and understood your concern. You can use antifungal creams for a period of three to four months. I hope this has helped you. Kindly follow up if you have more doubts.

Thank you.

Patient's Query

Hi doctor,

Thank you for the reply.

Answered by Dr. Shama Naaz

Hi,

Welcome back to icliniq.com.

You are welcome. I hope this has helped you. Kindly follow up if you have more doubts.

Thank you.

Patient's Query

Hello doctor,

Should I continue to apply the Oxiconazole cream? If yes, for how long? Can you please let me know the treatment to follow. When I apply the lotion the itching subsides, but returns during night or morning. There is no associated pain. When I initially started treatment there were two sites. But now I see one or two more. Because I am overweight, could that cause these bumps? Kindly help.

Answered by Dr. Shama Naaz

Hello,

Welcome back to icliniq.com.

I read your query and understood your concern. Your infection is clearing up, and the itching is likely a result of a subclinical infection that should resolve over time. To prevent the infection from returning, please continue applying the cream for the next two weeks. Do you experience any pain or discomfort in the white bumps, and how long have you noticed them? These bumps are caused by an infection of dormant hair follicles. Maintaining a balanced diet while avoiding excess sugar and carbohydrates is important. Additionally, consider applying warm compresses to the affected area for five to ten minutes daily.

For your fungal infection I suggest you follow the below mentioned instructions:

  1. Apply Oxiconazole cream twice daily locally for two weeks.
  2. Use moisturizing aloe cream on dry and itchy areas three times a day for two weeks.

I hope this has helped you. Kindly follow up if you have more doubts.

Thank you.

Patient's Query

Hello doctor,

Should I apply the cream to specific areas, like the itchy ones, and use moisturizing lotion on the rest?

Answered by Dr. Shama Naaz

Hello,

Welcome to icliniq.com.

I read your query and understood your concern. I suggest you apply Oxiconazole cream over the area where there was fungal infection. And apply moisturizing lotion over itchy areas. I hope this has helped you. Kindly follow up if you have more doubts.

Thank you.

Patient's Query

Hello doctor,

Do I need to take any oral medicine?

Answered by Dr. Shama Naaz

Hello,

Welcome back to icliniq.com.

I read your query and understood your concern. And no, you do not need to take any oral medications. I hope this has helped you. Kindly follow up if you have more doubts.

Thank you.

Patient's Query

Hello doctor,

I have experienced similar itching, primarily in the labia area. I have been using Oxiconazole cream twice a day for a few days now, but I wanted to seek your advice. Currently, I am on hypertension medication (Amlodipine 5 mg, Torasemide 5 mg) and vitamin D and Calcium tablets. Should I continue using Oxiconazole, or should I consider incorporating a different cream? I have also been using antifungal powder and moisturizing lotion, which helps alleviate itching, but when I sweat, the itching returns. I will also provide photos for reference. The skin appears wrinkled as it did before. Please note that I would prefer not to take oral medications if possible. Kindly help.

Answered by Dr. Shama Naaz

Hello,

Welcome back to icliniq.com.

I read your query and understood your concern. Firstly, I would like to inform you that subclinical infection refers to skin that appears normal but may contain Dermatophyte fungi. Even though the skin looks unaffected, these fungi can still be present. Subclinical dermatophyte infections can act as a reservoir for continued local infection and may contribute to recurrences. I hope this has helped you. Kindly follow up if you have more doubts.

Thank you.

Patient's Query

Hello doctor,

Due to some technical issue I am not able to see your reply to my last query. Kindly reply again.

Answered by Dr. Shama Naaz

Hello,I am not able to see your query, Kindly type it again. Thank you.

Patient's Query

Hello doctor,

I have experienced similar itching, primarily in the labia area. I have been using Oxiconazole cream twice a day for a few days now, but I wanted to seek your advice. Currently, I am on hypertension medication (Amlodipine 5 mg, Torasemide 5 mg) and vitamin D and Calcium tablets. Should I continue using Oxiconazole, or should I consider incorporating a different cream? I have also been using antifungal powder and moisturizing lotion, which helps alleviate itching, but when I sweat, the itching returns. I will also provide photos for reference. The skin appears wrinkled as it did before. Please note that I would prefer not to take oral medications if possible. Kindly help.

Answered by Dr. Shama Naaz

Hello,

Welcome back to icliniq.com.

I read your query and understood your concern. I suggest you use an antifungal cream containing Clotrimazole that is safe for use in the vaginal area. Additionally, itching may result from friction and moisture, so it is essential to keep the area dry after using the restroom to prevent moisture accumulation and fungal growth. Staying hydrated by drinking plenty of water is also beneficial. I suggest you avoid using intimate area wash products as they can alter vaginal pH and potentially increase the risk of infection. I hope this has helped you. Kindly follow up if you have more doubts.

Thank you.

Same symptoms don't mean you have the same problem. Consult a doctor now!

Dr. Shama Naaz
Dr. Shama Naaz

Dermatology

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