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

Answered by
Dr. Shama Naaz
and medically reviewed by Dr. Sneha Kannan
This is a premium question & answer published on Apr 30, 2021

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.

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Hello,

Welcome to icliniq.com.

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

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.

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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 Auxerg cream (Oxiconazole). Use Fungicros (Amorolfine and Phenoxyethanol) cream in the morning. And use Auxerg 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 like Dermadew soap or Moiz moisturizing bar. You can apply a moisturizer like Dermadew aloe (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.

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.

#

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.

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 Eumosone M cream last night, which gave relief. But the site is itching again. Should I use Fungicros cream in that region as well or continue with Eumosone M cream?

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Hi,

Welcome back to icliniq.com.

Please do not use Eumosone M cream (clobetasol and miconazole). 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.

Thank you doctor,

So should I use Fungicros cream 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.

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Hi,

Welcome back to icliniq.com.

Yes you should apply Fungicros cream 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.

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.

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Hi,

Welcome back to icliniq.com.

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.

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?

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Hi,

Welcome back to icliniq.com.

Thanks for the query. You can apply Sudif cream (Fusidic acid) and Sertaspor (Sertaconazole) cream.

Hi doctor,

When should I use all three creams- Fungicros, Auxerg, and Sertaspor (Onabet which I have used before) and where?

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Hi,

Welcome back to icliniq.com.

If you are not getting relief from Fungicros, you should change to Auxerg cream, a new generation antifungal cream. Sertaspor and Sudif creams are for itching in and around the vaginal area.

Hi doctor,

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

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Hi,

Welcome back to icliniq.com.

You can use antifungal creams for a period of three to four months.Thank you.

Hi doctor,

Thank you for the reply.

#

Hi,

Welcome back to icliniq.com.

Thanks for your queries. You are welcome.


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