Jock Itch (Tinea Cruris)

Symptoms

• itching, burning or chafing in the groin and inner thighs
• red, pink, or brown patches with a raised, scaly, sharply defined edge
• the center may clear as the rash expands, giving a ring-like look
• may spread to the buttocks, belly and anal area
• flaking, peeling or cracked skin
• worse with sweating and exercise

Is an itchy scrotum the same as jock itch?

Not usually. Jock itch typically spares the scrotum. An itchy scrotum is more often caused by:

• yeast (Candida) infection: bright red, moist rash that often involves the scrotum, with satellite spots
• intertrigo from friction and sweat
• contact dermatitis from soaps, detergents or condoms
• eczema or lichen simplex from chronic scratching
• scabies or pubic lice
• psoriasis

See itching of the scrotum.

Can jock itch cause testicle pain or swelling?

No. Jock itch affects only the skin. It can make the area sore from scratching and inflammation, and swelling of the skin can make the scrotum look different, but it does not cause pain or swelling of the testicles or change the shape of the scrotum's contents. Testicle pain, swelling or a lump has other causes, such as epididymitis, a hernia, a hydrocele, testicular torsion or a tumor, and needs prompt examination.

Causes and risk factors

The fungi (mostly Trichophyton rubrum) thrive in warm, moist skin. Infection often spreads from the feet: people with athlete's foot can carry the fungus to the groin on their hands or towels, or when pulling up underwear.

Risk factors:

• sweating, tight clothing, athletic gear and wet swimwear
• obesity
• diabetes and a weakened immune system
• sharing towels or clothing
• male sex and adolescence or young adulthood

Jock itch vs other groin rashes

Diagnosis

A doctor can usually diagnose jock itch by its appearance. A skin scraping examined under a microscope (KOH test) or a fungal culture confirms the diagnosis when it is unclear or not responding to treatment.

Treatment

Over-the-counter antifungals

• terbinafine cream once or twice daily, often for 1 to 2 weeks
• clotrimazole or miconazole twice daily for 2 to 4 weeks

Apply to clean, dry skin and about 2 cm (1 in) beyond the edge of the rash. Continue for 1 to 2 weeks after it clears, or as the label directs.

What to avoid

• steroid creams alone, or combination steroid-antifungal creams, unless prescribed: they can make fungal infections spread and change their appearance (tinea incognito)
• tight underwear and long periods in damp clothes

Prescription treatment

Oral antifungals such as terbinafine or itraconazole are used for widespread, severe or recurrent cases, or when hair follicles are involved.

Treat athlete's foot too

If you have athlete's foot, treat it at the same time to prevent reinfection, and put on socks before underwear.

Prevention

• shower after exercise and dry the groin thoroughly
• wear loose, breathable cotton underwear and change daily
• wash athletic gear after each use
• do not share towels
• use antifungal powder in the groin if prone to recurrences

Frequently asked questions

How long does jock itch last?

With antifungal cream, jock itch usually improves within 1 to 2 weeks and clears in 2 to 4 weeks. Without treatment, it can persist for months. Continue treatment for 1 to 2 weeks after the rash disappears to prevent it coming back.

Is jock itch contagious?

Yes. It spreads through direct skin contact and shared towels, clothing and sports gear. It can also spread from your own feet if you have athlete's foot.

Can women get jock itch?

Yes, although it is less common than in men. Women can develop tinea cruris in the groin and inner thighs, especially with sweating, obesity or athlete's foot. Vaginal yeast infections are a different condition.

Why won't my jock itch go away?

Common reasons are stopping treatment too early, untreated athlete's foot, using steroid creams, persistent moisture, or a diagnosis that is actually yeast, erythrasma or psoriasis. See a doctor if it is not improving after 2 weeks.