Jock itch, medically referred to as "tinea cruris," is a fungal infection of the groin area. The name jock itch refers to a higher prevalence of the infection in athletes as opposed to the general population and to the sometimes intense itch that accompanies the rash. Caused by the same fungi that cause athlete's foot, a group of fungi called "dermatophytes," jock itch should be treated at the same time as any athlete's foot outbreak to minimize the risk of cross-contamination.
Over-the-Counter Treatments
Jock itch is treated with antifungals. The two main types of drugs used are allylamines and azoles. Generally speaking, allylamines deliver faster results and offer fewer relapses, but they are more expensive. Azoles take a longer time to work, but are generally less expensive.
Terbinafine is an allylamine available under the name Lamisil AT as a cream or gel. One study reported by "The Journal of Family Practice" showed that Lamisil offered an 89 percent efficacy rate when used as a treatment once daily for a week. It was noted that Lamisil was particularly effective on hairy skin. Naftifine, sold as Naftin, is a terbinafine in cream and gel form.
Micatin and Monistat-Derm contain miconazole, an active azole, and are available as creams. Clotrimazole, under the name Lotrimin AF, is available as a cream or lotion. Sulconazole, sold as Exelderm, is broad-spectrum antifungal cream or solution that also offers anti-yeast benefits.
Ciclopirox is a topical synthetic, broad-spectrum anti-fungal available as a cream, lotion, liquid, gel and a shampoo under the brand name Loprox. It is also sold as a nail lacquer for treating a dermatophyte fungal infection of the nails under the name Penlac.
Ketoconazole, sold as a cream under the brand name Nizoral, is a synthetic broad-spectrum antifungal. It is one of the older treatments for tinea infections.
Sertaconazole, sold under the name Ertaczo, is an anti-fungal cream formulation.
Tolnaftate, the active ingredient in Tinactin, is available as a cream, gel, powder, spray and liquid.
Prescription Topical Treatments
When OTC treatments for jock itch don't cure the infection, your physician may prescribe a prescription-strength topical treatment. Econazole, sold under the name Spectazole, is a cream. It is available in generic form under the name econazole nitrate cream. Oxiconazole, an antifungal active compound, is available in both cream and lotion formulas under the brand name Oxistat.
Prescription Oral Treatments
Particularly severe cases of jock itch may require a systemic treatment using oral medications. Itraconazole is one medication available in capsule form under the name, Sporanox. Fluconazole, sold as Diflucan, and Terbinafine, available as a capsule under the name Lamisil, are also prescription oral treatments for cases that do not respond to topical OTC remedies. Mayo Clinic reports that there are side effects to systemic jock itch medications. These range from gastrointestinal upset to abnormal liver function.
A medication sometimes given to those who are allergic to other antifungals is griseofulvin, sold under the name "GrifulvinV." Griseofulvin is one of the older medications used to treat tinea infections. According to Mayo Clinic, griseofulvin takes longer to work and has side effects, including headache, rashes, light sensitivity and digestive tract discomfort.
Cautions
In 2001, the FDA issued a public health advisory because of possible "hepatic adverse events" with the administration of oral Lamisil.
Sporanox is contraindicated for those with congestive heart failure. In 2001, the FDA issued a public health advisory for systemic itraconazole, sold as Sporanox, because of the "possible association of serious cardiac adverse events with the administration of Sporanox and hepatic adverse events."
In a 2004 memorandum, the Department of Health and Human Services reported that the active ingredients in some prescription tinea treatment products, including ketoconazole, econazole, oxiconazole, sertaconazole, sulconazole, naftifine, betamethasone with clotrimazole, and ciclopirox, were shown to lack efficacy. Overall, the memorandum cited 1,663 reports of lack of efficacy, which represented 35 percent of all the reports included in the review. The memorandum notes that the efficacy of nonprescription formulations using these ingredients was not known because reporting of OTC products is not mandatory.
