Groin rashes are extremely common especially in Texas where the majority of the year it is hot and humid so in a typical day in both my Conroe dermatology and the Woodlands dermatology clinics I see between 5 to 6 patients with groin rashes. Groin rashes begin due to the friction and chafing of two skin surfaces rubbing together combined with sweat and heat, which causes the skin to breakdown and form a red macerated rash called intertrigo. Once intertrigo occurs, fungus and yeast can grow in this area. When fungus grows here, the rash is called tinea cruris and usually arises from toenail or foot fungus being dragged up to the groin when a patient puts on their underwear and carries the fungus with them into the groin area. Tinea cruris appears red, scaly and dry and is treated with Lamisil cream twice a day until it resolves. In contrast, candidiasis is a yeast that causes a groin rash that is more moist appearing and has a beefer red texture than the dull red dryness of tinea cruris. Also, candidiasis can have satellite pustules on the periphery of the rash. Unlike the dermatophytes in tinea cruris, the yeast of candidiasis can spread to other organs and can enter the blood stream causing a fatal septicemia in immunosuppressed patients. Candidiasis is treated with Lotrimin cream twice a day and Diflucan (fluconazole) is an oral anti-fungal medicine that may be prescribed for severe cases. Patients can prevent intertrigo by keeping the area dry using loose fitting underwear. Powders can be used to decrease the friction in this area. Powders function as mini ball bearings to allow two skin surfaces to essentially slide over each other with ease.
