Ditch that summer itch

Summer has brought more than just hot, steamy days and do-nothing lazy days on the beach. A regular complaint from pharmacy clients these days is itching, of many sorts. Many prescriptions now bear remedies for fungal infections - antifungal skin preparations, vaginal inserts and oral formulations.

Increased heat and sweating provide perfect breeding grounds for bacteria and fungi which would normally live quietly in harmony with us. Fungi usually thrive in warm, moist areas, especially where skin surfaces meet; for example, in the navel, groin, between toes and underneath the breasts. Athlete's foot, jock itch and other forms of ringworm are a type of fungus. Yeast is another type, for example, candida (thrush) and tinea versicolor (liver spots). Most of these conditions have one thing in common - itching.

Ringworm treatment

Ringworm is typically treated with products containing antifungals like clotrimazole (Canesten, Candid, Clotridenk); terbinafine (Lamisil, Terbisil); miconazole (Daktarin) and ketoconazole (Nizoral, Ketozal). They are available as creams, lotions, solutions, sprays, powders and shampoos. In persistent cases and in ringworm of the scalp, oral antifungal medications like terbinafine, itraconazole (Sporanox) and griseofulvin are taken for weeks.

Yeast infection

Yeast is another fungus which lives all over the body, especially in the vagina, mouth and intestines where there is a balanced mix of yeast and bacteria. Usually, yeast is controlled with a healthy immune system.

Bacteria like lactobacillus help keep yeast in check by making the yeast-prone environment acidic. But there are some triggers which disrupt the yeast/bacteria balance to offset a yeast infection, showing signs in the mouth, skin folds, nail bed, vagina or on the penis (candidiasis).

Vaginal yeast overgrows in different situations:

Antibiotics taken for 'bad' bacterial infections kill much of the 'good' bacteria which keep yeast at bay. In fact, many doctors prescribe high-dose oral antibiotics with antifungal vaginal preparations since they anticipate overgrowth of vaginal yeast.

Hormonal changes in menopause, pre-menstruation, pregnancy or using hormones like oral contraceptives.

Immune system suppression, for example, in HIV/AIDS or uncontrolled diabetes.

Underwear made from synthetic fabrics, pantyhose, tights and tight pants encourage heat and moisture, and are potential triggers for vaginal yeast infection. Wet swimwear and sweaty gymwear are other triggers.

One school of thought in preventing or treating vaginal yeast infections is to keep the yeast-prone environment acidic, by taking loads of good bacteria like lactobacillus acidophilus by mouth, in capsule form or as food (for example, yoghurt). Avoiding aforementioned possible triggers is another method of prevention.

Treat the yeast

Most of the antifungals used for ringworm treatment are effective for yeasts like candida. Fluconazole (Diflucan, Apo-fluconazole, Fluzon, Mycosyst), ketoconazole (Nizoral) and itraconazole are popular oral medications for yeast treatment.

Drug therapy for vaginal yeast infections includes vaginal tablets, creams or suppositories bearing antifungal ingredients like econazole (Pevaryl), isoconazole (Travogen), clotrimazole, ketoconazole or miconazole which, when inserted into the vagina, lessen the fungal population there.

Dahlia McDaniel is a pharmacist and final year doctoral candidate in public health at the University of London; email: yourhealth@gleanerjm.com.