Q: I’m an avid canoe paddler. Back in the 1970s when I got started canoeing, I learned that wearing denim cutoffs on the river was a very bad idea. I developed terrible jock itch, probably because my shorts stayed damp for hours.
In those days, the best treatment for a fungal infection was tolnaftate, the ingredient in the athlete’s foot remedy Tinactin. It’s pretty affordable, but sometimes when I need a stronger antifungal, I buy a product for vaginal yeast infections. It seems stronger than an athlete’s foot remedy.
The key, in my opinion, is to aim a spray of hot water on the area before applying the antifungal cream. I also apply tolnaftate cream these days as a preventive before I get on the river.
A: Jock itch (tinea cruris) is a fungal infection of the groin. Fungi love warm, moist skin folds. That’s why the toes, groin or under-breast areas are frequent targets.
Anti-fungal creams such as miconazole or clotrimazole can be used to treat such infections. They also are helpful in treating vaginal yeast infections, so we are not surprised you have found them effective.
Q: Due to a change in my insurance, I wasn’t able to refill my prescription for the depression drug Cymbalta. Saturday was my last dose, and by Monday I felt like I was losing my mind.
Today was the worst physical and emotional roller-coaster ride I have ever been on. I have gone from wanting to scream and throw things to crying in a matter of minutes. My head is spinning, and I have a creeping crawling feeling going up the back of my neck when I feel an outburst coming. Sometimes, without warning, I suddenly just start sweating. This is absolute craziness! Do you have any advice for getting through this?
A: Duloxetine (Cymbalta) is prescribed for lots of different problems: anxiety, depression, fibromyalgia and muscle or nerve pain. Before starting on this medication, patients should be warned that stopping suddenly can be a challenge.
Sweating, nausea, dizziness, irritability and electric shocklike sensations (brain zaps) all have been reported as withdrawal symptoms. They can last for several weeks, but they eventually disappear. You might ask your doctor whether switching to fluoxetine (Prozac) and withdrawing slowly from that drug would be an option.
We are sending you our Guide to Dealing With Depression, which discusses withdrawal and provides many nondrug alternatives for depression. Anyone who would like a copy, please send $3 in check or money order with a long (No. 10), stamped (66 cents), self-addressed envelope to: Graedons’ People’s Pharmacy, No. E-7, P.O. Box 52027, Durham, NC 27717-2027. It also can be downloaded for $2 from our website: www.peoplespharmacy.com.
Q: My 25-year-old grandson has been diagnosed with scalp folliculitis. The doctor gave him a prescription for an expensive cream, but it did not get rid of the problem. Is there anything else that might help?
A: Folliculitis is inflammation of the hair follicles, which can be caused by bacterial or fungal infection. A warm compress moistened with vinegar might help.
One reader reported that amber Listerine helped her son’s folliculitis: “You should see his skin since using Listerine faithfully. It is completely clear! We’ll see the dermatologist later this year, and I can’t wait to show him the results.”
Joe and Teresa Graedon answer letters from readers. Email them at www.peoplespharmacy.com. Their newest book is “Top Screwups Doctors Make and How to Avoid Them.”
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