It sounds like you’re dealing with a recurrent fungal infection, likely tinea cruris, which can be stubborn if not managed consistently. First, restarting your antifungal medication could be helpful. Fluconazole is often effective, but need need to be taken for the full course as prescribed to ensure the infection is completely eradicated. Consider resuming the medication, this time completing the full treatment duration recommended by your dermatologist. Keep in mind to discuss this plan again with your healthcare provider before restarting any medication.
Apart from medication, implementing lifestyle changes could potentially reduce recurrence. Keep the affected areas as dry and clean as possible, since fungi thrive in moist environments. Wear loose-fitting clothing and opt for breathable fabrics to minimize sweating, particularly in areas prone to moisture like the back and buttocks. Also, ensure you wash and dry these areas thoroughly after any physical activity or sweating.
Avoid scratching even when the itch is intense, as this can worsen the irritation and lead to bacterial infection. Over-the-counter topical antifungal creams might also help manage mild symptoms, but again, it’d be best to use them consistently as per instructions. Consider using fragrance-free and hypoallergenic products to reduce additional skin irritation.
Since your symptoms seem to worsen during menstruation, it might be worth keeping a diary to track flare-ups and present this to your managing clinician. This pattern could offer insights or prompt additional treatment choices, such as considering hormonal factors if they play a role. In terms of existing scarring and pigmentation, you might want to discuss options like topical treatments for hyperpigmentation with your dermatologist and assess safe, longer-term improvements. Always consult your healthcare provider before modifying any treatment plan, and particularly if symptoms persist or worsen despite these steps.
