DEAR DR. DONOHUE: I have had a very bad rash on my groin for six years. A biopsy was taken, and it came back as intertrigo. No one seems to know a cure for it. Is there one? – J.C.

ANSWER: Intertrigo comes about when skin rubs against skin. Women often get it in the crease beneath their breasts. Men and women can get in the groin. Overweight people whose skin sometimes hangs in folds are quite susceptible to it. Not only is abrasion of one skin surface over another responsible, but moisture between the two surfaces softens the skin and turns it red and causes skin layers to peel off. The whole affair can be quite uncomfortable.

You must stop the friction of skin scraping skin, and you must keep those skin surfaces dry and clean. If weight has a hand in this, then weight loss is necessary.

Start by applying wet compresses soaked in Burow solution and keep the compress on the skin surfaces for 15 minutes. Burow solution is found in all drug stores. Immediately after the compresses, dry the skin surfaces gently. Blowing on the skin with a hair dryer on a low setting is a good way to achieve dry skin without having to rub it with a towel. Do this three times a day and again before going to bed at night. Sprinkle drying powder on the opposing skin surfaces. Zeasorb-AF is a good one, and it has the added advantage of having an antifungal medicine in it. If you can’t find that brand, use any drying powder, except cornstarch. Wear cotton underwear and change it daily.

It shouldn’t take six years to get rid of intertrigo. If you’re not making progress in about 10 days, you’ll have to see the doctor, who can test for bacterial or fungal infection and prescribe the appropriate medicine for either. Another reason for seeing the doctor is to confirm the diagnosis. That has been done for you by the biopsy. Others, however, might confuse intertrigo with eczema, psoriasis or seborrheic dermatitis.

DEAR DR. DONOHUE: Does soft water take calcium and magnesium out of the body? I heard it does. We have very hard water, and I can’t get any suds in my washing because of it, so my husband installed a water softener.

Also, is it safe to drink water to which sodium has been added? Will it cause high blood pressure? – J.K.

ANSWER: Water “hardness” depends on its content of calcium and magnesium. A water softener takes out the calcium and magnesium and replaces those two minerals with sodium. Soft water, however, does not leach calcium and magnesium from the body.

The sodium question depends on how much sodium the water softener adds to the water. The manufacturer can tell you that information. It takes 80 to 160 mg of sodium per quart of water to soften very hard water. Only if people were on a stringent low-sodium diet might that amount of sodium push them over their daily sodium limit. For most people, soft water does not pose a threat of consuming too much sodium or of raising blood pressure. In the exceptional circumstance, the problem is solved by connecting only the hot-water pipe to the softener.

Sodium and potassium, known as electrolytes, are important to health. The booklet on sodium, potassium and other minerals explains their functions. Readers can order a copy by writing: Dr. Donohue – No. 202, Box 536475, Orlando, FL 32853-6475. Enclose a check or money order (no cash) for $4.75 U.S./$6.75 Can. with the recipient’s printed name and address. Please allow four weeks for delivery.

DEAR DR. DONOHUE: I have a rectal fistula. How did I get it, and what can be done about it? – X.B.

ANSWER: Fistulas are tunnels between two surfaces. In the case of a rectal fistula, it’s a tunnel between the rectal lining and the external skin of the buttock. Most rectal fistulas come from an abscess in one of the rectal glands. Fistulas drain pus.

Doctors can cauterize a fistula to get rid of any germs and to collapse the walls of the tunnel on themselves. Surgery might be necessary if cautery can’t get rid of it. You should consult a surgeon.

DEAR DR. DONOHUE: In your article on hepatitis C, you wrote that peginterferon is given by vein. It is not. It is given subcutaneously. – B.M.

ANSWER: You are right. I don’t know what I was thinking when I wrote that. The drug is given under the skin – subcutaneously – and not into a vein.

Dr. Donohue regrets that he is unable to answer individual letters, but he will incorporate them in his column whenever possible. Readers may write him or request an order form of available health newsletters at P.O. Box 536475, Orlando, FL 32853-6475. Readers may also order health newsletters from www.rbmamall.com.


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