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The Spokesman-Review Newspaper
Spokane, Washington  Est. May 19, 1883

People’s Pharmacy: Antifungal products protect against under-breast rash

By Joe Graedon, M.S., </p><p>and Teresa Graedon, Ph.D. King Features Syndicate

Q. Last summer, I had trouble with a painful rash under my breasts. My dermatologist recommended Zeasorb AF. She emphatically said to make sure it was the AF and not just plain Zeasorb. I have had no issues with the rash since I have been using Zeasorb AF.

A. During hot weather, skin folds often collect sweat and make a hospitable growing environment for fungus. This, in turn, can cause an uncomfortable rash that may be hard to treat. The fancy medical term for this condition is inframammary intertrigo.

Zeasorb AF contains the antifungal agent miconazole and no starch. No doubt that explains your dermatologist’s recommendation. Plain Zeasorb (super absorbent powder) is listed as containing cornstarch as the first ingredient.

Others have also had good results using antifungal products to treat under-breast rash. Here is what one reader wrote:

“A friend told me to use Monistat cream and after it healed to use Desenex powder to keep the area dry. I did, and in three days the rash was gone. I had suffered with it for many years, but now I make sure I have Monistat and Desenex powder in my first aid kit.

Monistat and Monistat 3-Day both contain miconazole, and so does Desenex. Another reader recommends a non-drug treatment:

“Prevention is better than sticky creams. A company called More of Me to Love sells underboob soft bamboo cotton inserts for your bra to go under the breasts. They absorb sweat wonderfully and keep you dry all day. No more rash.”

Q. My psychiatrist prescribed duloxetine last month for depression. I had to stop after five days because I couldn’t sleep. My muscles hurt and clenching my jaw gave me a nonstop headache. I felt terrible.

It’s been three weeks since I stopped and I am still having withdrawal symptoms. I can’t even shake my headache. I won’t try this class of antidepressants again.

A. Duloxetine (Cymbalta) is not the only antidepressant that can trigger unpleasant withdrawal symptoms upon stopping suddenly. Many people report sweating, nausea, headaches and worst of all, dizziness. Some describe a sensation like having their head in a blender.

People differ in their susceptibility to such withdrawal symptoms. Most prescribers would doubt that such a short exposure would result in a discontinuation syndrome, but we have heard from others like you.

To learn more about various strategies to treat depression and ways to reduce the impact of stopping antidepressants, you may wish to read our “eGuide to Dealing with Depression.” This online resource may be found under the Health eGuides tab at

Q. When I was in my early 40s, I was diagnosed with serious osteoporosis. I did the prescribed exercises and took Fosamax for nearly 20 years.

When I was diagnosed with Barrett’s esophagus, I had to stop the alendronate (Fosamax). It can harm the esophagus, so I took PPIs to protect myself from cancer of the esophagus.

Since then, I have not used any medication for my bones. My primary care physician wants me to use Prolia. I am aware of the possible side effects. If I couldn’t tolerate it, would there be any risks to stopping?

A. You are right to be cautious. Stopping denosumab (Prolia), even just missing a dose, can lead to fractures of the vertebrae. If you had to stop the Prolia, you’d have to go on a bisphosphonate, like alendronate, right away to prevent the fracture risk. Ask your PCP to review all the other possible treatments for osteoporosis so you have an idea of your options.

In their column, Joe and Teresa Graedon answer letters from readers. Write to them in care of King Features, 628 Virginia Drive, Orlando, FL 32803, or email them via their website: Their newest book is “Top Screwups Doctors Make and How to Avoid Them.”