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Is it safe to treat fungal infection during pregnancy?

Q: I have had a severe problem of fungal infection in my underarms for the past 2-3 years. I went to a skin specialist and he recommended some cream and it all seemed to subside. Some time ago, a severe itching again started in my underarms. I went to a skin specialist who had treated me effectively in the past. At that time I was 9 weeks pregnant, and informed the doctor about the same, and he prescribed Zimig 1% cream to be applied every night for 2 weeks. However, when I bought the cream, and casually read the literature for Zimig 1% Cream (Terbinafine Hydrochloride cream), it was mentioned specifically - Foetal toxicity and fertility in animals suggest no adverse effects. Since chemical experience in pregnant women is very limited, Zimig cream should not be used during pregnancy unless the potential benefits outweigh any potential risks. Terbinafine is excreted in breast milk; however, with Zimig cream treatment, the small amounts absorbed through the skin are unlikely to affect the infant. After I read this, I was quite apprehensive about using this cream, and I used it only occasionally when the itching was too much. I am currently 20 weeks pregnant. Last week I went to my doctor again, and told him that I didn't use the cream because of the warning. He got angry about the fact that I even tried to cross verify his prescription. But I am really worried about my baby, and his anger doesn't help. I am not trying to find fault with doctors, but counseling is better than outright anger. Currently, he has prescribed Candid-B cream to be applied at night. Because of my experience with Zimig, I am a bit afraid to use this cream too. Can you please advise me about what to do? The itching has intensified and I keep scratching myself even in public, since it is unbearable.

A:Itching in the arm pits can occur in many different conditions. This includes fungal infections, contact dermatitis, seborrhoeic dermatitis, etc. If the fungal problem recurs frequently then the predisposing cause(s) must be looked into and managed accordingly. Otherwise, it is likely you have got something else and hence can be managed by an alternative medicine. Even if you have fungal infection, you can still take an alternative anti-fungal medicine (which have been used extensively during pregnancy without any problems) without any apprehension.

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