Genital Skin 2/2: Itching, Color and Other Problems

We’ve had several questions about this. Please also see the post before last which covered different problems on genital skin.

It takes some courage to bring up concerns in the genital area so thank you.  Genital skin is different because it’s thinner, has more oil and sweat glands, can be prone to irritation, and it’s very stretchy. This makes sense if we think about how it functions and the fact that it expands and contracts a lot with arousal, sex, pregnancy, even just regular monthly hormone changes.

Symptoms you may experience:

  • Itching.  Causes of genital itching are diverse and can range from a yeast infection, to a sexually transmitted infection, to allergy, to detergent or dryer sheets; or even to a more complicated autoimmune problem.  One problem that often gets overlooked and misdiagnosed in women is something call LS&A (Lichen Sclerosus et Atrophicus).  Who invented these Latin names – sheesh!  It usually starts as itching and color changes on the labial skin. Often misdiagnosed as chronic yeast and other things, it’s very uncomfortable and can be painful with sex, contact with clothing and even washing.  This problem is usually easily treatable with a prescription cream. Please see a good dermatologist.
  • Irritation and soreness.  LS&A may be the cause but there are many causes; too much friction from prolonged sex, for example. Or some are allergic to ingredients in personal lubricants.  Propylene glycol for example, is a fairly common allergen. Please see the list above, and make sure you see a doctor if symptoms persist longer than a week or so. If it’s just a friction issue, then allow the skin rest for several days or a week will usually solve it.
  • Swelling.  Again, can be any of the above. Please see your doctor. If it persists it could be caused by blocked lymphatic channels due to a mass or tumor in the lower abdomen. In men, a sudden swelling of a testicle is a medical emergency since it could indicate “torsion” of the testicle due to a twisted and blocked blood supply to the testicle.
  • Cancer. While it’s fairly rare on genital skin, it does occur. Some of these tumors are caused by old or silent HPV (human papilloma virus) infection. HPV is the wart virus, so if you have a history of genital warts please let your primary care and gynecologist know so you can be monitored appropriately.

If you have persistent problems after seeing a doctor, please don’t give up and go see a good dermatologist. We even have a female dermatologist in the Seattle area who specializes in problems of the vulva (Dr. Paula Zook).  Many larger cities also have someone with a special interest in this area.

I hope this helps,

Dr. Brandith

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