What causes yeast infection rashes on the inner thigh. How can you identify the symptoms of intertrigo. What are the most effective treatments for skin fold infections. How to prevent recurrent yeast overgrowth in moist areas.

Understanding Intertrigo: The Culprit Behind Inner Thigh Rashes

Intertrigo is a common skin condition that occurs when folds of skin rub against each other, creating an environment ripe for irritation and infection. This friction-induced inflammation often manifests as a red, raw-looking rash in areas where skin meets skin, such as the inner thighs, armpits, under the breasts, or in abdominal folds. While intertrigo itself is not an infection, the warm, moist conditions it creates can lead to secondary yeast or bacterial overgrowth.

Who is most susceptible to developing intertrigo? The condition can affect individuals of all ages, but certain groups are at higher risk:

• Infants (commonly known as diaper rash)
• Older adults
• People with limited mobility
• Individuals with obesity
• Those with diabetes or weakened immune systems

Environmental factors also play a role, with intertrigo being more prevalent in hot, humid climates and during summer months. The combination of heat, moisture, and skin-on-skin contact creates the perfect storm for this uncomfortable condition.

Identifying the Telltale Signs of Intertrigo

How can you recognize intertrigo? The primary symptom is a distinctive rash that appears in skin folds. Here are the key characteristics to look out for:

• Redness and inflammation in affected areas
• Raw or macerated skin appearance
• Itching or burning sensation
• Possible oozing or weeping of the skin
• Unpleasant odor (in cases of secondary infection)

Intertrigo can develop in various locations where skin folds are present. The most commonly affected areas include:

1. Inner thighs
2. Under the breasts
3. Abdominal folds
4. Groin area
5. Between the buttocks
6. Finger and toe webs

It’s important to note that intertrigo may occur in one or multiple sites simultaneously. If you notice persistent redness, itching, or discomfort in any of these areas, it’s wise to consult a healthcare professional for proper diagnosis and treatment.

The Role of Yeast and Bacteria in Skin Fold Infections

While intertrigo begins as a friction-induced irritation, the moist, warm environment created by skin folds provides an ideal breeding ground for microorganisms. This can lead to secondary infections that exacerbate the condition. The two most common culprits are:

Candida Yeast Infections

Candida albicans, a type of yeast naturally present on the skin, can overgrow in the damp conditions caused by intertrigo. This overgrowth leads to a fungal infection characterized by intense itching, redness, and sometimes a white, cottage cheese-like discharge.

Bacterial Infections

Various bacteria, including Staphylococcus and Streptococcus species, can also thrive in the affected skin folds. Bacterial infections may cause increased redness, swelling, and a foul odor.

Is it possible for both yeast and bacteria to coexist in an intertrigo infection? Absolutely. In many cases, a mixed infection can occur, complicating both diagnosis and treatment. This is why it’s crucial to seek medical advice for persistent or severe cases of intertrigo.

Diagnostic Approaches for Intertrigo and Associated Infections

Accurate diagnosis is key to effective treatment of intertrigo and any secondary infections. How do healthcare professionals determine the underlying cause of an inner thigh rash or other skin fold irritation?

• Visual Examination: A dermatologist or primary care physician will inspect the affected area, looking for characteristic signs of intertrigo and potential infections.
• Patient History: The doctor will ask questions about symptoms, duration, and any factors that may exacerbate the condition.
• Skin Swab: If a yeast or bacterial infection is suspected, the healthcare provider may take a swab of the affected area for laboratory analysis.
• KOH Preparation: This simple test can quickly detect the presence of fungal elements in skin scrapings.
• Culture: In some cases, a culture may be necessary to identify specific bacterial or fungal strains and determine appropriate treatment.

Why is proper diagnosis so important? Different underlying causes require different treatment approaches. For example, a purely friction-related intertrigo may respond well to barrier creams and drying agents, while a Candida infection will necessitate antifungal medications.

Effective Treatment Strategies for Intertrigo and Yeast Infections

Once diagnosed, intertrigo and associated infections can often be managed effectively with a combination of home care and medical interventions. What are some of the most recommended treatment approaches?

Home Care and Over-the-Counter Options

• Keep the affected area clean and dry
• Use absorbent powders to reduce moisture
• Apply barrier creams to protect the skin from friction
• Wear loose-fitting, breathable clothing
• Use antifungal powders or creams for mild yeast infections

Prescription Treatments

For more severe or persistent cases, a healthcare provider may recommend:

• Topical antifungal medications (e.g., clotrimazole, miconazole)
• Topical antibiotics for bacterial infections
• Low-potency corticosteroids to reduce inflammation
• Oral antifungal or antibiotic medications for widespread or stubborn infections

A common treatment regimen recommended by dermatologists includes:

1. Cleansing the area with ketoconazole 1% shampoo, leaving it on for 2-5 minutes before rinsing.
2. Thoroughly drying the skin, potentially using a hairdryer on a low setting.
3. Applying a mixture of equal parts clotrimazole 1% cream and hydrocortisone 1% cream twice daily for 3-8 weeks or until the rash clears.

How long does it typically take for intertrigo to resolve with proper treatment? While mild cases may improve within a week, more severe or complicated infections can take several weeks to heal completely. Patience and consistency in following the treatment plan are key to success.

Preventing Recurrent Intertrigo and Yeast Overgrowth

Prevention is often the best medicine when it comes to intertrigo and associated infections. What strategies can individuals employ to reduce their risk of developing these uncomfortable skin conditions?

• Maintain good hygiene: Wash affected areas daily with a gentle, antibacterial soap.
• Keep skin folds dry: Use absorbent materials or antiperspirants to reduce moisture.
• Wear appropriate clothing: Choose loose-fitting, breathable fabrics that don’t trap heat and moisture.
• Manage underlying conditions: For those with obesity or diabetes, working with healthcare providers to manage these conditions can reduce intertrigo risk.
• Use preventive treatments: Applying antifungal powders or creams in prone areas can help prevent yeast overgrowth.

For individuals prone to recurrent intertrigo, healthcare providers may recommend a maintenance regimen, such as using ketoconazole shampoo as a body wash once weekly and thoroughly drying skin folds after bathing.

When to Seek Professional Medical Advice

While many cases of intertrigo can be managed at home, certain situations warrant professional medical attention. When should you consult a healthcare provider for an inner thigh rash or other skin fold irritation?

• The rash persists despite over-the-counter treatments
• You experience severe pain, swelling, or fever
• The rash spreads to new areas or becomes widespread
• You have a weakened immune system or diabetes
• There are signs of a severe infection, such as pus or red streaks

A dermatologist or primary care physician can provide a thorough evaluation, accurate diagnosis, and tailored treatment plan for stubborn or complicated cases of intertrigo. They can also offer guidance on long-term management strategies to prevent future occurrences.

Understanding Related Skin Conditions

While intertrigo is a common cause of skin fold rashes, several other conditions can present similarly. How do these related skin issues differ from intertrigo, and what should individuals be aware of?

Inverse Psoriasis

Also known as intertriginous psoriasis, this condition causes smooth, red patches in skin folds. Unlike typical psoriasis, inverse psoriasis lacks the characteristic scaling and often appears shiny. It commonly affects the armpits, groin, and under the breasts.

Hailey-Hailey Disease

This rare genetic disorder causes skin cells to adhere improperly, leading to blisters and erosions in skin folds. It typically affects the neck, armpits, and groin areas. Hailey-Hailey disease is chronic and can be challenging to manage.

Pemphigus

Pemphigus is an autoimmune condition that causes blistering of the skin and mucous membranes. While it can affect any area of the body, it often begins in the mouth and may spread to skin folds.

Bullous Pemphigoid

Another autoimmune disorder, bullous pemphigoid causes large, fluid-filled blisters on the skin. It can affect flexural areas and may be mistaken for intertrigo in its early stages.

Why is it important to distinguish between these conditions and intertrigo? Each requires a different treatment approach, and misdiagnosis can lead to ineffective management and prolonged discomfort. If you’re uncertain about a persistent skin rash, especially in skin folds, consulting a dermatologist can ensure proper diagnosis and treatment.

By understanding the causes, symptoms, and treatment options for intertrigo and related conditions, individuals can take proactive steps to maintain skin health and comfort. Remember, while many cases of intertrigo can be managed at home, persistent or severe symptoms should always be evaluated by a healthcare professional to ensure appropriate care and prevent complications.

Causes, symptoms, pictures, and treatment

Intertrigo is a skin condition that causes a rash in skin folds, such as under the breasts, in the groin, or in stomach folds. The rash may be sore or itchy.

It happens when areas of moist skin rub together. Bacteria and yeast can grow in this environment, leading to an infection.

In this article, we describe what intertrigo is, what it looks like, and what causes it. We also cover diagnosis, treatment, and prevention.

Intertrigo is a skin condition that happens when folds of skin chafe against each other.

It usually develops in the inner thighs or armpits, or under the breasts or tummy fold.

Some people may experience yeast or bacterial infections in the folds of skin.

Areas of moist skin rubbing together cause intertrigo. The warm, damp environment makes the skin conducive to irritation and the growth of yeast and bacteria, which can lead to an infection.

While it can happen at any age, intertrigo tends to affect infants, older people, and those with a reduced ability to move around. In babies, it is often called diaper rash. Most cases occur in hot or humid environments and during the summer.

Intertrigo is also more common in adults with incontinence, obesity, diabetes, or a weakened immune system.

Specific health conditions that can contribute to the development of intertrigo include:

Inverse psoriasis

Also known as intertriginous psoriasis, this form of psoriasis develops in the folds of the skin. It can look red and shiny.

Hailey-Hailey disease

Hailey-Hailey disease is a rare genetic disorder that causes skin cells to stick together and breaks down the layers of the skin.

People with Hailey-Hailey disease usually experience blisters and irritations on the neck, armpits, and genitals and in the folds of the skin.

Pemphigus

There are different types of pemphigus, but they all happen when the body’s immune system attacks the healthy cells in the top layer of the skin.

It typically causes blisters in the mouth, nose, throat, eyes, or genitals.

Bullous pemphigoid

A fault in the immune system causes bullous pemphigoid. People with the condition can develop mild, itchy welts or more severe blisters on the skin. These tend to appear on areas of the skin that flex or move.

Intertrigo looks like a red, raw rash on the skin. It may feel sore or itchy, and it can sometimes ooze.

It can develop in any fold of the skin. The most commonly affected areas of the body include:

• the inner thighs
• under the breasts
• in the fold of skin underneath a protruding belly
• the groin
• between the buttocks
• in the webs of the fingers
• in the webs of the toes

Intertrigo may develop in one or more of these places.

It will often be a specialist skin doctor, or dermatologist, who diagnoses intertrigo. They will do this by inspecting the skin and asking a series of questions about the person’s symptoms.

If the dermatologist suspects that a yeast or bacterial infection has developed in the skin fold, they may take a swab and send it to a laboratory for analysis.

An article in the Journal of the Dermatology Nurses’ Association offers the following advice on treating intertrigo:

• Wash the affected area with ketoconazole 1% shampoo, which is available from most drugstores. People should leave it on for 2–5 minutes and then rinse it off.
• Use a hairdryer on a low setting to ensure that the area is completely dry.
• Mix equal amounts of clotrimazole 1% cream (or miconazole 1% cream) and hydrocortisone 1% cream and apply a thin layer to the affected area. People should do this twice a day until the rash is clear, which may take 3–8 weeks.
• Once the rash has cleared, continue to use the ketoconazole 1% shampoo as soap in the affected area at least once a week.
• Dry the skin with a hairdryer after every bath or shower, or whenever it feels particularly damp.

The best way to prevent intertrigo is to keep the area dry. People who experience the condition due to obesity can speak to a doctor about ways to lose weight and reduce the risk of skin complications.

The American Osteopathic College of Dermatology suggest that people prevent intertrigo by:

• placing a wad of absorbent material, such as cotton, in the affected fold to absorb sweat
• using antiperspirants
• washing daily with an antibacterial soap
• dusting the affected area with an absorbent antifungal powder once it is clean and dry

Anyone who finds that the problem keeps coming back should speak to a doctor.

Intertrigo is a skin condition that happens when areas of moist skin rub against each other. It causes a red, raw-looking rash and can lead to yeast and bacterial infections.

It can happen to anyone, but it is most common in babies, older people, individuals with mobility problems, and those with obesity.

People can easily treat the rash at home with over-the-counter creams and lotions. They can also prevent it from coming back by keeping the area clean and dry.

Anyone who experiences multiple incidences of intertrigo should speak to a doctor.

6 Types of Groin Rashes in Women

Last Updated: Jan 10, 2023

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Dr. Meenu GoyalGynaecologist • 19 Years Exp.DGO, MBBS

Skin rashes are a regular problem in both men and women. These can be caused by a variety of factors, both internal and external to the body. However, rashes on the genitals area in females and the groin area can be very problematic, painful and embarrassing. Some could be caused due to problems within the body while some could be contracted externally such as groin rashes caused by STDs (sexually transmitted diseases). Here we try to find out different rash treatment for inner thigh in female.

Women tend to be affected by rashes as the genital area along with the innerwear tends to be a fertile breeding ground for microorganisms. Infections can also grow uninhibited if medications or appropriate precautions aren’t taken. Some of the common types of groin rashes in women in females along with their causes are mentioned below.

1. Chaffing or intertrigo: This is one of the most common forms of Groin rashes, which are both painful and can be unsightly as well; these look like inflamed spots. This is primarily caused by the rubbing of the inner thighs against each other.
2. Jock itch: Although more commonly associated with men, Jock itch can affect women as well. Medically known as ‘tinea cruris’, jock itch occurs when the moisture from your sweat gets trapped within the folds or creases of skin in the groin area thus, encouraging fungi (dermatophyte fungi) to grow there. It is more common among obese people or if you happen to wear tight clothing during exercise. The rash will look like raised papules, which are red in color and quite itchy.
3. Fungi & Yeast Infections Yeast infections caused by fungi candida usually occur when the pH (the alkaline to acidity) balance of the vagina is disrupted. This will not only result in vaginal discharge, itching pain, and discomfort but will also result in rashes around the vagina along with swelling.
4. Contact Groin Rashes:Dermatitis may be transferred either through the skin to skin contact or by using shared utensils and clothing items such as towels. Contact dermatitis or skin infections look like red rashes and can happen anywhere within the body, including the genitals and groin.
5. Friction rashes: Some rashes occur as a result of adverse reactions to items of clothing rubbing against the skin such as jeans or using razors or the use of nylon thongs. These rashes occur due to the body reacting to these and look more like inflammation of the skin.
6. Groin Rashes caused by STIs and STDs: Certain groin rashes may develop on a woman’s groin as a manifestation of sexually transmitted diseases and infections. Some examples of these are Chlamydia, gonorrhea or syphilis and herpes; just to mention a few. These are usually accompanied by mild to severe pain and can only be cured after a proper consultation with the doctor.

Get to the doctor: Heat rashes, intertrigo and friction rashes usually go away by themselves. Treatment for groin rash on the inner thigh in females such as vaginal yeast infections may require topical creams while other forms of bacterial infections can be treated by creams or oral antibiotics after proper consultation with a physician. If the pain is unusual and the rashes tend to persist along with other symptoms, you should immediately visit your doctor for further analysis and treatment. If you wish to discuss any specific problem, you can consult a gynaecologist.

In case you have a concern or query regarding gynaecological issues, you can consult a gynaecologist online & get the answers to your questions through .

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Genital herpes – symptoms, diagnosis, treatment methods.

Primary infection is when the virus enters the body for the first time and the person has not yet developed antibodies to it. This can manifest itself both with the first rash on the body, and asymptomatically, which happens most often. External manifestations of primary infection with the virus last up to 14-22 days with an increase in symptoms in the first week. The disease can proceed for quite a long time, not only the genitals can be affected, and be accompanied by general and local / local symptoms. Common symptoms include fever, headache, malaise, and myalgia. Local phenomena include pain, painful urination, itching, discharge (from the vagina or urethra). Symptoms may gradually disappear up to 2-3 weeks. Sometimes there may be a more complex course of HSV that require hospitalization (severe aseptic meningitis, disseminated infection, etc.). In such cases, the course of the disease can be delayed up to 1.5 months.

Non-primary infection with occurs in people who have already been exposed to the virus and who have antibodies to it. In these patients, the disease, as a rule, proceeds with less severe symptoms: the duration of which is about 15 days. Sometimes, the virus can be asymptomatic, and the course of the disease lasts 7-8 days.

Recurrent infection is detected in those patients who have both symptoms of genital herpes and antibodies to the reactivated type of virus. The course of relapse can also be asymptomatic, and therefore, HSV can be diagnosed by performing specific research methods. The severity and duration of the course of the disease during relapse is even less than with the above forms of genital infection, and is only 2-3 days. Relapse in type 2 HSV occurs more frequently than in type 1 HSV. The frequency and nature of the appearances in patients can be quite different and affect the well-being.

Causes causing activation and/or recurrence of HSV:

• immunosuppression;
• hypothermia or vice versa overheating of the body.
• stress and some physiological conditions of the body.;
• medical manipulations / surgical interventions.
• intercurrent diseases (acute disease, joined to existing chronic ones, for example: secondary infection).

The first manifestation of herpesvirus infection, as a rule, manifests itself more rapidly than subsequent relapses. In some patients, they are short-lived. Most infected people do not have symptoms of genital herpes.

HSV affects the skin and mucous membranes (most often on the face and genitals), the central nervous system, causing meningitis, encephalitis, eyes (conjunctivitis, keratitis). Also, HSV can provoke a pathological course during pregnancy and childbirth, and cause miscarriage, miscarriage, developmental anomalies and / or fetal death, generalized damage by the pathogen of the virus in all organs and systems of the newborn. There has been an association between cervical cancer in women and prostate cancer in men. HSV, like some other herpesviruses, it is capable of a latent course of the process, which subsequently reactivates and can cause constant exacerbations of the disease and asymptomatic isolation of the virus.

Ways of transmission of HSV

Airborne. Contact household. Through non-sterile instruments, personal hygiene products (razors, etc.). Sexually. Vertical transmission of the virus (from mother to fetus). The disease is transmitted mainly through sexual contact, regardless of the form of intimacy (genital, oral, anal) from a patient with genital herpes or a carrier of the virus. Infection can occur when the partner who is the source of the infection has a recurrence of the disease or, most importantly, when he sheds the virus without having clinical symptoms. Sometimes, HSV can infect individuals who do not have active manifestations of the virus at the time of sexual intercourse or even episodes of virus activation, and therefore do not even know that they are infected. It is not excluded the possibility of infection through household through personal hygiene products. HSV is introduced into the body through the skin mucous membranes, after which it is captured using viral receptors by sensory nerve endings. Herpes has a devastating effect on the patient’s immune system and, therefore, becomes the cause of secondary immunodeficiency. Relapses of HSV disrupt the patient’s full-fledged sexual life, and are often the cause of neuropsychiatric and psychological disorders. Manifestations on the mucous membrane and skin are the most common manifestation of the disease, and infection with genital herpes is one of the most common sexually transmitted diseases.

The risk of infection of the baby during pregnancy and childbirth depends on many factors, and can reach a 75% probability. Intrauterine infection caused by HSV-2 is less common. In the vast majority of cases, infection of the newborn occurs during childbirth when the baby passes through the birth canal of the mother. Moreover, the transmission of infection is possible both in the presence of lesions in the cervix and vulva, and with asymptomatic isolation of the virus. When the virus is isolated during pregnancy, it can cause fetal death, causing missed / non-developing pregnancies and provoke miscarriages, both in the early and late stages of gestation. HSV takes the 2nd place after the rubella virus in terms of fetal abnormalities. Possible, infection of the newborn and after childbirth, with active manifestation in the woman in labor and honey. personnel, but this happens very rarely.

Symptoms

Typical localization in women: on the large and small labia, on the vulva, clitoris, in the vagina, and on the cervix, and also often on the perianal region, and buttocks. In men, these are the glans penis, foreskin, and urethra.

There are several forms of recurrent genital herpes:

1. Manifest form of recurrent herpes is characterized by the presence of herpetic elements in the lesion. Typical manifestations of the disease are vesicles, erosion, sores, exudation, recurrent nature of the disease. Some patients with genital herpes complain of general malaise throughout the body, headaches, fever to subfebrile values, some have disturbed sleep, and also anxiety and irritability appear. As a rule, at the stage of development of the disease, patients note a burning sensation, itching, “irritation and” tickling “, pain in the genital area. The affected area becomes somewhat edematous, reddens, and then, single or multiple small vesicles up to 2-3 mm appear. The contents of these vesicles are initially transparent, then cloudy, and become purulent. Within a few days, the blisters empty, dry up, crusts form, which gradually fall off, and spots remain in place of these rashes for several days, and subsequently disappear completely.
2. Atypical form occurs in the form of swelling and itching. The affected area is represented by deep recurrent cracks in the skin, genital mucosa and underlying soft tissues, which heal in 4-5 days.
3. Abortive herpes is most common in patients who have already received antiviral drugs and vaccine therapy. Herpetic lesions in this form of herpes bypass the stages due to the manifest form, and may appear as itchy spots or papules that resolve on their own within 1-3 days. Abortive forms of herpes include: erythematous, papular, and prurigoneurotic, in which there are no vesicular elements. Diagnosis of varieties of genital herpes, occurring in an erased abortive form, sometimes causes great difficulties. The disease is usually recognized when the typical recurrences of herpes alternate with rashes or occur simultaneously with them.
4. Subclinical form of genital herpes is mainly detected when examining individuals with STDs (sexually transmitted diseases), or in married couples with impaired reproductive functions. This form is characterized by “microsymptoms” (short-term appearance of mild, superficial cracks, accompanied by slight itching), or the complete absence of any external manifestations.

Patients with genital herpes are conditionally divided into three stages depending on the location and severity:

• Stage 1 – damage to the external genital organs.
• Stage 2 – herpetic colpitis, cervicitis, urethritis.
• Stage 3 – herpetic endometritis (virus infection of the uterine mucosa), salpingitis (fallopian tubes) or cystitis (inflammation of the bladder).

Herpetic vesicles form characteristic polycyclic scalloped figures. Subsequently, superficial, covered with a grayish coating of sores are formed according to the number of former bubbles or continuous erosion with a smooth bottom and not undermined edges, surrounded by a bright red rim. The sores are not deep and do not bleed. Herpetic ulcers are sometimes very painful. Sores and erosions heal without leaving scars. Herpetic eruptions on the labia minora and vulva in women, in some cases, cause significant swelling of the labia. With herpetic cervicitis, the cervix is ​​edematous, often has erosion. Relapses occur either spontaneously, or after sexual intercourse, or before and after menstruation. Often the appearance of genital herpes is provoked by other infections. Herpetic recurrent infection can be localized not only in the area of ​​the external genitalia, but also affect the mucous membrane of the vagina, cervix and ascending through the mucous membrane of the uterine cavity, fallopian tubes, mucosa of the urethra and bladder, and cause a specific lesion in them.

The clinical picture of the herpes virus in men appear most often in the form of small vesicles, and the formation of superficial ulcers on the glans penis, foreskin, groove area. The course of the disease is characterized by recurrent episodes. Complaints with herpetic urethritis in men begin with the appearance of pain, with irradiation to the scrotum, penis, urethra, legs, buttocks, perineum, burning sensation in the urethra. Patients also note these complaints during urination, the appearance of light or yellowish discharge from the urethra, redness and swelling in the area of ​​​​the opening of the urethra. At the stage of erosion healing, erythematous or pigmented spots are visualized in this place. The chronic course of recurrent balanoposthitis is detected in most patients with herpes.

Infection of the genitals caused by HSV in some patients provokes psychological and even psychosexual disorders, in the form of embarrassment, fear of sexual intercourse, depression, loss of self-confidence, mental trauma, anger, decreased self-esteem, loss of self-esteem, increased anxiety, negative emotions, hostility and even aggressiveness towards the source of infection. Many, out of fear of rejection, hide the information that they have genital herpes. Women perceive and endure this news more emotionally, due to the psychological characteristics of the weaker sex. Moreover, in those patients who first encountered genital herpes, there are deeper psychological problems than with other sexually transmitted diseases. Frequent exacerbations, and pronounced manifestations of the disease can affect his behavior and even change the character of the patient.

Diseases of the vulva

Diseases and affections of the vulva are varied. These include dematoses: atopic dermatitis, atrophic changes against the background of a hypoestrogenic state, neurodermatitis, allergic contact dermatitis, intertrigo (mechanical dermatosis), psoriasis, lichen sclerosus, lichen planus and others; vulvar cysts, vestibular papillomatosis, benign tumors of the vulva, systemic diseases, vulvar infections and others. All of these diseases are accompanied by hyperemia (redness) and itching, burning, but it is possible to make a correct diagnosis only when examined by a doctor and sometimes using an additional method – vulvoscopy.

The lesions and diseases of the vulva are varied. These include dematoses: atopic dermatitis, atrophic changes against the background of a hypoestrogenic state, neurodermatitis, allergic contact dermatitis, intertrigo (mechanical dermatosis), psoriasis, lichen sclerosus, lichen planus and others; vulvar cysts, vestibular papillomatosis, benign tumors of the vulva, systemic diseases, vulvar infections and others. All of these diseases are accompanied by hyperemia (redness) and itching, burning, but it is possible to make a correct diagnosis only when examined by a doctor and sometimes using an additional method – vulvoscopy.

Treatment and examination of dermatosis includes a consultation of two specialists – a gynecologist and a dermatologist.

Consider each disease separately.

• Vulvar atopic dermatitis
• Neurodermatitis of the vulva
• Atrophic changes due to hypoestrogenic state
• Contact dermatitis of the vulva
• Allergic contact dermatitis of the vulva
• Intertriginous dermatitis of the vulva
• Vulvar psoriasis
• Vulvar lichen sclerosus
• Lichen planus of the vulva
• Vulvar cysts
• Vestibular papillomatosis
• Benign tumors of the vulva
• Systemic diseases
• Infections of the vulva

Atopic dermatitis of the vulva

is the most common type of dermatitis. Approximately 20% of the population is affected. It usually occurs in young girls who have a history of some kind of atopic disorder (bronchial asthma, allergic reactions, hay fever, urticaria) heredity or suffer from it. Atopic dermatitis is prone to recurrence and is accompanied by severe itching. The disease became clear recently, when a hereditary defect in keratinization was found in those suffering from it, which increases the permeability of the epidermis and leads to its dryness. Allergens, irritating substances and pathogenic microorganisms easily penetrate into small cracks in the parched epidermis. Soap or hygiene products, increasing the damage to the barrier function of the epidermis, contribute to the penetration of other irritating substances and allergens into its defects. Atopic dermatitis occurs as a result of a complex interaction of irritating and allergenic chemicals or drugs against the background of a hereditary immunodeficiency state, in some cases against the background of a hereditary defect in the barrier function of the epidermis, skin infections, fungal, bacterial, protozoal or viral, lead to exacerbations of atopic dermatitis due to direct action and additional allergization. Staphylococcus aureus most often causes and maintains exacerbations of atopic dermatitis.
The main symptoms of atopic dermatitis – “itching – scratching – itching” and weeping (moisture), lead to a sharp thickening of the skin with pigmentation disorders and the appearance of a rash. Scratching becomes the entrance gate of a secondary infection. Often the cause of the exacerbation is alkaline soap and personal care products, fragrances and even wet sanitary napkins. Skin changes depend on the age of the process. Most often, the labia majora are affected, less often the small or inner thighs and the intergluteal fold.

In treatment, first of all, it is necessary to eliminate the causes and triggers of dermatitis.

Vulvar neurodermatitis

is a disease that is a transition from atopic dermatitis, which leads to a vicious circle of “itching – scratching – itching”. Synonyms of neurodermatitis of the vulva – “simple chronic lichen”, “hyperplastic dystrophy”, “scaly hyperplasia”. Skin changes occur the same as in atopic dermatitis, but mental overstrain is an important trigger. The most characteristic symptom of neurodermatitis of the vulva is persistent itching, often for many years, aggravated by warmth, during menstruation and under the influence of stress factors. Combing is habitual, almost obsessive. The skin of the vulva thickens, becomes more or less pigmented, the process constantly extends to the inguinal folds and thigh. Treatment is multifaceted and complex. There are frequent relapses.

Atrophic changes due to hypoestrogenic state

Accompanied by a drop in the level of the hormone estrogen in the blood, due to the onset of natural menopause and other conditions: removal of the ovaries, resection of the ovaries, ovarian dysfunction, the use of antiestrogens, selective suppression of estrogen receptors.

Prior to menarche (beginning of the menstrual cycle, puberty) and during breastfeeding, estrogen levels are relatively low. This leads to thinning and dryness of the epithelium of the vulva and vagina, with a weakening of its barrier function, predisposing to irritation and infection.

Atrophic vulvovaginitis, as this disease is called, is accompanied by symptoms such as burning and itching, soreness of the vulva, difficulty in urination associated with increased frequency and pain, pain during intercourse. The epithelium of the vulva and vagina becomes thinner and becomes pale. Sometimes there is a narrowing of the entrance to the vagina, cracks and hemorrhages. In severe cases, profuse discharge with an unpleasant odor appears.

Treatment includes hormonal therapy and, in case of secondary infection, antibacterial therapy.

Vulvar contact dermatitis

is an inflammation of the skin caused by an exogenous irritant. It is important to distinguish simple contact dermatitis from allergic dermatitis. Both of them can have an acute, subacute and chronic course. Vulvar contact dermatitis occurs as a result of permanent direct chemical or physical damage to the skin that is not associated with immune mechanisms. Its causes are manifold, for example, the effect of urine, feces. It predisposes to low estrogen levels, concomitant skin diseases, infection, trauma – everything that weakens the barrier function of the epithelium and makes the skin more sensitive to damaging effects. However, repeated contact with chemicals leads to the development of true allergic contact dermatitis.
Contact dermatitis of the vulva is a very common disease. Worried about increased sensitivity of the skin, itching and burning of the vulva. Patients often resort to self-treatment with antifungal drugs, antipruritic or anesthetic ointments, applying them to already inflamed skin, and the medical workers to whom these patients turn are already at a loss to establish the cause of contact dermatitis. Therefore, you should consult a doctor at the first worries that appear, so that the doctor can identify the cause and prescribe the correct treatment. So, the most common causes of simple contact dermatitis of the vulva: soap and its substitutes, urinary and fecal incontinence, sweating, vaginal discharge, irritation with pads and underwear.

Treatment is staged, with the exclusion of the cause of the disease.

Allergic contact dermatitis of the vulva

It is a severe allergic reaction to small amounts of a chemical.
Allergic contact dermatitis of the vulva usually begins acutely, unlike simple contact dermatitis. Itching and burning come on suddenly. Sometimes the patient herself indicates the cause. Itching may be combined with burning. The reason may be some irritant factor: highly alkaline or highly scented soaps and its substitutes, highly scented pads and other allergens, the list of possible allergens is very long. Often, by the time of treatment, the disease takes a subacute or chronic phase of the course. A severe acute inflammatory reaction is accompanied by hyperemia (redness), the formation of vesicles (vesicles), and even blisters, weeping (moisture), scratching with bloody or yellow crusts, sometimes a secondary infection joins.

Treatment is based on various methods, but first of all, the elimination of the main allergen, otherwise it is unsuccessful.

Intertriginous dermatitis of the vulva

– this is an inflammation of the skin in the folds caused by friction, exposure to heat, sweating, accumulation of moisture under clothing. The disease is especially common in women with deep skin folds.
Its main reason is the friction of the contacting surfaces of the skin and their maceration then in the heat. Inflamed weeping surfaces are easily infected with bacteria and fungi of the genus Candida (popularly called “thrush”). Hydration, tight-fitting clothes made of synthetic fibers, urinary and fecal incontinence predispose to the disease. Patients with obesity and diabetes mellitus, in particular the elderly, in whom obesity is combined with immobility and incontinence of feces and urine, especially often suffer from intertriginous dermatitis of the vulva.
Such dermatitis is characterized in the femoral-genital and inguinal folds, and the overhanging fold in the lower abdomen, and on the skin under the mammary glands, increased skin sensitivity, burning, and an unpleasant odor expressed to one degree or another. The skin in all these folds is subjected to constant friction. This type of dermatitis should not be confused with psoriasis, lichen sclerosus, benign familial pemphigus.

The treatment is complex, with the addition of a secondary infection, antibiotic therapy is also indicated.

Vulvar psoriasis

– chronic hereditary dermatosis, which is characterized by reddish papules and plaques, covered with densely attached silvery-white scales. Psoriasis affects 2% of the population. The defeat of the vulva with it is often observed, but in many cases it remains unrecognized, since patients and doctors do not notice it. Turning to dermatologists, patients do not present relevant complaints.
The provocateur of psoriasis of the vulva are minor injuries (rubbing, scratching), infections (bacterial or fungal), chemical irritants (cosmetics), some medications. Mental overstrain weakens the barrier function of the epidermis (skin). Rashes of psoriasis at the site of scratching due to itching that accompanies depression and anxiety. Promotes the manifestation of psoriasis and fluctuations in hormone levels. Most often, vulvar psoriasis occurs during puberty and menopause. It provokes the development of alcohol consumption and smoking. Rashes of psoriasis of the vulva are mainly promoted by traumatization of the skin. The main concern in psoriasis is itching of varying intensity. It leads to scratching, which in turn leads to burning and pain.

Treatment of vulvar psoriasis is complex and consists of local and systemic therapy.

Vulvar lichen sclerosus

One of the chronic inflammatory dermatoses most commonly affecting the vulva.
It is characterized, including on the vulva, by thinning and depigmentation of the skin and scarring, anxiety by itching, burning, less often pain. Lichen sclerosus leads to deformation of the vulva and its functional impairment. The prevalence of this disease is unknown, since the disease is not always accompanied by complaints, as a result of which some patients do not go to doctors. Lichen sclerosus occurs at any age, from 6 months to old age, but mostly between 40 and 70 years. Causes and development are due to many factors: hereditary, related to cellular immunity (T and B-lymphocytes) and autoimmune, hormonal, infectious, local. It has been associated with certain HLA class II antigens, antibodies to certain tissue antigens, and autoimmune disorders. The role of hormonal factors is confirmed by the fact that the disease often begins against the background of estrogen deficiency – in childhood or postmenopause. Disorders of androgen metabolism are suspected but not proven. However, the etiological role of hormones has not yet been proven. The development of lichen sclerosus is also associated with pathogenic microorganisms, especially the spirochete Borrelia burgdorferi, but apparently it is not the true causative agent of the disease. The role of other microorganisms has not been confirmed. However, there is no doubt about the importance of local influences, from scratching to radiation exposure, as triggering factors. The clinical picture is varied. Typical complaints of itching or its combination with sore pain, hypersensitivity of the skin, difficulty urinating associated with increased frequency and pain, pain during intercourse.
In 20% of cases, foci of lichen sclerosus are found on other areas of the skin, usually on the neck, in the armpits, and on the mammary glands. The vaginal mucosa is not affected. Occasionally, lesions of the oral mucosa are observed.

Treatment includes topical and general therapies.

Lichen planus of the vulva

Relatively common dermatosis and mucositis (inflammation of the oral cavity) mediated by cellular immune mechanisms. The skin and oral mucosa are usually affected, in 25% of cases only the mucous membranes. Damage to the oral mucosa in women in 57% of cases is accompanied by damage to the vulva and vagina. The true prevalence is unknown, as it often goes undiagnosed. Even in patients with lesions of the oral mucosa and skin, the genitals are not always examined. Synonyms: erosive lichen planus, desquamative inflammatory vaginitis, vulvovaginal gingival syndrome.

The causes of lichen planus are unknown, but much evidence clearly points to its autoimmune nature, mediated by cellular immune mechanisms. According to the latest data, there may be a link between the DQB1 * 0201 antigen of the HLA system and lichen planus of the vulva, vagina and gums. Widespread damage to the basement membrane zone of the epidermis is found, apparently of an autoimmune nature.

Clinical variants:

• Classic – pruritic polygonal papules and plaques on the wrists and ankles, on the pubis and labia, but are not accompanied by atrophy and scarring;
• Vulvovaginal-gingival syndrome is an erosive lesion of the mucous membranes of the mouth, vulva, conjunctiva and esophagus with atrophy and scarring.

Damage can be on the scalp, and on the nails, eyes, mucous membranes of the mouth, nose, esophagus, larynx, bladder, anus. In most cases, the disease develops at the age of 30-60 years and is accompanied by various complaints. The most common of them: soreness when touched and pain and itching individually and in combination. However, complaints, even with characteristic changes, are not always. Sometimes itching may join, which manifests itself differently depending on the form.
The pattern of changes in the vulva depends on the variant of the disease. In most cases, there are red erosions with scalloped “lace” whitish edges. Their surface is often shiny, vitreous. But small, purple with peeling papules and plaques localized on the pubis, labia majora, and thighs can be observed. Scratching contributes to the spread of rashes and is accompanied by secondary changes. With these pictures, the vulva loses its normal structure over time and untimely treatment. Often, damage to the vulva and vagina is preceded by damage to other areas of the skin and mucous membranes. The diagnosis is made on the basis of the clinical picture and biopsy data. Sometimes lichen planus is accompanied by lichen sclerosus.

Treatment includes topical and systemic therapies.

Vulvar cysts

On the vulva, you can sometimes find cysts of different sizes and different origins, which appear as a result of inflammation or injury.
Bartholin gland cysts can be seen with the naked eye.
The clinical picture of the inflammatory process of the Bartholin gland and its excretory duct depends on the anatomical structure. The Bartholin’s gland is located deep in the thickness of the muscles of the perineum. Several small excretory ducts emerge from it, merging into an ampulla, from which then the main excretory duct of great length emerges, but narrowing towards its external opening. The excretory duct of the gland is affected more often than it itself. Diseases of the Bartholin gland and its duct – bartholinitis – include canaliculitis, abscess of the Bartholin gland, cyst of the Bartholin gland, rarely endometriosis.
Small sebaceous retention cysts are observed over the entire surface of the labia, more often between the hairy area and the small lips. They contain yellowish content. As a rule, only itching disturbs. Often, when viewed through a colposcope, small erosive surfaces are found. Sometimes the cysts are large.

Treatment is conservative, in advanced cases surgical.

Vestibular papillomatosis

It is a collective term that clinically includes typical small acute condylomas caused by papillomavirus infection and micropapillomas (pseudocandylomas), which are not associated with papillomavirus infection.
It is often asymptomatic, discovered by chance, although sometimes it is accompanied by leucorrhoea, pain and burning of the vulva, a manifestation of pain during intercourse.

Treatment for anxiety. Depending on the situation, a biopsy is sometimes required followed by surgical treatment. The approach is individual. The main tactic for this disease is observation by a gynecologist.

Benign tumors of the vulva

Tumors of the vulva are diverse and require surgical treatment with subsequent histological examination.