We had a few questions about this. Please see also previous post that deals with different problems on genital skin.

It takes courage to bring up genital concerns, so thank you. Genital skin is different because it is thinner, has more oil and sweat glands, can be easily irritated, and is very stretchy. This makes sense if we think about how it works and the fact that it expands and contracts a lot with stimulation, sex, pregnancy, even just the occasional monthly hormone change. .

Symptoms you may experience:

  • Itchy. The causes of genital itching are varied and can range from yeast infections, sexually transmitted infections, allergies, detergents or dryer sheets; or even a more complex autoimmune problem. An often overlooked and misdiagnosed problem in women is the so-called LS&A (Lichen Sclerosus et Atrophicus). Who invented these Latin names – sheesh! It usually begins as an itch and color change on the skin of the lips. Often misdiagnosed as chronic yeast and other things, it is very uncomfortable and can cause pain during sex, contact with clothing, and even laundry. This problem can often be easily treated with prescription creams. Go see a good dermatologist.
  • Irritation and pain. LS&A can be the cause, but there are many causes; such as too much friction due to prolonged sex. Or some are allergic to the ingredients in personal lubricants. For example, propylene glycol is a fairly common allergen. Please see the list above and make sure you see your doctor if symptoms persist for more than a week or longer. If it’s just a matter of friction, letting the skin rest for a few days or a week will usually resolve it.
  • Swelling. Again, could be any of the above. Come see your doctor. If the condition persists, it may be due to blocked lymph channels due to a mass or tumor in the lower abdomen. In men, sudden testicular swelling is a medical emergency as it can be a sign of testicular “twisting” due to twisting and blocking of blood supply to the testicle.
  • Cancer. Although it is quite rare on the skin of the genitals, it does happen. Some of these tumors are caused by an old or insidious infection with the human papilloma virus (HPV). HPV is the virus that causes warts, so if you have a history of genital warts, please let your gynecologist and primary care provider know so you can be monitored appropriately.

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

I hope this helps,

Dr. Brandith

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