A few tips for handling that rash down under

Dr. Tristi Muir

Dr. Tristi Muir

Our Bodies, Our Lives

Like it or not, it’s swimsuit season. You hit the gym and work out to look good in revealing summer wear — causing sweating and rubbing of the vulva and inner thighs (“chub rub”).

When you dive into the summer itself, you find yourself lounging in a wet swimsuit bottom. This constant moisture provides a perfect environment for bacteria and yeast to proliferate.

Breaks in the skin due to rubbing, itching or shaving can lead to a secondary infection that can cause enough redness, itchiness and pain to ruin a beautiful summer day.

Unfortunately, many women suffer in silence — they are embarrassed to see a doctor — and search for an Internet cure.

Let’s explore what could be going on down under.

Red, itchy areas on the vulva are most commonly caused by dermatitis of the skin, chronic yeast infection or psoriasis. Vulvar dermatitis can be caused by exposure of the delicate vulvar skin to an irritant, such as bacteria, yeast or chemicals.

Many products have ingredients that irritate the vulvar skin, including soaps, scented pads or panty liners, lubricants or douches. Remember that the vagina is like a self-cleaning oven with a delicate acid-base balance. Douching can throw off this balance and potentially propel non-sterile water into a sterile uterus, leading to infection. Because there are many chemicals in topical creams, be wary of falling for a magical cure online. It may fan the fire of inflammation.

So what should you do? The vulvar skin should be washed with water only, no soaps, and patted dry with a cotton towel. Avoid tightfitting clothes, jeans and pantyhose. Throw away your thongs, sleep in the nude and wear 100 percent cotton undies — the cotton draws the moisture away from the vulva.

Many women use pads for a variety of reasons: menses, urinary or fecal incontinence, vaginal discharge or “just in case.” These pads create a moist environment and can hold irritants such as perfumes onto the delicate vulvar skin. Try to avoid pads, but if you need to, use them for the shortest time possible and search for unscented, natural pads. For women with incontinence, if the urine or feces is irritating the vulva, protect the irritated skin with an ointment that is used for diaper rash, such as Desitin.

Shaving the pubic region is the rage during the summer months. Even the “Brazilian” (bald) vulvar look has become very popular. But shaving causes cuts in the vulvar skin. With the proliferation of bacteria and yeast in a moist, hot environment, rashes, folliculitis and staph infections can occur. Avoid shaving as much as aesthetically possible.

Yeast love moist, warm skin. Itching may lead to rawness and pain. Treatment with an oral tablet (prescription diflucan) or topical over-the-counter antifungal medication helps to put out the fire in your loins. If you find that topical antifungal fans the fire rather than putting it out, you may have sensitivity to a chemical in the cream. Stop the cream and see your health care provider.

If your rash does not respond to the vulvar tips listed above or if you have a chronic skin condition, don’t let embarrassment spoil your summer fun. Make an appointment with your health care provider and fill your summer with wonderful memories.

Our Bodies, Our Lives focuses on issues surrounding women’s sexual, gynecological and emotional health. Dr. Tristi Muir is the director of the UTMB Pelvic Health and Continence Center at Victory Lakes. Visit www.utmbhealth.com/pelvichealth.

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