Genital irritant dermatitis

Irritant genital dermatitis (irritative dermatitis) is a rash or redness on the genitals that occurs in sensitive people after contact with a specific irritant. Irritants can be any drugs applied to the skin of the genital organs. The most common ones are soap, detergents and condoms.

The rash appears as redness of the penis or redness of the vulva (a woman's external genitalia), which causes genital itching in men or genital itching in women, discomfort and pain. After redness, blisters and scabs appear on the genitals - places where a genital infection can develop.

Treatment of genital irritative dermatitis is based on recognizing the irritant and avoiding it. Corticosteroid creams and cool baths relieve symptoms.

Genital irritant dermatitis - causes

Genital irritant contact dermatitis is an inflammation of the skin. It manifests itself as redness (genital rash) and mild swelling of the skin resulting from a nonspecific reaction to direct chemical injury. The agent, which acts as a strong irritant, causes damage to the epidermal skin cells and an inflammatory response, leading to redness, swelling and ulceration of the skin.

Chemicals that remove the lipid layer of the skin or damage the cell membrane cause irritation.

Common irritants:

soap and detergents;
hygiene products (for example, tampons, sanitary pads, wet wipes);
baths, shower gel, oils, perfumes;
toilet paper;
condoms (latex);
washing the genitals too often;
wearing synthetic and colored underwear.

Differential diagnosis

Differential diagnosis in the early stages should be carried out with the following diseases [1, 2, 13-15]:
- with neurodermatitis - the epithelium is thickened, compacted, dry, the skin pattern is enhanced with inflammatory papules of a brownish-pink color, the skin is hyperemic, shagreen-like, itching appears and on other parts of the body;

— vitiligo is characterized by a lack of pigmentation, sometimes mild itching, and no atrophic changes;

- for lichen planus - multiple grouped papular rashes with atrophic changes or sclerosis with the formation of keloid-like scars;

- with diabetes mellitus - severe itching of the vulva, the tissues of the external genital organs are swollen, have a “doughy” consistency, and are sharply hyperemic.

As a chronic inflammatory dermatosis with a long course of cycles of “itching-scratching-itching” and the formation of scars, SALV is a triggering factor for carcinogenesis or contributes to it. Apparently, dysregulation of immune processes also predisposes to the development of vulvar malignancy.

Treatment

One of the initial measures is the elimination of irritating factors, careful care of the vulva, treatment of secondary infections, local use of estrogens, which prevents atrophy of the vulva and vagina. This consists of following a diet (excluding spicy, salty, sweet foods, caffeine-containing products, alcohol) and intimate hygiene rules (limiting/excluding soap-containing products, deodorants, synthetic underwear, pads, tampons). For severe manifestations of itching, desensitizing therapy and sedatives are recommended [2].

The most widely accepted and recommended gold standard treatment for PALS is topical application of ultrapotent corticosteroid ointments [16], especially clobetasol propionate 0.05% ointment. The anti-inflammatory properties of clobetasol are most effective in the treatment of SALV, which is reflected in the reduction of inflammation and the prevention of progression of the condition and subsequent scarring. Topical ultrapotent corticosteroids are first-line therapy in the treatment of SALV (mometasone furoate, clobetasol proprionate (Ib, A). Clinical guidelines published in 2014 by the American Association of Child and Adolescent Gynecologists suggest the use of highly active glucocorticoid drugs in the long term as first-line drugs mode.They have the following effects:

- anti-inflammatory effect;

- antihyperplastic effect on the proliferating superficial layers of the skin;

- antiallergic, local analgesic and antipruritic properties;

- inhibitory effect on the functions of cellular and humoral immunity.

Summarizing recommendations for the treatment of SALV in children, taking into account the level of evidence, American colleagues presented them as follows:

1. Therapy in patients with SALV should begin with the use of highly active glucocorticoid drugs. Level II-2 B

2. There is limited data justifying the possibility of using immunomodulators both when treatment is ineffective and when patients refuse medications with glucocorticoids. Level II-3 B.

3. SALV should be suspected in children if there are complaints of various disorders of urination and defecation, including dysuria and dyschezia. Level C

In patients with SALV, it is necessary to exclude autoimmune diseases. It should also be noted that the diagnosis of SALV in children and adolescents does not necessarily require a vulvar biopsy. A biopsy of the skin of the vulva can be performed only if there are areas of the skin of the vulva and perianal area suspicious for atypia and/or with persistent resistance to therapy.

Patients with SALV require mandatory monitoring every 6-12 months to assess complaints, exclude changes in the architecture of the vulva and perianal area, and also to prevent the possible risk of malignancy [6].

As already noted, in the treatment of SALV, super-potent corticosteroids clobetasol or halobetasol in the form of 0.05% ointments are used. Because relapses can be frequent, prolonged, and can lead to atrophy and scarring, long-term maintenance therapy is recommended and is considered safer. Since there are no randomized controlled studies comparing the potency of steroids, the frequency of use and duration of treatment for each patient is selected on an individual basis. According to the results of a study by M. Gurumurthy et al. [17] reported that in a trial of clobetasol propionate ointment, complete remission was achieved in 66% of patients and a partial response to treatment was obtained in 30%. The scars did not progress. Conversely, there was no improvement in 75% of patients without treatment, and progression of scars was observed in 35% of women [17].

Depending on the severity of the clinical effect, modern topical corticosteroids (TCS) are divided into four groups [3, 18, 19] (Table 1):

Table 1. Current topical corticosteroids

- weakly active drugs (hydrocortisone 1%, prednisolone 0.5%, fluorocinolone acetonide 0.0025%);

- drugs of moderate action (alclomethasone dipropionate 0.05%, betamethasone valerate 0.025%, clobetasol butyrate 0.05%, deoxymethasone 0.05%, flumethasone pivalate 0.02 and 2%);

- potent drugs (betamethasone valerate 0.1%, betamethasone dipropionate 0.025 and 0.5%, butesonide 0.25%, fluorolorolone acetonide 0.025%, fluorcinoid 0.05%, fluorcinolone acetonide 0.025%, triamcinolone acetonide 0.02, 0 .1% and 2%, methylprednisolone aceponate 0.1%, hydrocortisone 17-butyrate 0.1%, mometasone fluorate 0.1%);

- drugs with very strong activity (clobetasol propionate 0.05%, difluorocortolone valerate 0.05%, galcinonide 0.1%).

Corticosteroids include halogenated (fluorinated) and non-halogenated ones [18-20]. Fluorinated corticosteroids (dexamethasone, betamethasone, flumethasone, triamcinolone, clobetasol, fluticasone, fluocinolone, flumethasone), as a rule, have greater anti-inflammatory activity, but more often lead to side effects. Non-halogenated corticosteroids include prednisolone derivatives (mometasone fuorate, methylprednisolone aceponate, hydrocortisone acetate and hydrocortisone 17-butyrate) [3, 20].

The mucous membranes of the vulva are relatively resistant to steroids, which suggests using ointments with maximum steroid potency to achieve a good effect. For 2-3 months they are applied daily, then 3 times a week in a thin layer on the vulva. In the circumference of the anus, where the skin is thinner, the ointment is applied daily for 4 weeks, followed by a transition to three times a week, and later - once or twice a week. The effectiveness of treatment is evidenced by a significant reduction in the number of cracks, erosions, hemorrhages and thickened white lesions. Even with effective treatment, they do not always disappear completely.

Various dosing regimens can be used. One of the most common is the daily use of high and maximum potency steroids: once a day for 3 months. In children, to avoid skin atrophy, TCS is used weekly for 3 months.

The use of TCS twice daily has additional benefit in the onset of lichen sclerosus. Proactive maintenance therapy with twice-daily mometasone furoate ointment 0.1% is effective and safe in maintaining remission and may help prevent the occurrence of malignant changes (Ib, A). The use of 30 g of the maximum potency steroid should continue for 3 months.

In postmenopause, long-term, for 6 months, use of corticosteroids of maximum activity is necessary. Within 12 weeks, in 77-90% of observations, it is possible to achieve significant improvement and disappearance of complaints, and in 23% of observations, complete disappearance of skin changes. Long-term treatment allows you to maintain remission of the disease for a long time. The patient should be monitored throughout her life. For thickened, hypertrophied, treatment-resistant lesions, administration of triamcinolone into them can be effective [1]. The use of TCS in combination with antibacterial and antifungal agents, such as gentamicin or fusidic acid and nystatin or azole antifungals, may be advisable when a secondary infection occurs. They can be used for a short period of time to eliminate infection (IV, C).

An allergic reaction to any corticosteroid ointment may occur after prolonged use. It should be taken into account that TCS can change the manifestations of some skin diseases, which can complicate the diagnosis. In addition, the use of TCS may delay wound healing [21].

When carrying out long-term local corticosteroid therapy in the anogenital area, serious side effects are detected:

- skin thinning;

- “rebound” reaction, which occurs when therapy is suddenly stopped and manifests itself in the form of dermatitis with intense redness of the skin and a burning sensation;

- formation of striae;

— development of fungal infections;

- suppression of adrenal function as a result of systemic absorption.

According to research results [2], it has been proven that all side effects resolve quickly as the activity of topical corticosteroids decreases and the frequency of their use.

The selection of treatment tactics for SALV is based on theoretical assumptions. Therapy for patients suffering from SALV is associated with polypharmacy, as it should help simultaneously eliminate the phenomena of atrophy, hyperkeratosis, reduce microcirculatory disorders, inflammation, and improve the healing of erosions on the skin of the vulva and perineum. However, the inappropriate use of antiseptics, antibiotics, antiviral and other groups of drugs often increases the activity of the pathological process and the spread of SALV. In case of lichen sclerosus, long-term observation is necessary to prevent increasing scarring and early detection of malignant neoplasm, the risk of which is not great, but real. As a rule, treatment leads to long-term remission. Its absence is a reason to doubt the diagnosis. A possible complication is contact dermatitis as a reaction to local treatment or excessively careful hygiene, infection, or the development of vulvar cancer. The ineffectiveness of local corticosteroid therapy is often associated with a violation of the patient's regimen, including due to misunderstanding or the inability to fully apply the ointment due to obesity or arthritis. Scars can be painful.

According to the European guideline for the management of vulval conditions 2016, patients with VALV require treatment [21]. About 10% of patients are not pruritic but have clinical signs of lichen sclerosus and should also be treated (IV, C).

In recent years, there has been a debate among specialists about the need to continue further treatment while relieving the initial symptoms. This is due to the fact that there is no data on disease activity at that time. However, it is indicated that SALV can progress further and lead to scarring, despite the lack of symptoms after prophylactic treatment, patients are indicated for continuous therapy for many years to prevent progression (IV, C).

A 5-year follow-up period showed that continuous treatment with an individually selected corticosteroid prevented the progression of symptoms, further scarring and the development of carcinoma, respectively, in 58% of cases versus 93.3%, 40% versus 3.4%, and 0% versus 4. 7% [21].

One of the representatives of the modern generation of TCS is the domestic combination drug for external use - tetraderm (Table 2).

Table 2. Composition of tetraderma cream for external use According to its pharmacological action, it has anti-inflammatory, antibacterial, wound-healing, antifungal, and glucocorticoid effects.

Pharmacodynamics

The activity of the drug is due to the pharmacological properties of the components included in its composition.

Gentamicin is a broad-spectrum antibiotic from the aminoglycoside group. Has a bactericidal effect, active against gram-negative microorganisms: Pseudomonas aeruginosa, Aerobacter aerogenes, Escherichia coli, Proteus vulgaris, Klebsiella pneumoniae

;
gram-positive microorganisms: Staphylococcus aureus
(coagulase-positive, coagulase-negative and some strains producing penicillinase).

Dexpanthenol is a derivative of pantothenic acid. Stimulates skin regeneration, normalizes cellular metabolism, accelerates mitosis and increases the strength of collagen fibers. Penetrates into all layers of the skin. It has a weak anti-inflammatory effect.

Mometasone is a synthetic CS that has a local anti-inflammatory, antipruritic and anti-exudative effect, induces the release of proteins that inhibit phospholipase A2 and lipocortins, which control the biosynthesis of inflammatory mediators (prostaglandins and leukotrienes, cellular inflammatory mediators) by inhibiting the release of their common precursor - arachidonic acid.

Econazole is a synthetic imidazole derivative. It has an antifungal and antibacterial effect, inhibits the biosynthesis of ergosterol, which regulates the permeability of the cell wall of microorganisms. It is easily soluble in lipids and penetrates well into tissues; it is active against dermatophytes Trichophyton, Microsporum, Epidermophyton,

yeast-like fungi of the genus
Candida, Corynebacterium minutissimum,
as well as
Malassezia furfur (Pityrosporum orbiculare)
, which causes pityriasis versicolor, and some gram-positive bacteria (streptococci, staphylococci).

Indications for use of the drug Tetraderm

Treatment of dermatoses of inflammatory origin with concomitant bacterial and mycotic infection or a high probability of secondary infection (simple and allergic dermatitis, atopic dermatitis (including diffuse neurodermatitis), limited neurodermatitis, eczema, dermatomycosis (dermatophytosis, candidiasis, pityriasis versicolor), especially when localized in the groin area and large folds of skin; simple chronic lichen (limited neurodermatitis).

Directions for use and doses

Externally.

The cream is applied to the affected areas of the skin in a thin layer, gently rubbing, 2 times a day until a positive clinical result is achieved. The duration of treatment is individual, depends on the size, location of the lesion and the severity of the disease and is usually 1-2 weeks. It is not recommended to use Tetraderm for more than 4 weeks.

Second-line therapy for SALV

Topical calcineurin inhibitors (TCIs) - pimecrolimus, tacrolimus - have a dermatotropic, immunosuppressive, anti-inflammatory local effect, specifically bind to the cytosolic receptor macrophilin-12 of T-lymphocytes and inhibit calcium-dependent phosphatase - calcineurin. Currently, TICs are recommended as second-line therapy for SALV. Pimecrolimus cream 1% is an immunosuppressant that inhibits T cell activation by blocking the transcription of early cytokines, and thus significantly reduces the itching, burning and inflammation associated with SALV. In addition, it prevents the release of pro-inflammatory cytokines, mediators of inflammation from mast cells in vitro

in response to stimulation by IgE antigen, does not affect keratinocytes, fibroblasts and endothelial cells.

Although TCIs can provide effective symptomatic relief, topical clobetasol is superior to pimecrolimus in reducing inflammation and improving clinical symptoms. However, pimecrolimus cream has a more acceptable safety profile and does not cause skin atrophy, although its use is associated with an increased risk of complications due to suppression of local immunity. As a result, TCI should be administered under the supervision of a specialist who can monitor the potential risk of malignancy of SALV. Given the proven effectiveness and safety of topical corticosteroids, experts agree that TICs should be reserved for cases of SALV not responding to topical corticosteroids [2].

TIC is used externally 2 times a day, applied in a thin layer to the affected areas of the skin and gently rubbed until completely absorbed. Treatment is continued until symptoms disappear completely. At the first signs of relapse, therapy should be resumed. If symptoms persist for 6 weeks, the patient's condition should be re-evaluated.

The most famous forms of TEC:

1. Tacrolimus - Protopic ointment 0.03 and 0.1%. Undesirable effects of this drug include: burning and itching sensation, redness, pain, irritation, rash at the application site, development of folliculitis and acne. Isolated cases of malignancy (skin and other types of lymphomas, skin cancer) have been recorded.

2. Pimecrolimus - Elidel cream 1%. Side effects include a burning sensation at the site of application of the cream, the development of impetigo and skin infections, rhinitis, and urticaria.

The most relevant seems to be 0.03% tacrolimus ointment for the effective treatment of children with anogenital lichen sclerosus 2 times a week, while reducing relapses is possible (IIIA, B). A comparison of pimecrolimus (1% cream) and clobetasol propionate (0.05%) cream showed an improvement in the symptoms of itching, burning, pain 12 weeks after the onset of vulvar lichen sclerosus, while clobetasol was used to quickly relieve the inflammatory process (Ib, A) . Other studies of pimecrolimus showed that 42% of patients were in “complete remission” after 6 months of use (IIb, B). Local irritation was the most common side effect with tacrolimus and pimecrolimus. The long-term risks of TIC use still need to be studied, as there are concerns about the possibility of an increased risk of malignancy due to local immunosuppression with long-term SALV therapy [21].

Emollients

One of the important components of SALV therapy are emollients ( eng.

. emollient - emollient) softening and moisturizing agents. These products do not contain potential allergens such as propylene glycol and lanolin, can minimize local inflammation, increase the moisture content of the stratum corneum of the skin, strengthen weakened skin barrier function and reduce subclinical inflammation [2].

According to the results of a study conducted by T. Simonart et al. [22], it was found that more than 50% of women who used a daily moisturizer along with topical corticosteroids maintained remission for 58 months. And more than 2/3 of women stopped using topical corticosteroids while remaining on emollients for a long time.

Based on their source of origin, emollients are divided into plant (natural), chemical and synthetic. Plant emollients are, first of all, natural oils. They soften the skin and protect it, making it elastic. They are absolutely harmless. These include popular cosmetic oils: peach, olive, jojoba. Chemical emollients include paraffin, petroleum jelly and ointments based on it (“Propolisnaya”, “Calendula”), and mineral oils. Synthetic emollients are produced industrially by carrying out various reactions and mixing fatty acids, esters and other components. These are cyclomethicones, dimethicones and synthetic oils. The most well-known and studied are the products from the Emolium, Locobase Ripea, and Lipikar line.

Effects of emollients:

— begin to act immediately after application to the skin, reducing moisture evaporation due to the occlusion effect;

— with further penetration into the stratum corneum, the lipids replace the missing lipids of the epidermis and maintain skin moisture for several hours (medium-term effect);

- lipids reach the deeper layers of the skin and enter the empty “storage areas” - lamellar bodies; if necessary, they are released to maintain the water-lipid balance of the skin (long-term effects).

Estrogen-containing drugs

This group of funds

has a proliferative effect without having a systemic effect on the endometrium and mammary glands [23, 24]. Orniona cream is one of the most modern domestic preparations that contains estriol, an analogue of the natural female hormone. Estriol is used to correct estrogen deficiency in pre- and postmenopausal women. Effective in the treatment of urogenital disorders. In the case of atrophy of the epithelium of the vagina and cervix, which occurs with SALV, estriol stops these disorders, helps restore normal microflora and physiological pH of the vagina, thereby increasing the resistance of the vaginal epithelium to infectious and inflammatory processes. Unlike other estrogens, estriol interacts with the nuclei of endometrial cells for a short period of time, so that with daily use of the recommended daily dose, endometrial proliferation does not occur. Thus, there is no need for cyclic additional administration of progestogens, and “withdrawal” bleeding is not observed in the postmenopausal period.

Indications for use:

- hormone replacement therapy (HRT) for the treatment of atrophy of the mucous membrane of the lower urinary and genital tract associated with estrogen deficiency in postmenopausal women;

— pre- and postoperative therapy in postmenopausal women who are about to undergo or have already undergone surgery via vaginal access;

- for diagnostic purposes in case of unclear results of cytological examination of the cervical epithelium against the background of atrophic changes (as an adjuvant).

Contraindications for use:

- established hypersensitivity to the active substance or to any of the excipients of the drug;

- untreated endometrial hyperplasia;

- established, known or suspected breast cancer;

- diagnosed or suspected estrogen-dependent tumors (for example, endometrial cancer);

- bleeding from the vagina of unknown etiology;

- thrombosis (venous and arterial) and thromboembolism currently or in history (including deep vein thrombosis, pulmonary embolism, myocardial infarction, stroke), cerebrovascular disorders;

- conditions preceding thrombosis (including transient ischemic attacks, angina) currently or in history;

- congenital or acquired predisposition to the development of arterial or venous thrombosis, for example deficiency of protein C, protein S or antithrombin III;

- liver disease in the acute stage or a history of liver disease, after which liver function tests have not returned to normal;

- porphyria;

- pregnancy and breastfeeding.

Directions for use and doses

Ornion cream should be inserted into the vagina before bed using a calibration applicator. One dose (when filling the applicator to the ring mark) contains 0.5 g of Ornion cream, which corresponds to 0.5 mg of estriol. The course of treatment consists of prescribing estriol at a dose of 500 mcg per day for 2-3 weeks daily, then switching to a maintenance dose 1-2 times a week. A small part of a single dose is applied directly to the vulva, and the rest into the vagina with a dispenser. With the detachment of hyperplastic plaques, there is increased pain that passes quickly.

Ornion cream can be used both in women with a history of hysterectomy and in women with an intact uterus. When carrying out HRT for the treatment of atrophy of the mucous membrane of the lower urinary and genital tract associated with estrogen deficiency in postmenopausal women, one intravaginal cream is administered daily for no more than two weeks until symptoms alleviate. Then the dose is gradually reduced to a maintenance dose depending on the clinical picture (for example, one injection 2 times a week).

For pre- and postoperative therapy in postmenopausal women who are about to undergo or have already undergone surgery via vaginal access,

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Irritant genital dermatitis - symptoms

Symptoms may appear minutes to hours after exposure to the irritant. In rare cases, symptoms may appear even after several weeks or months (cumulative contact dermatitis). This type of dermatitis usually occurs after exposure to mild irritants, such as detergents, for an extended period of time.

Patients complain of redness, itching, burning, pain and discomfort in the genitals.

There are several stages:

Erythematous stage - redness of the genitals;
Vesicular stage - formation of blisters on the genitals;
erosive stage - the appearance of ulcers on the genitals;
squamous stage - the formation of a thicker stratum corneum.

The typical presentation of irritant contact dermatitis includes diffuse redness of the affected skin with crusting.

The damaged skin may develop furrows, causing genital pain and itching.

Damaged genital skin is a place where inflammation and infection easily develop.

In men, diseases of the genital organs are not uncommon. Inflammation of the glans penis is most often caused by infection or chronic skin changes resulting from poor hygiene and irritation. Untreated sexually transmitted diseases can lead to balanitis (inflammation of the head of the penis).

Irritation of the glans penis can be caused by insufficient rinsing of soap after showering, using washes that are not suitable for the genitals, or other inappropriate preparations (lotions, fragrances).

Symptoms of balanitis:

redness on the foreskin around the glans;
redness on the penis,
itching of the genitals in men;
thickening of the foreskin;
white round plaques on the head of the penis;
painful skin on the penis;
difficulty urinating.

Treatment of inflammation of the glans penis depends on the cause that caused it.

What to do if your labia are peeling

The first thing to do is check for blistering rashes, plaque or bites. These manifestations indicate the pathological nature of peeling.

It is important! If there is any peeling, itching or redness in the groin area, sexual intercourse should be avoided. Sexual contact can introduce infection and worsen the problem.

To exclude the disease, you need to consult a dermatovenerologist who treats both infectious and non-infectious skin lesions. Including peeling and itching in the groin area.

In addition, you can try treating peeling with homeopathic medicines, which successfully cope with many skin problems. Homeopaths rightly believe that all skin rashes, peeling and itching are just a signal that the functions of some organs and systems in the body are impaired. Homeopathic treatment is aimed at establishing these functions and balancing the interaction of all body systems.

Photo 2: If peeling occurs, it is necessary to change personal hygiene products, replace underwear with cotton ones that do not cause unpleasant reactions, and temporarily stop depilating the bikini area. Source: flickr (Muhamad Arifin).

Inflammation of the vulva (vulvitis) and vagina (vaginitis)

Vulvitis is an inflammation of the vulva, that is, inflammation of the external female genital organs. If the vagina is also affected, then we are talking about vulvovaginitis.

Causes of vulvitis include infections, irritants, medications and hormonal changes. Poor intimate hygiene can promote the growth of fungi and bacteria and also cause irritation.

Based on the causes of occurrence, vaginitis can be divided into several groups:

non-infectious vaginitis - a consequence of contact dermatitis;
atrophic vaginitis - in women during menopause, due to a lack of estrogen, the vagina becomes thinner and becomes susceptible to infections;
infectious vaginitis - infection by microorganisms;
bacterial vaginosis is a consequence of an imbalance in the bacterial flora of the vagina;
fungal infection of the genital organs - vaginal candidiasis.

The most common symptoms in women are unusual discharge, genital irritation and itching. The skin becomes red and swollen. An unpleasant vaginal odor emanates from the vagina, and a burning sensation is felt when urinating.

The diagnosis is very easy to make based on the history and clinical picture.

Allergic contact dermatitis must be distinguished from irritant contact dermatitis by performing an epicutaneous skin test for allergens.

When diagnosing irritative dermatitis, a skin test is negative.

Causes that should be excluded when diagnosing irritant dermatitis:

allergic contact dermatitis;
genital psoriasis;
genital fungus in men (penile fungus);
genital fungus in women (vaginal candidiasis);
genital herpes;
syphilis;
inflammation of the glans penis (balanitis);
inflammation of the foreskin (balanoposthitis);
inflammation of the vagina (vaginitis);
inflammation of the vulva (vulvitis);
inflamed sebaceous glands;
hair folliculitis.

Homeopathy for peeling skin of the labia

It is important to choose a drug that is suitable not only for symptoms, but also for personal characteristics. The following remedies help with itching and flaking:

Lycopodium (Lycopodium clavatum). This drug is suitable for those women who are tormented not only by peeling and itching, but also by burning. All symptoms intensify in the evening and during the cold season.
Hydrocotyle asiatica. The product should be used by women whose skin is prone to the formation of scales, thickening and rashes in various areas, including the labia. Among the personal characteristics, such women are characterized by frequent drowsiness and low mood.
Ignatia amara. This drug is intended for women who are subject to rapid mood swings. Great for those whose symptoms arise after severe stress or fear.

Before taking homeopathic remedies, you should consult your doctor.

Irritant dermatitis on the genitals - treatment

The most important step in treating genital irritant dermatitis is recognizing the irritant and avoiding it.

Cold compresses and baths can help relieve symptoms, and topical corticosteroid creams can be used in the short term.

The patient should reduce frequent washing of the genitals with scented soaps and stop wearing tight synthetic clothing, which may cause irritation. Women should stop using wet sanitary napkins, panty liners, and scented and colored toilet paper.

Unpleasant sensations in intimate areas, video

Gynecologist Irina Garyaeva about vaginal dryness.
Source - KVD - dermatovenerological dispensary Sources:

THERAPY OF UROGENITAL DISORDERS CAUSED BY ESTROGEN DEFICIENCY. Serov V.N. // Obstetrics, gynecology and reproduction. – 2010. – No. 1. – P. 21-35.
PROBLEMS OF UROGENITAL DYSTROPHY IN WOMEN OF REPRODUCTIVE AND PERIMENOPAUSAL AGE. Karahalis L.Yu. // Kuban Scientific Medical Bulletin. – 2007.
Features of urogenital disorders in perimenopause. Balan V. E., Ankirskaya A. S., Muravyova V. V., Tikhomirova E. V. // Materials of the V Russian Forum “Mother and Child”. - 2003. - P. 290.
The overactive bladder. Bulmer P., Abrams P. // Rev Contemp Pharmocother. – 2000. – No. 11. R. 1–11.
Characteristics of hot flashes in women of different age groups. Karahalis L. Yu., Fedorovich O. K. // AG-info. - 2006. - No. 2. - P. 26–31.
https://www.verywellhealth.com/natural-remedies-for-vaginal-dryness-90070
https://www.healthline.com/health/vaginal-itching
https://www.medicalnewstoday.com/articles/321615.php
https://www.webmd.com/women/guide/vaginal-dryness-causes-moisturizing-treatments#1

Diagnostics

In order to more reliably determine whether the neoplasm belongs to anogenital warts, a test is carried out with a 5% solution of acetic acid, after treatment with which papillomas in intimate places retain a grayish-white color with a changing, intensifying vascular pattern of normal skin. Laboratory tests can also be used in diagnosis - identification of the HPV genotype with a prognosis for the course of the disease.

To diagnose precancerous conditions against the background of papillomas in intimate places in women, consultation with an obstetrician-gynecologist and urologist is recommended when papillomas are localized in intimate places in men, for example, with intraurethral localization. If there are papillomatous processes in the anal area, consultation with a proctologist is recommended.

Routes of infection

Infection is possible not only through sexual intercourse, although this is the most common cause. HPV infection is also possible through household means:

when using common hygiene and tableware;
through contact with an infected person in the acute stage in the presence of microtraumas;
the possibility of HPV transmission through household items is still being debated.

The transplacental route of infection is rare - from mother to child, even at the stage of intrauterine development of the fetus.

Causes of papillomas

The cause of the appearance of papillomas in intimate places is the human papillomavirus (HPV), which circulates in the blood of almost every man and woman, starting from adolescence.
According to WHO, 80-90% of the population is infected with HPV. Most often, papillomas occur in young people who have a large number of sexual partners. Genital-anal papillomas are typical manifestations of human papillomavirus infection. In 90% of cases they are caused by the sixth and eleventh types of HPV.

In the daily life of every person, the following exposures increase the risk of infection:

smoking;
stress;
using other people's hygiene products;
visiting baths, saunas;
shaking hands with carriers at the acute stage;
decreased immunity.

Globally, the spread of HPV is influenced by many factors, including socioeconomic, medical, hygienic and geographic. The virus can stay in the body for years without showing itself. Its activation is provoked by a weakening of the protective forces of the immune system, which entails the appearance of papillomas in intimate places, both in women and men.

Pregnancy, hormonal imbalances, metabolic disorders, acute viral infections, long-term chronic diseases, poor nutrition and lack of sleep can also trigger the growth of papillomas in intimate places.