Interview with a dermatologist about intimate skin problems
Intimate skin problems, such as ulcers or rashes on the labia or penis, may be considered embarrassing to bring to the doctor. But it could actually be something contagious, or something that can worsen without proper treatment.
Sending a picture via a smartphone and receiving professional advice, anonymously, is a better option than the “wait and see” approach.
However, in most cases, it is usually a condition that is fairly easy to deal with, and then it’s a shame to go around and worry needlessly, says one of iDoc24 dermatology consultants.
Some things are difficult to photograph, but a picture usually gives some information. In many cases, a good description of the problem can help determine whether you actually should go to the doctor for further tests or treatment.
The best option is to visit a specialist in venerology, skin diseases or a gynecologist. But if for some reason you do not want to go to the doctor, or don’t have a chance to get an appointment, it may be sensible to get an initial assessment from a tele-consultation.
Discharges and ulcers
Discharges are one of the most common problems among both male and female patients visiting a STI clinic (STI = Sexually Transitted Infections). Discharges irritate the skin and make it red and sensitive. Urinating can be painful. Discharges may be caused by everything from yeast infections to sexually transmitted infections – or both.
Small, painful ulcers may be herpes – the blisters that appear may already have bursted by the time the patient seeks help.
Once you have aquired the type of herpes that affects the genitals (type 2), the symptoms usually recur several times during a life time.
The type of herpes virus that gives a rash around the mouth (type 1) is very common. 4 out of 5 people in a population carry the virus. This type of herpes does not normally cause a problem, but may flourish in times of stress or when the immune system is weakened.
Keep an eye on slow-healing wounds
It is wise to be observant about sores in the genital area that do not heal properly, even if they do not cause any pain.
The first symptom of syphilis is usually a non-painful wound that does not improve within a week. Chronic wounds may, in exceptional cases, actually be skin cancer.
But most people who pay a visit to a STI clinic have simple infections. The most common problem among men is balanitis, an irritation of the glans that causes a red rash, which itches and stings.
Many boys and men are concerned that they may have suffered from a venereal disease but in fact it’s more like a rash, and it is not contagious.
Balanits is almost always due to a too intense desire to be constantly fresh and clean – everywhere. But the thin skin of the glans does not tolerate frequent washing with soap, perheps several times a day, according to dermatologists.
Excessive hygiene and the current fashion of shaving the hair of the genital are the reasons for many harmless but troublesome problems.
Not all STIs are visible
In order to secure the diagnosis of some sexually transmitted infections governed by the Infectious Diseases Act – including chlamydia, gonorrhea, and syphilis – you have to take samples. Symptoms are not always visible, but a common symptom is discharge that irritates the skin.
But at least every second person who carries the most common sexually transmitted infection – chlamydia – has no symptoms at all.
By contrast, condyloma’s typical genital warts, are spread through sexual contact and can appear both around the genitals and around the anus.
Genital warts usually disappear with time but they can be both painful and aesthetically embarrassing for a long time. There are medical ways to remove warts.
Papules and spots with special appearances
Other visible skin disorders with special appearance are molluscum lesions. The skin-colored or pink papules generally occur in children and disappear by themselves over time. They often sit in the bends of the knees or elbows, but they can also appear in the genital area.
Both molluscum lesions and genital warts can be spread when they bleed, e.g. during shaving. Shaving also increases the risk of folliculitis, inflammation of hair follicules. These usually heal without treatment or with some anti-bacterial soap.
But sometimes there can be an inflammation of the labia in women. This may develop into an abscess and be terribly painful- these patients tend to seek help urgently.
A relatively unknown diagnosis, for women as well as men, is lichen sclerosus. In women, the manifestation is thin and damaged skin, e.g. on the labia, while men often experience a “tight” and painful foreskin, with is a redness of the skin. Later, white lines may be seen on the inside of the foreskin. There is medical help, but often it takes many years before patients get the right diagnosis and treatment.