Your Guide to Genital Skin Conditions

What You Need to Know About Skin Disorders that Affect Your Gentialia

Female doctor discussing with a patient
What skin conditions affect the genitalia in men and women?. Eric Audras/Getty Images

What common genital rashes and skin conditions occur in men and in women? What are the causes and how common are these conditions?

Defining Genital Skin Issues

The genitals are male or female reproductive organs. Since the reproductive organs are in the pelvis, "genital" refers to the internal reproductive organs in the pelvis and the skin at the bottom of the pelvis around the vagina and anus in women and around the penis, scrotum, and anus in men.

Skin Conditions Which May Occur Anywhere, Including the Genitals

Some skin conditions occur anywhere on the body and may just happen to occur on the genitals. Conditions such as this include psoriasis, and melanoma, those most serious type of skin cancer.

Other conditions can occur in different regions of the body, but commonly occur in the genitals. These include conditions such as hidradenitis suppurativa (boils which occur in the groin and armpits) and intertrigo a rash which usually occurs in skin folds such as in the genital region, under the breasts, and in the armpits. Yet other skin conditions occur only on the genitalia, such as balantis.

Causes of Genital Rashes

Skin issues related to the genitals can be itchy, painful and embarrassing, but they are actually quite common. There are a number of causes for a genital rash that range from sexually transmitted diseases to allergic reactions, to infections, to autoimmune disorders.

The most common culprits of genital rashes include:

Fungal infections - Fungal infections have a tendency to grow in warm, moist environments, such as the genitalia and include:

  • Jock itch - Jock itch is a fungal infection which is similar to athletes foot. Whereas athletes foot is caused by the fungus Trichophyton rubrum, jock itch is caused by Candida albicans, the same fungus which causes fungal yeast infections. Jock itch is diagnosed in the same way as vaginal yeast infections, through a KOH test.
  • Vaginal yeast infection - Yeast infections are caused by a yeast-like fungus called Candida albicans. It often causes a thick, cottage-cheese like discharge, and is accompanied by severe (and often embarrassing) itching. It sometimes occurs due to the overgrowth of yeast which occurs with antibiotic use, and is a very common occurrence in women who are treated with antibiotics. It may also be related to wearing clothing which traps heat and moisture in the genital region. Vaginal yeast infections commonly occur in healthy women, but are more likely to occur in women with diabetes, women who are pregnant, and women who are overweight.
  • Diaper rash - Diaper rashes may be caused by irritation, yeast infections, or less common causes such as zinc deficiency or hereditary disorders.
  • Balantis (see below)

Viral infections - Viruses such as HPV 16 and HPV 18 (the cause of most genital warts) can also cause skin rashes.

  • Molluscum contagiousm - Molluscum contagiosum is a condition which appears with multiple small warty like growths. It is caused by a pox virus, but is different than the chickenpox in important ways (it doesn't stick around the body after an infection.) It can be transmitted as a sexually transmitted disease but is often found in children as well.
  • Human papillomavirus (HPV) - There are over 100 different strains of the HPV virus. Two strains, HPV 16 and HPV 18 are responsible for around 90 percent of genital warts. The virus is spread by skin to skin contact, often sexually. The newer HPV immunizations may provide immunity.

Autoimmune disorders - There are a number of allergies and autoimmune disorders than can lead to a genital rash.

  • Psoriasis - Psoriasis is a common skin disorder affecting roughly two percent of the population.
  • Lichen planus (see below)
  • Reactive arthritis - Reactive arthritis or Reiter's syndrome is an autoimmune reaction to an infection in the body.

    Contact dermatitis - Contact dermatitis is a common rash that occurs when the skin comes in contact with an allergen or irritant, such as latex or harsh chemicals.

    Atopic dermatitis - Allergic dermatitis or atopic dermatitis results from an allergy to a substance which comes in contact with the skin.

    Parasitic infections - Genital rashes may be caused by parasitic infections including:

    • Pubic lice - Pubic lice, or crabs often occur in the pubic hair as a form of sexually transmitted disease. They may, however, occur in hair on other areas of the body, even on the eyelashes.
    • Scabies - Scabies tends to be an extremely itchy rash which may occur anywhere on the body, but tends to spare the face. These photos show examples of the rash.

    Sexually transmitted diseases (STDs) - STD's can cause genital rashes as well. These infections occur more often in those who do not practice safe sex or who have multiple sexual partners, but may occur in people who have only had intercourse one time, or with skin to skin contact without penetration as well.

    • Genital herpes - Genital herpes can cause painful sores on the genitalia, though many people who are infected have never noticed any symptoms.
    • Genital warts (as noted above)
    • Syphilis - Syphilis is a sexually transmitted disease that occurs in stages. In the first stage, an open sore may occur on the genitals. This sore or rash is often painless, and if not noticed, the disease can advance into the later stages of the disease.

    Common Genital Skin Conditions

    Some level of skin-related immunodeficiency is typically the culprit for a genital skin disorder. In many cases, proper diagnosis and treatment correct the immune dysfunction and strengthen the skin barrier to prevent future infection.

    Common Genital Skin Issues Among Women

    Some of the more common genital skin issues in women include:

    • Contact dermatitis is a very common skin condition. There are several triggers that cause contact dermatitis, including a dry climate, fragrances in soaps and other body care products, laundry detergent and fabric softener residue, elastic and latex.
    • Human papillomavirus (HPV) is a genital wart infection caused by the HPV particle that compromises the skin's protective barrier. Genital warts are caused by a different strain of HPV than those which cause cervical cancer, but it's common for people to contract infections with more than one form of HPV.
    • Lichen planus is skin disorder that causes increased production of vaginal discharge and white blood cells. When a rash is present, it often appears as purplish appearing lumps.
    • Lichen sclerosus is a condition characterized by persistent vaginal itching, making the patient more prone to yeast infection and squamous vulvar cancer.
    • Vaginal yeast infections often occur in conjunction with chronic vulvar eczema. Yeast organisms release proteins that cause an allergic reaction and creates an environment that incubates the infection.

    Common Genital Skin Issues Among Men

    Common genital skin issues in men include:

    • Balanitis is inflammation that affects the head of the penis and/or foreskin. It is most common in uncircumcised men, and affects roughly one in ten uncircumcised men. The term balantis is a symptom rather than the name of a specific disease, as balantis can be caused by many conditions including contact or allergic dermatitis, poor hygiene, yeast infections, or STD's including gonorrhea, chlamydia, and syphilis. Symptoms include local redness, with a orange or yellow appearance common, pain with urination, and a foul-smelling discharge. Complications can range from scarring, to an increased risk of penile cancer.
    • Contact dermatitis is caused by external triggers like fragrances in body care products, synthetic fabric, laundry detergent and latex products like condoms.
    • Intertrigo is a yeast infection caused by the presence of yeast organisms that thrive in warm, moist environments, including the genital region. It usually occurs in skin folds, such as the armpits, genitals, under the breasts, and in fat folds.

    Treating Genital Skin Conditions

    Treatment for genital rashes depends on the cause. In many cases a genital rash itches, which can be treated with an over-the-counter cream, like hydrocortisone. A physician might also prescribe a cream that soothes itching while treating the underlying cause.

    Sexually transmitted infections like syphilis are treated with antibiotics, and genital warts are treated with prescribed medication. Genital herpes, however, cannot be cured, but rather controlled with medication. Lice can be eradicated with medicated shampoos or body washes, and scabies is remedied with medicated creams.

    For those who have had skin issues due to sexually transmitted diseases, regular physical exams and Pap smears are recommended. Infections which cause genital warts or syphilis do not cause cancer, but it is common for people infected with one type of STD to also be infected with other forms, such as other strains of HPV which can lead to cervical or penile cancer.

    Talking to Your Doctor About Genital Skin Issues

    While it can be embarrassing to make an appointment to see your doctor, this can be very important. Some of these conditions can worsen and cause permanent skin changes if not treated appropriately. Some can even lead to cancer.

    Even "milder" conditions such as eczema should be addressed. While these conditions may seem to be more of a nuisance, chronic use of creams such as hydrocortisone can lead to thinning of the skin, which can, in turn, put you at risk for further genital skin issues.

    Sources:

    Zendell, K. Genital Lichen Planus: Update on Diagnosis and Treatment. Seminars in Cutaneous Medicine and Surgery. 2015. 34(4):182-6.

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