GENITAL ALLERGIC CONTACT DERMATITIS

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If your dermatologist, allergist, or gynecologist has diagnosed you with allergic reactions, the information below will provide more guidance on what substances to avoid and how to avoid them.

There are many causes for rashes in the genital area. Some cases may be due to infection [such as yeast or bacterial infections], while others may be due to inflammatory skin conditions or other causes. Diagnosis will require a medical history and a physical exam, and may even require further testing. If your doctor has diagnosed you with dermatitis of the genital area, the recommendations below may help.

The skin of the genital area is very sensitive, and so it can be irritated easily. This is known as irritant dermatitis. In other cases, people can become allergic to items or substances that contact this area.

 

What is allergic contact dermatitis (ACD)? Why is it so hard to diagnose?

ACD is a type of allergic reaction. In this type of allergy, a substance contacts the skin, and later results in a rash. The rash from poison ivy is one example. The rash classically occurs 2-3 days later, but it may happen just a few hours later, or one week later. This delay is what makes ACD so hard to figure out.

Once the rash occurs, it may last for weeks, and sometimes up to 8 weeks. People may stop using the triggering product for 1-2 weeks, but that’s usually not long enough to see results.

What substances trigger ACD of the genitals?

The genital area is one of the most sensitive areas of the body. This area may react to:

1. Products that contact the skin directly, such as soaps and laundry detergent.

2. Topical medications, including OTC or Rx creams, ointments, suppositories, or sprays.
3. Products that are in brief contact with the skin, such as moistened toilet paper.
4. Substances that are on the hands and then transferred by scratching, such as hand cream.
5. Other substances, such as condoms, underwear, or sanitary pads or tampons.

 

What are some of the most common substances that trigger ACD of the genital area? How can I avoid them?
1. Fragrance additives. These are found in many products, such as soaps and laundry detergent. These can even be found in products that are labeled "fragrance-free." In the next section, we list products that are truly fragrance-free.

2. Other preservatives and substances in skin care products, such as in creams, lotions, and body washes. See our list of recommended products.

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3. Topical medications. Sometimes people purchase over-the-counter products to try to help their rash. Some of these products can result in allergic reactions. We've seen many cases of allergy to benzocaine, which is a numbing ingredient found in products such as Lanacaine and Solarcaine. We've also seen many cases of allergy to topical antibiotics, such as neomycin in Neosporin and bacitracin in Polysporin. Other people have become allergic to Benadryl cream or Sarna lotion.

4. Moistened toilet paper wipes or baby wipes. In recent years, we've seen many cases of allergy to these types of wipes. Moistened wipes contain water, and therefore require preservatives. We've seen allergic reactions to methylchloroisothiazolinone, Quaternium-15, and other chemicals used in these wipes.

5. Clothing. Some people become allergic to the dyes, rubber additives, or other chemicals used in their underwear or elastic.

 

What products should I stop and what products should I use instead?

The products below do not contain any of the common triggers of ACD. They do not contain any synthetic fragrance additives, natural fragrance additives, botanicals, formaldehyde, methylchloroisothiazolinone, or lanolin. Some are available at major retailers, and others must be ordered via phone or website.

Note that every product must contain some additives, and some people are allergic to less common substances. Therefore, if these recommendations do not help, then you may require further testing. It can take up to 8 weeks of allergen avoidance for your skin to recover. Your physician will recommend or prescribe a medicated ointment to use on the genital area during this time to help with the inflammation.

1. Stop using your current soap. If the rash is not severe, you may use Aveeno fragrance-free bar soap or Vanicream bar soap or Cetaphil gentle skin cleanser [liquid only] or Cerave HYDRATING cleanser. If the skin is very inflamed and irritated, then you should use Albolene moisturizing cleanser. This is an old-fashioned product that women still use to remove their makeup. It acts as a cleanser, and leaves additional moisture behind.

2. Stop any moistened wipes. If you have residual stool that remains in the perianal area and continues to irritate the skin there, which is common, then you should either use plain water to rinse the area and then pat dry, or you may moisten regular toilet paper with water. You may also use Albolene on toilet paper to remove residual stool.

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3. Stop using any and all over-the-counter medications, including numbing creams, antibiotic creams, Benadryl cream, tea tree oil, or other. Use only the medications prescribed or recommended by your physician.

4. Stop all current moisturizers. Use only pure Vaseline petroleum jelly [make sure no added fragrance or flavorings]. The Vaseline also creates a type of barrier for the genital or perianal skin, which helps protect the area from irritation by urine or stool.

4. Avoid all fragranced products, including body sprays, bubble bath, laundry detergent, or scented or deodorant sanitary pads or tampons. Some laundry detergents that are fragrance-free are Tide Free, All Free and Clear, and Cheer Free.

5. Use only white cotton underwear.

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For more product recommendations, please see this page on hypoallergenic skin care products