Health, fitness and Food

Managing Eczematous dermatitis

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– AN EMBARRASING  PROBLEM


Any woman who suffers from itching in the private parts of her body, (genitals and around buttocks) can be embarrassed if in company. She has to suffer silently because she cannot lower her dignity by scratching in public. Privately also it is a suffering, scratching such a delicate part of the body tends to cause much pain. In addition, infection can set in while scratching, leading to boils and other problems.

Genital itching is due to wide variety of reasons, the most common being infection. Fungal infections of the vulva or vagina like thrush or Taenia cause intense itching which is intermittent. There is no visible lesion, but in case of thrush there can be associated thick white discharge. Fungal infections of the genital parts can be isolated or part of generalised infection of whole body. Bacterial infections of genital parts can also be associated with pain and itching. In addition there can be associated boils or small abscesses on the private parts. The bacterial infection itself can cause abscess and also scratching can lead to it. Any sexually transmitted disease like syphilis, gonorrhoea, etc. can have itching as one of the manifestations. Viral infection like herpes genitalis causes minute vesicular eruptions and also itching over the genitals. Worms particularly pin worm infestation also cause intense itching on vulva, vagina and also anus. Scabies is commonly infection of the whole body, but at times may affect only genitals. This is especially found in women who have a good hygiene but are infected unknowingly.

Apart from poor hygiene, sexual contact with infected partner can also be a source of infection of private parts in women. Those that are immune depressed or diabetics are more prone to these infections. Eczematous dermatitis which is the result of allergy to certain substances can also occur in region of genitals causing intense pruritus.

Women that are in their menopause and after can suffer from itching without any infection. Depletion of estrogen levels in the body causes dryness of the vulva and vagina, which are otherwise moist. This dryness leads to itching which can be severe and worrisome at times. In this case, regular application of some light lubricating substance or estrogen creams provide relief in this condition but their long term benefit is disputed.

Whatever may be the cause, itching in the private parts creates a very embarrassing position for women. Some simple measures adopted are very useful to prevent these problems. Good hygiene of private parts helps in preventing settling of germs of any kind of infections. Washing the parts after urinating and sexual activity is desirable in this aspect. One needs to be cautious about hygiene during menses. Women are more prone to develop infection of the genital and urinary organs at this time because blood is a good medium for germs to grow. At all times one should strive to keep herself clean and dry. Hot water should be avoided to clean private parts as it could irritate the tender skin and aggravate pain and burning sensation. Ideally, cotton underpants should be used instead of nylon ones. Nylon panties prevent good ventilation of the skin and help germs to grow. If any infection is present even allergic

 

conditions like eczema, these infections will be aggravated by nylon type of clothing. If after observing all cautions the problem still persists, it is advisable to consult a doctor.



 


Dr Rachna Pande                                                                                 

Specialist – internal medicine

 

Musanze –  Rwanda

 

 

 

Diagnosis
The diagnosis of dermatitis is made on the basis of how the rash looks and its location. The doctor may scrape off a small piece of affected skin for microscopic examination or direct the patient to discontinue use of any potential irritant that has recently come into contact with the affected area. Two weeks after the rash disappears, the patient may resume use of the substances, one at a time, until the condition recurs. Eliminating the substance most recently added should eliminate the irritation.

If the origin of the irritation has still not been identified, a dermatologist may perform one or more patch tests. This involves dabbing a small amount of a suspected irritant onto skin on the patient's back. If no irritation develops within a few days, another patch test is performed. The process continues until the patient experiences an allergic reaction at the spot where the irritant was applied.

Treatment
Treating contact dermatitis begins with eliminating or avoiding the source of irritation. Prescription or over-the-counter corticosteroid creams can lessen inflammation and relieve irritation. Creams, lotions, or ointments not specifically formulated for dermatitis can intensify the irritation. Oral antihistamines are sometimes recommended to alleviate itching, and antibiotics are prescribed if the rash becomes infected. Medications taken by mouth to relieve symptoms of dermatitis can make skin red and scaly and cause hair loss.
Patients who have a history of dermatitis should remove their rings before washing their hands. They should use bath oils or glycerine-based soaps and bathe in lukewarm saltwater.

Patting rather than rubbing the skin after bathing and thoroughly massaging lubricating lotion or nonprescription cortisone creams into still-damp skin can soothe red, irritated nummular dermatitis. Highly concentrated cortisone preparations should not be applied to the face, armpits, groin, or rectal area. Periodic medical monitoring is necessary to detect side effects in patients who use such preparations on rashes covering large areas of the body.

Coal-tar salves can help relieve symptoms of nummular dermatitis that have not responded to other treatments, but these ointments have an unpleasant odor and stain clothing.
Patients who have stasis dermatitis should elevate their legs as often as possible and sleep with a pillow between the lower legs.

Tar or zinc paste may also be used to treat stasis dermatitis. Because these compounds must remain in contact with the rash for as long as two weeks, the paste and bandages must be applied by a nurse or a doctor.

Coal-tar shampoos may be used for seborrheic dermatitis that occurs on the scalp. Sun exposure after the use of these shampoos should be avoided because the risk of sunburn of the scalp is increased.

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