Genital skin care fact sheet

What is this?

Dermatitis, candida (thrush) or tinea infections can cause the genital skin to itch. Herpes and syphilis can also cause itch and soreness. It is important to see your doctor to get a diagnosis for your symptoms.

To maintain good genital skin care, follow the advice below.

How to wash your genital skin

As the genital skin and skin near the anus is very sensitive we recommend that you limit washing to once a day. Wash your genital skin with:

• warm water or
• a pH adjusted wash for sensitive skin. Many brands are available, such as Cetaphil®, QV®, Dermaveen®, Aveeno®, Hamilton® or
• use an unperfumed moisturiser, such as sorbolene or aqueous cream

Avoid irritants

The more ingredients a product contains, the more likely it will cause irritation. Anything that lathers will remove healthy oils from the skin.

Potential irritants include:

• soaps, shower gels and bubble baths, feminine hygiene products
• cleansing wipes (for example, baby wipes)
• daily use of panty liners; limit use of pads and panty liners to periods
• perfumed products
• tea tree oil and other disinfectants
• medicated topical treatments, unless prescribed by your healthcare professional
• fabric softeners
• douches
• black underwear, some people may have a dye allergy

Protect the skin and keep it dry

Avoid situations where the genital skin is wet for long periods of time. When the skin is wet for a long time, with water, sweat or urine, the skin becomes weaker. This increases the risk of irritation, dermatitis and infection. Moisturise skin if it is dry.

General recommendations include:

• remove wet swim wear or gym clothes as soon as possible
• carry spare underwear to change into if your underwear becomes damp
• avoid underwear made from synthetic fabrics such as polyester, lycra and spandex
• wear cotton underwear, avoid black if there is a suspicion of dye allergy
• if you experience urine or faecal incontinence or diarrhoea, use a barrier ointment to protect the skin. Change continence pads regularly. Consider seeing a continence physiotherapist
• consider protective ointments before exercise
• ointments don't contain preservatives, unlike creams, and are less likely to be irritating. Ointments also protect better against wetness than creams
• use regular moisturisers such as Vaseline®, Dermeze®, and zinc paste

Reduce friction or rubbing

Try not to scratch or rub at irritated skin. Skin damaged by friction and rubbing is more easily infected by common skin bacteria and yeasts that otherwise would not cause a problem. Scratching can also lead to thickening of the skin and nerve fibres. This may increase itching and encourage the itch-scratch cycle, especially at night and if you have a tendency to hay-fever and asthma.

To help reduce itching you can:

• avoid rubbing the genital skin with a washcloth or paper – use water if possible
• pat dry rather than rubbing with a towel
• avoid shaving and waxing the genital area
• avoid tight clothing
• pads and liners can chafe as well as cause allergies
• if you are scratching at night, cut your nails and wear loose underwear to bed. If you wake scratching, get out of bed and cool the skin
• keep cool – avoid electric blankets and hot showers or baths
• use distraction or relaxation techniques when you get the urge to scratch
• you may find anti-histamines helpful. To start with, try a once a day non-sedating antihistamine, but discuss a night time sedating one with your doctor

Sexual activity and genital skin care

• Water based lubricants are recommended with condoms but can dry to an irritating powder. After sex, rinse any lubricant residue off with water and moisturize the genital skin. Experiment with various brands of water based lubricants.
• If condoms are not needed, vegetable oils will be less irritating and may lubricate for longer. Suitable vegetable oils include: Almond, Olive, Coconut and Crisco vegetable oil.
• Oils can weaken condoms, so oil should not be used as a lubricant with condoms.
• Keep intercourse brief.
• If using condoms and the various water based lubricants irritate your genital skin, but dryness is a problem, discuss this with your partner. If you are relaxed and well aroused the need for a lubricant may be less. If you still need a lubricant, consider the oils above.

Genital first aid for moist, inflamed and split skin

Salt water baths or soaks help with healing, are soothing and reduce risk of infection. To prepare a salt bath:

• add a fistful of salt to a shallow bath and soak, or
• mix 1 level teaspoon of salt into 1 litre of cool water, soak a washcloth and apply to genital skin for 5-10 minutes
• pat genital skin dry
• repeat for 3-5 days

Potassium permanganate solution can be used as a wet soak:

• Potassium permanganate crystals can be bought from a pharmacy
• A potassium permanganate solution is made by dissolving crystals or powder in water aiming for a 1-in-8,000 solution
• Cotton balls or fine gauze cloth should be soaked in the solution and applied to the affected skin for 5-10 minutes
• Potassium permanganate soaks are not suitable for dry skin conditions
• Make sure that the crystals or powder are fully dissolved before using the solution
• Note that potassium permanganate may leave a brown stain on skin and nails as well as the container holding the solution. Apply soft paraffin to nails before treatment to prevent staining

Pain on urinating or with bowel actions

Urine or faeces on broken skin can hurt. Drink plenty of water to keep urine dilute and avoid constipation. Consider applying Vaseline® or a local anaesthetic gel or ointment to the skin 10 minutes before toileting. If you have a vagina, lean forward when urinating to avoid urine dripping backwards onto inflamed skin. For extensive ulcers, try urinating in a bath of water.