Irritation of the intimate areas: could it be vulvar eczema?

Irritation of the intimate areas can be triggered by numerous factors and is not necessarily indicative of eczema. Hygiene products and scented soaps can contain harsh substances that disrupt the natural balance of the vaginal flora, thus leading to irritation. Similarly, feminine hygiene products such as scented tampons or wearing overly tight underwear can cause irritation when they come into direct contact with the delicate skin of the intimate area.

These irritations can then lead to a fungal infection or a bacterial overgrowth. These often occur when the vaginal environment is unbalanced and certain populations of microorganisms living there are overrepresented. To avoid them, it is preferable to opt for sufficiently loose cotton underwear to allow air to circulate.

Finally, irritation of the intimate areas can be due to a dermatosis, such as the psoriasis or eczema. These skin conditions are both characterised by feelings of discomfort and itching and can affect different parts of the body, including the intimate areas. Whatever the cause of these irritations, if they do not naturally disappear after a few days, it is important to consult a healthcare professional. They will be able to determine the origin of the irritations and prescribe a suitable treatment to alleviate your discomfort.

Itching in the vulval area can be associated with vulvar dermatitis. This condition is often due to the intimate parts coming into contact with allergens. These can come from intimate creams, soaps, underwear or even the latex of condoms. Care products applied to the hands that come into contact with the genital areas can also be implicated. It is also possible that vulvar eczema is of atopic origin, that is to say, linked to an individual's genetic predisposition and very sensitive skin. However, this is less common for this type of eczema.

Vulvar eczema presents itself through the emergence of red patches covered with small vesicles on the vulva and at the entrance of the vagina. When the individual scratches, these vesicles rupture, causing a discharge and leading to the formation of crusts. It is also possible to develop eczema in the groin folds. The symptoms are then similar to those of eczema affecting the folds of the legs and arms.

However, it is important to note that the symptoms of eczema are similar to those of other skin conditions such as psoriasis. This is why a differential diagnosis must be carried out by a doctor to confirm whether it is indeed vulvar eczema or vaginal eczema. This diagnosis is made through a patient interview accompanied by a clinical examination. If contact eczema is suspected, patch tests are performed to identify the responsible allergen(s).

While vulvar and vaginal eczema are common in women, men can also be susceptible to this type of skin condition. In this case, it refers to eczema of the male intimate areas. Penis eczema is particularly prevalent and is characterised by red patches on the male genital organ. These can also be located on the pubic area and cause skin lesions. Similar to genital lip eczema in women, this disease causes itching and pain.

Genital eczema in men can also affect other areas of the intimate parts such as the testicles. The main cause of intimate area eczema in men is contact with allergens. It is indeed very rarely due to atopy. The main allergens responsible are latex found in condoms and certain substances contained in care products such as gels and soaps.

As soon as symptoms of intimate area eczema are identified, it is recommended to promptly consult a doctor. They will be responsible for the diagnosis to determine the causes of the irritation. They will prescribe a suitable treatment which it will then be important to follow through to the end, in order to prevent relapses. If the eczema is of allergic origin, it will be necessary to remove the causative agent from the daily life of the affected person.

In the event of eczema in intimate areas, you will likely be prescribed topical corticosteroids, that is to say cortisone-based creams. These medications have proven anti-inflammatory and soothing properties against eczema. In alternation with these creams, it is often recommended to apply more traditional emollients, that is to say rich-textured moisturising creams, in order to protect the skin and aid in its healing.

• GOLDENBERG G. & al. Eczema. The Mount Sinai Journal of Medicine (2011).

• BORRADORI L. & al. Dermatologie et infections sexuellement transmissibles. Elsevier Masson (2017).