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The skin down there

Taking care of delicate business

By Corinna Arcellana-Nuqui

APRIL 2012 

skin down there

The words for it seem so clinical in English: warts, rashes, discharge in the vaginal or anal area. In practice and actual conversation, though, shyness can get in the way. OB-GYN Ma. Alexandra Esmundo-Umali, M.D. and dermatologist Ma. Carmina Zubieta-Nuqui, M.D. provide some answers to common questions:

A rash in the anal-genital area is uncomfortable and has not cleared up in a week. What should one do?

Get a consultation with an OB-GYN or a dermatologist. Don't go combing the Internet, or polling your intimate friends regarding what to do.

A little knowledge can be more dangerous than none at all. For example, to the question "How do I treat this itch which I am guessing is a yeast infection?" The Internet yields all kinds of answers and can confuse the reader even further.

Now as to some of the more frequently asked questions: Do you drink yogurt or smear it on your vulva to make the pH more acidic? Do you push in an acidophilus suppository, or do you wash with vinegar? Do you buy the most popular cream for yeast at the drugstore, polling the counter pharmacist? The answer is “no” to all.

How can one tell if a rash points to a sexually transmitted infection (STI) or another kind of infection?

There are many factors involved when one has a rash. Be prepared to consult a qualified specialist and answer questions about your personal history and intimate habits. A complaint can be caused by either an allergic reaction, a parasitic infection, or a sexually transmitted disease. It's not up to the lay person to diagnose and distinguish the differences between infections—the golden rule is to do no harm to oneself and get qualified help.

Both the dermatologist and the OB-GYN stress that getting help at once can prevent complications and make diagnosis easier. It's all too common to have pride or shame get in the way, and to try self-medication or borrowing medicine from others to treat symptoms. An innocent rash caused by contact with a harsh feminine wash can cause a girl to scratch even more, leading to a secondary infection. Then she resorts to borrowing a steroid or antifungal cream from her mother and uses it for weeks—and the condition becomes chronic. By the time she consults a doctor, the obscuring secondary infections might just make it more challenging for even a qualified expert to uncover the cause of the rash in the first place.

Uninformed, unintentional harm

Then there’s the unintentional harm that one can bring about just by wanting to be "clean." Just to give an example of what can go wrong: A woman who had just given birth and still had episiotomy (incision made in the perineum) sutures wanted to keep clean, so she soaked her panty shield in isopropyl alcohol to sanitize it. The alcohol dissolved the sutures and the wound gaped open.

A woman removes the hair in her bikini area with wax strips at home. Later, a small bump in the hairless area swells and itches. Worrying it might be a sexually transmitted disease, she decides to open her browser and thinks about search terms. She spends hours looking at images and gets more scared and doesn't consult a doctor because she is sure it's worse to have anyone find out. Later, after consults with a dermatologist, she finds out it's an ingrown hair that caused an infection around the follicle. It's far better to face a doctor and get an experienced clinical eye to examine, rather than try armchair research.

For more information on these delicate female issues, get a copy of the April issue of HealthToday magazine, out now in newsstands and bookstores.

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