Brief Answer:
Let us start with camphor powder in coconut oil for the time being

Detailed Answer:
Dear XXXX,

I can empathize your situation. Itching is a highly irresistible feeling which puts one in a very embarrassing situation.

Since you have ruled out STDs and herpes, let us think of some simpler and commoner situations. If you answer following questions, I will be better of to come to some diagnosis.
1. Do you have any white discharge from vagina? if so please explain whether it is white or transparent (bacterial vaginosis) and if white is it flaky (candidiasis) or frothy greenish white (trichomonal)?
2. Do you have dark discolouration around your private parts and thighs, may be going up to your umbilicus (ring worm). Would it be possible for you to upload the photograph of the lesion for my review?
3. Do you see three pustules where you scratch? (mites)
4. Please also upload all the reports you have got.

The itchy lesions have to be described fully, and more important have to be observed to come to some diagnosis.

Meanwhile, you can make a paste of camphor powder in coconut oil and apply over the affected area. It will give you some temporary relief.

I have explained and guided you with whatever small information you had provided. Please furnish me with the required information and documents. I will be providing you more information you ask for and guide you for your treatment, XXXX.

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Brief Answer:
Multiple infections

Detailed Answer:
Dear XXXX,

Thanks a lot for giving so much of important information.

You are having multiple infections. Initially please clarify, when you say you have type 1, do you refer to HIV or Diabetes?

The flaky discharge you are having from vagina is a candidial discharge. Follow the following instructions :
1. These instructions and treatment is for both the sexual partners, to be followed simultaneously.
2. Anti fungal pessaries for you and cream for your partner.
3. Shave the private parts clean to avoid reinfection.
4. Everyday boil underclothes.
5. Clip the nails short.
6. Observe sexual abstinence till declared cured.
It takes about 10 days time for the treatment.

The pustular lesions which hurt you like a sting are mostly mites. Permethrin lotion can help you for this. Along with clean personal hygiene is most important.

However, If I can visualize the lesions, I can opine better.

Please update me with the required information so that I can clarify more. For any more information, I am always available for you, XXXX.

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Brief Answer:
Clotrimazole / Gentian violet

Detailed Answer:
Dear XXXXX,

I would have loved to prescribe you the medicines. There are few constraints:
1. You are in USA. USA does not recognize the prescription of the doctors from the rest of world. Even when I was in US and needed some medicines, I could not get them from the chemists shop. He would not honour my prescription.
2. I do not know the trade names of the medicines that I want you to take. Therefore I have informed you the generic names of the medicines.
3. Unless I see your pustular lesions, I cannot prescribe.

For your candidiasis, the OCM you can use is Gentian violate 1% application. However, it is too messy and stains the skin and clothes. The stains on the clothes are permanent while skin stains do not go by washing. Single application is sufficient.

If you can get Clotrimazole vaginal pessaries for you and cream for the partner, it is very convenient and non-messy. It is very effective also. You will have to put one pessary every day at bed time for 7 days should give you relief. I believe this is also over the counter medicine. I am providing you detailed instructions for using the pessary:

Just dip the pessary in the water to wet it only, do not hold in the water lest it dissolves. Then insert the pessary in your vagina and push it as deep as possible by your middle finger. After inserting the pessary, you should not get up; lie down, on your back for at least 2 hours, otherwise there is possibility of pessary falling out of vagina.

You will have to procure prescription for the other medicines from the local doctor .

Since you area known case of HSV1 and this viral infection is known to recur, the pustular rash is most likely to be herpetic. I will nor advise you to apply Permethrin to it unless the lesion is precisely diagnosed. I would have liked to see the photographs of all your lesions - close and zoom view. Repeated infection of HSV is due to diminished immunity. Have you got yourself tested for HIV. If not, please get tested and upload the reports for me to view them.

If you are happy with this discussion, you may please post your review and rate me with 5 stars.

If you want any more information, I am always available for you, XXXX.

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