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What Is The Cause And Treatment For Recurring Vaginal Atopic Dermatitis?
Question: Hi! I am having a problem with recurring vaginal atopic dermatitis. I've been living with this for almost seven months. I have seen two gynecologists and have been under the treatment of a dermatologist since January. The rash is on the perineum as well as the labia. I have had numerous std tests done and they have all come back negative.. until February when I had a positive hsv1 test. Since February, I have had a tiny ulceration below my clitoris that has not gone away either. I recently had it swabbed for hsv1 and it came back negative, but it had also been months since it started. The doctor said it could be a false negative or it could be from the dermatitis. To continue on, my boyfriend not only gifted me with the lovely cold sore, but also with a hpv infection that happened last month. My dermatologist removed the warts with nitrogen and I have not had any issues.. Other than slight scarring.
I'm not sure if this is related to the dermatitis hpv or if it's my hemorrhoids speaking, but my anus has also been extremely itchy and uncomfortable.. More so than the dermatitis actually.
I have been uncomfortable now for 7 months.. With a red itchy sometimes sore vagina. The base issue is the dermatitis.. And the doctor said the compromised condition of my skin could have been the reason the other two infections happened.
So to sum it up..
Atopic dermatitis - 7 months
Cold sore/ulceration- 3 months
Hpv- one month (the gyno said there are zero signs of anything.. But I happen to think that's what is causing the itching)
I have tried everything and have put myself under great stress trying to figure this out. I have been celibate for months.. Have changed my diet and sleep patterns. I have bought every supplement possible to try and boost my immune system so my body can better heal. For the past month I've been drinking water heavily as well as taking biotin lysine and vitamin e.
I don't have insurance and this whole ordeal has gotten very expensive. After two tubes of betamethasone ointment, my doctor gave me elidil. Which is amazing.. But only temporarily. I have gone through two tubes and the skin has still not fully healed. The medication is also very expensive!
I work on my feet about 60 hours a week.. Normally in tighter pants. A long night at work can make this feel unbearable.. As does a yeast infection. Sometimes even wearing underwear will make it flare up! I have been moisturizing with coconut oil and started using sea buckthorn seed oil two days ago.. But I think it may have caused a yeast infection (my whole family is prone to them). I have been breaking open vitamin e capsules and applying that daily as well. A combination of the elidil(which I am currently out of) and vitamin e seems to work the best... But nothing has relieved my symptoms completely.
I understand this seems like a lot, but I don't know what to do anymore! I want to feel normal again and not have to spend a fortune treating this. I am looking for alternative options here. I've spent many days crying and worrying about this... Please help!!
I'm not sure if this is related to the dermatitis hpv or if it's my hemorrhoids speaking, but my anus has also been extremely itchy and uncomfortable.. More so than the dermatitis actually.
I have been uncomfortable now for 7 months.. With a red itchy sometimes sore vagina. The base issue is the dermatitis.. And the doctor said the compromised condition of my skin could have been the reason the other two infections happened.
So to sum it up..
Atopic dermatitis - 7 months
Cold sore/ulceration- 3 months
Hpv- one month (the gyno said there are zero signs of anything.. But I happen to think that's what is causing the itching)
I have tried everything and have put myself under great stress trying to figure this out. I have been celibate for months.. Have changed my diet and sleep patterns. I have bought every supplement possible to try and boost my immune system so my body can better heal. For the past month I've been drinking water heavily as well as taking biotin lysine and vitamin e.
I don't have insurance and this whole ordeal has gotten very expensive. After two tubes of betamethasone ointment, my doctor gave me elidil. Which is amazing.. But only temporarily. I have gone through two tubes and the skin has still not fully healed. The medication is also very expensive!
I work on my feet about 60 hours a week.. Normally in tighter pants. A long night at work can make this feel unbearable.. As does a yeast infection. Sometimes even wearing underwear will make it flare up! I have been moisturizing with coconut oil and started using sea buckthorn seed oil two days ago.. But I think it may have caused a yeast infection (my whole family is prone to them). I have been breaking open vitamin e capsules and applying that daily as well. A combination of the elidil(which I am currently out of) and vitamin e seems to work the best... But nothing has relieved my symptoms completely.
I understand this seems like a lot, but I don't know what to do anymore! I want to feel normal again and not have to spend a fortune treating this. I am looking for alternative options here. I've spent many days crying and worrying about this... Please help!!
Brief Answer:
Relax, take a deep breath & done Give up!
Detailed Answer:
Hi there XXXX
I do understand what you are going through as I deal with this in my practice every day & truly empathise with you.
Stop & take a rain check!
I do hope that boyfriend who gifted you the HPV et HSV has been chucked out & do always practice safe sex from now on & use protection even if a steady friend concerned...for 3 reasons: 1. Not to spread the virus 2. Not to aquire more of the virus & increase your load that sometimes happens 3 Not to aquire any new virus.
I understand Elidel is expensive...use it sparingly when the redness starts to appear in future. It is of no use in a full blown eczema. Here only a steroid-antibiotic combination (eg Fucicort from Leo pharmaceuticals) will help.
I do understand you are looking for some long term relief & the HSV is clouding things.
Give this cream a try : ATODERM P.O. ZINC from a company called BIODERMA.
I have found this cream highly effective in 70% or so of my patients with Atopy more as a "preventive" measure & as a "protective" measure & may help solve your pant/work/friction related issues & can be used liberally & daily as it contains no steroid.
For the yeast infection currently take a single 200mg Fluconazole tablet with food (Once only).
Do try avoiding tight pants but understand it may be difficult given your job description.
Stop experimenting too much...sometimes 'overkill' is worse as I believe are 'gynecologists' ;-) (just kidding)
As for the Herpes & HPV, the former is pesky & keeps recurring but take comfort in that it is present in about 70% or more of the world population & HSV1 need not be transmitted through sex only. Having said that oral sex too can contribute if you have been indulgent. If it appears, keep a 5% Acyclovir ointment ready & the sooner you start applying it 4-5 times daily on the spot that herpes appears, the better you will feel...do apply it on the ulcerated area too inspite of swab being negative.
On that topic, have you had any anal sex & if so, that can explain the irritation at that end. If not, then perhaps it is a general stress that is aggravating it &/or a pin worm infection. It would not hurt to take a single 400mg tablet of Albendazole (Zentel) & repeat this after 6 months.
I understand it is expensive to visit docs regularly & you want to feel normal again. Do consider a Holiday to Bangalore/Kerala in XXXXXXX that you can combine with a medical tourism & get some alternative branches of medicine to look into your issue & this may be a worthwhile option exploring going forward.
Stress is a major issue & perhaps a 2 week holiday is just what the doctor ordered!
Get your mind off the region & focus on something you enjoy doing & that relaxes you even if it is sex. Believe me, it will get better with time.
Do always wear cotton underwear & avoid tampons & panty liners for sometime till things settle down.
Trust I have addressed each point you are concerned about & I shall leave you with a thought to consider : " I always wondered how I could go through life as a kid with one hand till one day I met a gentleman in the railway station with no arms "
Good Luck & do Hope your issues will be sorted soon.
Cheers!
Dr Praveen Rodrigues MD
Relax, take a deep breath & done Give up!
Detailed Answer:
Hi there XXXX
I do understand what you are going through as I deal with this in my practice every day & truly empathise with you.
Stop & take a rain check!
I do hope that boyfriend who gifted you the HPV et HSV has been chucked out & do always practice safe sex from now on & use protection even if a steady friend concerned...for 3 reasons: 1. Not to spread the virus 2. Not to aquire more of the virus & increase your load that sometimes happens 3 Not to aquire any new virus.
I understand Elidel is expensive...use it sparingly when the redness starts to appear in future. It is of no use in a full blown eczema. Here only a steroid-antibiotic combination (eg Fucicort from Leo pharmaceuticals) will help.
I do understand you are looking for some long term relief & the HSV is clouding things.
Give this cream a try : ATODERM P.O. ZINC from a company called BIODERMA.
I have found this cream highly effective in 70% or so of my patients with Atopy more as a "preventive" measure & as a "protective" measure & may help solve your pant/work/friction related issues & can be used liberally & daily as it contains no steroid.
For the yeast infection currently take a single 200mg Fluconazole tablet with food (Once only).
Do try avoiding tight pants but understand it may be difficult given your job description.
Stop experimenting too much...sometimes 'overkill' is worse as I believe are 'gynecologists' ;-) (just kidding)
As for the Herpes & HPV, the former is pesky & keeps recurring but take comfort in that it is present in about 70% or more of the world population & HSV1 need not be transmitted through sex only. Having said that oral sex too can contribute if you have been indulgent. If it appears, keep a 5% Acyclovir ointment ready & the sooner you start applying it 4-5 times daily on the spot that herpes appears, the better you will feel...do apply it on the ulcerated area too inspite of swab being negative.
On that topic, have you had any anal sex & if so, that can explain the irritation at that end. If not, then perhaps it is a general stress that is aggravating it &/or a pin worm infection. It would not hurt to take a single 400mg tablet of Albendazole (Zentel) & repeat this after 6 months.
I understand it is expensive to visit docs regularly & you want to feel normal again. Do consider a Holiday to Bangalore/Kerala in XXXXXXX that you can combine with a medical tourism & get some alternative branches of medicine to look into your issue & this may be a worthwhile option exploring going forward.
Stress is a major issue & perhaps a 2 week holiday is just what the doctor ordered!
Get your mind off the region & focus on something you enjoy doing & that relaxes you even if it is sex. Believe me, it will get better with time.
Do always wear cotton underwear & avoid tampons & panty liners for sometime till things settle down.
Trust I have addressed each point you are concerned about & I shall leave you with a thought to consider : " I always wondered how I could go through life as a kid with one hand till one day I met a gentleman in the railway station with no arms "
Good Luck & do Hope your issues will be sorted soon.
Cheers!
Dr Praveen Rodrigues MD
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Thank you for the quick response and for the other treatment options.
I have indeed had a full std screen since breaking up with my boyfriend:) All is well.
There had been no anal sex.. Ever. And my doctor insists that it's nothing. So I'm hoping it goes away. Ice seems to help.
There is some concern with the ulceration as my doctor is starting to doubt whether it is from the hsv1.. He had a cold sore the week before oral sex.. But there was never a confirmation as to where I had contracted it. My blood test just came back positive for it.. It hurts on the inside sometimes. I feel like it's location(tucked in a crevice) makes it harder for it to heal.. Always moist etc..
The dermatitis was pretty severe in January and I guess this very well could've part of it.. But does that ever happen with a cold sore? Would it stay there for 4 months? I should probably add that it's less than a mm in size.. But nonetheless, it's there.
Also.. In your experience, as far as the dermatitis goes, how long can something like this take to clear up? Is it safe to use products like elidil long term?
I have had eczema on my face and hands before.. Do you think this is what the dermatitis has turned into?
And could you please offer me advice on where to look into "medical tourism" as you called it? Please and thank you:)
I have indeed had a full std screen since breaking up with my boyfriend:) All is well.
There had been no anal sex.. Ever. And my doctor insists that it's nothing. So I'm hoping it goes away. Ice seems to help.
There is some concern with the ulceration as my doctor is starting to doubt whether it is from the hsv1.. He had a cold sore the week before oral sex.. But there was never a confirmation as to where I had contracted it. My blood test just came back positive for it.. It hurts on the inside sometimes. I feel like it's location(tucked in a crevice) makes it harder for it to heal.. Always moist etc..
The dermatitis was pretty severe in January and I guess this very well could've part of it.. But does that ever happen with a cold sore? Would it stay there for 4 months? I should probably add that it's less than a mm in size.. But nonetheless, it's there.
Also.. In your experience, as far as the dermatitis goes, how long can something like this take to clear up? Is it safe to use products like elidil long term?
I have had eczema on my face and hands before.. Do you think this is what the dermatitis has turned into?
And could you please offer me advice on where to look into "medical tourism" as you called it? Please and thank you:)
Brief Answer:
Apply the 5% Acyclovir cream for the sore
Detailed Answer:
Hey XXXX
Glad you seem to have taken it in your stride to go forward.
As for the ulcer, do try using the 5% Acyclovir ointment on the region 4-5 times/day & see if it heals. If HSV related, it should settle.
Also may be worthwhile to do a serum (blood) HSV1 & 2 Ig G & IgM assays. This will not only tell you if the infection was recent or old , it will also give you a titer for future reference & to see if treatments work.
Dermatitis & Eczema are synonymous more or less...so don't worry about it. It appears you are an atopic individual & emollients will have to be your best friend to 'prevent' the eczemas from occurring; also use cleansers like Dove & avoid 'detergents' even in the sensitive areas.
Atopy is an ongoing process so there can never be any clear marker for clearance but if you think positive, avoid a few things (you will have to do some blood & skin tests' & we could do them here in XXXXXXX if you wish on your holiday) & moisturize well & make sure you use protection during sex, you should be fine. XXXXXXX Hospital, XXXXXXX where I work does dabble in medical tourism but I dare say if you booked your own stay & couple that will travel et al you could save some. It all depends on what your interests' are..do let me know & if you wish, I could guide you on a personal level on my time just to help you out as you seem to have had a rough time in the recent past.
Glad your issues all settled & this too shall pass.
Cheers.
Dr Praveen Rodrigues MD
Apply the 5% Acyclovir cream for the sore
Detailed Answer:
Hey XXXX
Glad you seem to have taken it in your stride to go forward.
As for the ulcer, do try using the 5% Acyclovir ointment on the region 4-5 times/day & see if it heals. If HSV related, it should settle.
Also may be worthwhile to do a serum (blood) HSV1 & 2 Ig G & IgM assays. This will not only tell you if the infection was recent or old , it will also give you a titer for future reference & to see if treatments work.
Dermatitis & Eczema are synonymous more or less...so don't worry about it. It appears you are an atopic individual & emollients will have to be your best friend to 'prevent' the eczemas from occurring; also use cleansers like Dove & avoid 'detergents' even in the sensitive areas.
Atopy is an ongoing process so there can never be any clear marker for clearance but if you think positive, avoid a few things (you will have to do some blood & skin tests' & we could do them here in XXXXXXX if you wish on your holiday) & moisturize well & make sure you use protection during sex, you should be fine. XXXXXXX Hospital, XXXXXXX where I work does dabble in medical tourism but I dare say if you booked your own stay & couple that will travel et al you could save some. It all depends on what your interests' are..do let me know & if you wish, I could guide you on a personal level on my time just to help you out as you seem to have had a rough time in the recent past.
Glad your issues all settled & this too shall pass.
Cheers.
Dr Praveen Rodrigues MD
Note: Hope the answers resolves your concerns, however for further guidance of skin related queries consult our Dermatologist.Click here to book a consultation
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Answered by
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