Management of genital dermatitis

Management of genital dermatitis includes general measures in addition to topical corticosteroids.

General measures include frequent use of emollients (usually a bland moisturiser such as aqueous cream), weight reduction in patients who are obese, and addressing incontinence if present.

Eliminate irritants and allergens if possible. Advise the patient to avoid:

  • applied substances (eg imidazole creams for misdiagnosed Candida, wet wipes, feminine hygiene products)
  • sanitary pads and panty liners
  • soap, excessive washing and bubble bath (use a soap substitute, or wash in a bath with bath oil)
  • tight occlusive clothing (eg nylon underwear, G-strings, lycra dance or sports clothes)
  • wet swimwear.

In addition to general measures and avoidance of irritants and allergens, use a topical corticosteroid. For genital dermatitis, use:

methylprednisolone aceponate (adult, or child 4 months or older) 0.1% ointment topically, once daily for 2 to 4 weeks until symptoms resolve methylprednisolone aceponate methylprednisolone aceponate methylprednisolone aceponate

FOLLOWED BY

hydrocortisone 1% ointment topically, once daily for 2 to 4 weeks to prevent recurrence. hydrocortisone hydrocortisone hydrocortisone

When the skin condition has returned to normal and the skin is no longer itchy, the patient should continue to avoid irritants and allergens, and use a bland barrier preparation (eg zinc-based emollient, liquid paraffin+petrolatum ointment) to protect the skin against moisture and friction.

Relapse is common with genital dermatitis; at the first sign of relapse, repeat the above course of topical corticosteroid.

If genital dermatitis is resistant to treatment, see Lack of response to treatment of dermatitis. If ordering repeat microbiological testing, ask the laboratory to report non–Candida albicans yeast species.