Genital skin problems

Genital skin problems are very common and can be very uncomfortable, distressing and embarrassing. They can interfere with sexual functioning, self-image and interpersonal relationships. Some genital disorders are infectious, including sexually transmitted diseases.

This page provides links to information on DermNet about skin conditions affecting the genital area.

Many skin conditions result in itching (pruritus):

• Pruritus ani
• Pruritus vulvae in women and in children

Itch is commonly due to an dermatitis (eczema). The types of dermatitis most often affecting the genitals are:

• Lichen simplex (localised itch-scratch-itch response)
• Atopic dermatitis (widespread familial tendency)
• Seborrhoeic dermatitis (usually affects scalp as well)
• Irritant contact dermatitis (from wetness, incontinence, vigorous cleansing)
• Allergic contact dermatitis (most often due to perfumes or rubber)

Other skin conditions causing genital itch include:

• Psoriasis (persistent red scaly or moist patches)
• Lichen sclerosus (white scarred patches)
• Lichen planus

Some conditions tend to be more sore than itchy, especially:

• Aphthous ulceration
• Behcet disease
• Erosive lichen planus (which usually also affects the mouth)
• Plasma cell balanitis/vulvitis
• Desquamative vaginitis
• Crohn's disease, in which ulcers and granulomas arise
• Vulvodynia, most often presenting as provoked localised vulvodynia (vestibulodynia), generalised unprovoked vulvodynia (dysaesthetic vulvodynia) or pudendal nerve entrapment syndrome

Non-venereal skin infections may present in the genital area, presumably because of warmth and humidity.

Bacterial skin infections include:

• Boils (deep infection of hair follicle)
• Folliculitis (surface infection of hair follicle)
• Impetigo (school sores)
• Erythrasma (dry brown patches)
• Cutaneous tuberculosis

An overgrowth of the normal vaginal bacteria, lactobacilli, may cause cytolytic vaginosis. Replacement of lactobacilli by anaerobic bacteria may result in bacterial vaginosis, resulting in a frothy white discharge.

Conditions confused with bacterial infections in the groin:

• Balanitis
• Hidradenitis suppurativa
• Hailey Hailey

Fungal skin infections include:

• Tinea cruris (Jock itch)
• Vulvovaginal candidiasis (thrush) and cyclic vulvovaginitis

Rashes confused with fungal infections in the groin:

• Intertrigo

Viral skin infections include:

• Genital herpes
• Genital warts
• Herpes zoster
• Molluscum contagiosum

The groin is also a favoured site for some parasitic infestations:

• Pubic lice
• Scabies
• Schistosomiasis
• Amoebiasis
• Filariasis
• Leishmaniasis

Important sexually transmitted infections include:

• Syphilis
• Lymphogranuloma venereum
• Chancroid
• Granuloma inguinale (donovanosis)

Skin lesions:

• Angiokeratomas
• Pilar and epidermal cysts
• Pearly penile papules
• Penile intraepithelial neoplasia (squamous cell carcinoma in situ, Bowen disease of penis, erythroplasia of Querat)
• Bowenoid papulosis (precancerous plaques due to genital warts)
• Invasive squamous cell carcinoma (arising most often from genital warts, lichen sclerosus or lichen planus) and vulval intraepithelial neoplasia (squamous cell carcinoma in situ)
• Extramammary Paget disease
• Peyronie disease, in which a fibrous band appears on the penis
• Vulval labial melanotic macules (see DermNet's page about the lip freckle, labial melanotic macule)