Do I have heat rash in my lady bits? What do I do?

June 22, 2012 1:18 PM

Embarrassing lady business question. Specifically: heat rash (maybe?) on/in my vulva.

For several years now, whenever it gets hot and humid, I become very prone to getting painful areas in the crevasses of my vulva (between the inner and outer lips, for instance, or even on my clitoral hood -- yikes). They feel hot and look red, and hurt mostly only when touched or when they get wet (i.e. in the shower). I pretty much can't wear pants at all in the summer, and for the past year or so, I can't wear them year-round either without this problem happening. I know what a yeast infection feels like, and I don't think this is one, unless it's somehow happening solely on the outside of my vagina. I did show the rash to my gyno last year and she basically shrugged and told me to try diaper rash cream (which I haven't done).

I did see this previous question, which seems similar, though I don't itch, just burn, and my rash is in my vulval folds: http://ask.metafilter.com/182364/Stop-itching-please

Things I already do: Sleep naked; use unscented, dye-free detergents and soap; wear cotton underwear and skirts/loose clothing. Things I haven't tried: cornstarch-based baby powder; anti-fungal creams. My skin already feels irritated and I don't want to irritate it further. (Also, I, um, would like the area to remain nice-tasting. There, I said it.) Anyone have any experience with this? Advice? I have my annual gyno appt. next week but we're in the middle of a heat wave right now so I'd love to do something in the meantime... Thanks.

posted by anonymous to health & fitness (23 answers total)

I think the diaper rash cream may have been in case it was a friction irritation sort of thing, which I've gotten on my inner thighs (aka, "chub rub"), and I can vouch for how well diaper cream works. Although, that's an awfully weird place for that to be happening. But if your doctor said to try it, it couldn't hurt to at least try and see if it helps. (I hear you on the nice-tasting element, but it only took a few days to take care of things.)

Give it a shot.
posted by EmpressCallipygos at 1:26 PM on June 22, 2012

You might have a lichen. You get a cream and go about your life. See a Gyn.
posted by Ruthless Bunny at 1:27 PM on June 22, 2012

Oh, don't put talc on anything that might be fungal, fungi eat talc.
posted by Ruthless Bunny at 1:27 PM on June 22, 2012

Ouch!

Sounds like you're doing everything you can, but I'd try cornstarch baby powder for immediate relief. Then get a second opinion. Request some tests, too; it's possible you have a low-grade infection of some kind that is only symptomatic when you're sweating. Gardnerella comes to mind.
posted by Specklet at 1:28 PM on June 22, 2012

Sounds more like a bacterial infection. I get them in my nether regions (although more on my inner thigh area) sometimes in the hot weather when I've been sweating alot. All burning, no itching. For me, the most important thing is making sure I am completely dry down there after a shower. Completely. As in I use a hair dryer on the cool setting to make sure my whole external lady area is dry. Then I use antiperspirant on my inner thigh areas. For treatment, I use A&D ointment, which provides immediate relief, but can take several days to clear everything up. My mom has an actual prescribed ointment that she got from her dermatologist that works faster.

If it is bacterial, for the love of christ do not use a cornstarch powder. That will make it worse. Much worse.
posted by kimdog at 1:33 PM on June 22, 2012

On preview: perhaps trying diaper rash ointment/cream would be a better choice than a powder. I, too, seem to remember that hot and red skin on my lady parts was irritated by powder.

Also, Ruthless Bunny is incorrect: there is no such thing as a lichen infection. (There are skin conditions called lichen sclerosus and lichen planus, but they have nothing to do with lichen the biological entity.) And fungus does not eat talc; talc is one of the most frequently recommended topical treatments for fungal infections.
posted by Specklet at 1:40 PM on June 22, 2012

It sounds like yeast to me. Yeast infections can occur pretty much anywhere, and are especially prone to happen in warm, moist fold-y places--right where you're talking about. Itching is a common problem with them, but it's not something that everyone has, especially when the infection's on your skin.

Anyhow, you can buy an antifungal cream, and that should help clear it up. Totally don't use cornstarch, though I have friends who swear that talc-based powders help things clear up by keeping the areas drier. For severe problems, there are oral antifungals--it might be worth asking your GP about it.

(IANADoctor, I don't play one on television, etc.)
posted by MeghanC at 1:41 PM on June 22, 2012

I get something that might be heat rash and might be yeast from long motorcycle rides in very hot weather. Anti Monkey Butt Powder is very helpful for comfort, and I just use OTC antifungal cream for treatment.
posted by scratch at 1:50 PM on June 22, 2012

Also, Ruthless Bunny is incorrect: there is no such thing as a lichen infection. (There are skin conditions called lichen sclerosus and lichen planus, but they have nothing to do with lichen the biological entity.) And fungus does not eat talc; talc is one of the most frequently recommended topical treatments for fungal infections.

That's interesting because I got the lichen diagnosis from a gyn and the talc recommendation from a dermatologist.
posted by Ruthless Bunny at 2:03 PM on June 22, 2012

I would forgo the part about wanting to remain "nice tasting" until all this clears up, since you shouldn't be expecting ANYONE to go down on a rashy, irritated area.

Follow your doctor's advice. It sounds like you've done everything you can possibly think of EXCEPT following your doctor's advice. Why? What more do you think a bunch of internet strangers will have to offer you?

I bought diaper rash cream to use on swimsuit chafing last week. Worked like a charm!
posted by hermitosis at 2:04 PM on June 22, 2012 [4 favorites]

Organic coconut oil if you're naturally-inclined. Healing, helps with all kinds of infections. Smells lovely.
posted by mleigh at 2:21 PM on June 22, 2012

I get this if it's hot and I don't dry off completely before putting on my undies.

For short-term relief I would fill a bath tub with just enough cool to luke-warm water to cover your lady bits. Add in 4-5 tbsp of baking soda and soak for 10-15 minutes. Repeat as needed.

On Talc: I have never heard anything about fungi eating talcum powder, but my dermatologist is pretty anti-talc. She suggests talcum-free powders, and that these powders be used to prevent irritation and infection rather than treat it.
posted by OsoMeaty at 2:31 PM on June 22, 2012

Talc (a mineral) should never been used on or around female genitalia. It has been linked to reproductive system cancer (ovarian). Cornstarch powder is ok, talcum powder is not.
posted by quince at 2:53 PM on June 22, 2012 [6 favorites]

Yeah, no, I didn't mean to say that talc is the way to go, here; I agree it's not good for lady bits and is not a cure for fungal infections. Sorry for adding confusion.
posted by Specklet at 3:21 PM on June 22, 2012

I concur with MeghanC that it sounds like skin yeast. This can happen to me under my boobs during hot weather. I fight it by keeping my skin clean (including regular swipes with isopropyl alcohol) and dry (talc and antifungal medicated powder.)

I agree that it's probably a good idea to take it to your gyn, but if you want to try treating it at home, the miconazole-containing antifungal creams (look in the athlete's foot section) are what you want.

I personally don't get too worked up about the cancer risks involved in using talcum powder, because I don't put it directly on my vulva, and I don't feel the need to powder anything near my labia. Your situation is different and your mileage will vary. But I will tell you that if your problem is skin yeast, they will happily eat the yummy, yummy cornstarch if you go that route. There are antifungal powders also, but you can sidestep the whole powder issue with the creams.

I hope you find relief one way or another. Sounds miserable!
posted by Sublimity at 3:37 PM on June 22, 2012

An easy thing to try is switching to a soap with tea tree oil in it. It has antibiotic and antifungal properties and has worked wonders for me in the past when I've had these sorts of problems.
posted by zug at 4:48 PM on June 22, 2012 [1 favorite]

Specifically, Dr. Bronner's Tea Tree soap is what I've always used.
posted by zug at 4:49 PM on June 22, 2012

I actually get the same exact symptoms sometimes. Some monistat external cream for a few days usually helps.

However my symptoms have never persisted so long, so I would suggest trying the cream and then mentioning it to the gyn when you have an appointment (and skip using the cream maybe a day or two before the gyn visit).
posted by Lt. Bunny Wigglesworth at 5:49 PM on June 22, 2012 [1 favorite]

Arg, I need to proofread my posts. After using the cream my symptoms have ALWAYS cleared up - but I never got it diagnosed, so I'm not sure if it was fungal and it was actually just a short-term (week-lone) irritation that would have gone away had I not used the cream but it always went away after I started using the cream... sorry for the unintentionally vague "usually"
posted by Lt. Bunny Wigglesworth at 5:54 PM on June 22, 2012

If it's fungus, plain vinegar will clear it up. DON'T douche with it, just splash enough on to cover your whole vulva.
posted by brujita at 6:01 PM on June 22, 2012

...okay, one more....

Some antifungal creams will also include hydrocortisone in addition to miconazole - if you try one of those creams you might also reduce the irritation even if it is simple, non-infection related irritation. If you think it's this, one the symptoms clear up, perhaps use a lubricant for a few days to prevent the irritation again, and use gentle cleansers.
posted by Lt. Bunny Wigglesworth at 6:04 PM on June 22, 2012

It sounds like skin yeast to me, too, for what it's worth. My gynecologist recommended a dab or two of monistat cream and patience when I had similar symptoms.
posted by town of cats at 6:41 PM on June 22, 2012

Prescription clotrimazole (antifungal) has worked really well for me when nothing else is strong enough. I live in a humid climate and even my bf's foam matress causes big red patches on skin areas which get poor circulation at night. My GP prescribed it, and it's a cream most effectively applied right after showering.
posted by AnnaAnachronous at 7:32 AM on June 23, 2012