[22F] With red, itchy, and painful spot in perineal area

Patient Description

A 22-year-old female reports experiencing a singular red, itchy, and painful spot located between the vaginal opening and the anus for the past three days. The itching is described as burning and painful, similar to a blister caused by tight shoes. The patient has tried anti-itch cream, which provides some relief. The symptoms have worsened due to continued sexual activity. The patient has experienced similar itching before, but not as severe. The itching is intermittent, coming and going, with no additional symptoms reported.

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Arora's Assessment

What might be happening

Based on the information you have provided, here are some possible explanations for your symptoms:

  • Friction or Irritation: Given that you mentioned having lots of sex, the red, itchy, and painful spot could be due to friction or irritation from sexual activity. This can cause minor skin damage, similar to a blister from tight shoes.

    • Treatment: Typically, this can be managed by reducing friction, using lubricants during sex, and allowing the area to heal by taking a break from sexual activity.
  • Yeast Infection: Yeast infections can cause itching, burning, and redness in the genital area. While they often come with other symptoms like discharge, it's possible to have a localized infection.

    • Treatment: Over-the-counter antifungal creams or suppositories can be effective. If symptoms persist, a doctor can prescribe stronger medication.
  • Contact Dermatitis: This is a skin reaction to an irritant or allergen. It could be caused by personal care products, lubricants, or even laundry detergents.

    • Treatment: Identifying and avoiding the irritant is key. Topical corticosteroids can help reduce inflammation and itching.
  • Sexually Transmitted Infection (STI): Some STIs can cause itching, burning, and redness. It's important to consider this possibility, especially if you have had unprotected sex.

    • Treatment: A healthcare provider can diagnose and treat STIs with appropriate medications.

What you can do

While it's important to consult a healthcare provider for a formal diagnosis and treatment, here are some steps you can take in the meantime:

  1. Avoid Sexual Activity: Give the affected area time to heal by taking a break from sexual activity.
  2. Use Lubricants: If you resume sexual activity, use a water-based lubricant to reduce friction.
  3. Maintain Hygiene: Keep the area clean and dry. Avoid using harsh soaps or scented products.
  4. Over-the-Counter Creams: You can continue using anti-itch creams, but consider trying an antifungal cream if you suspect a yeast infection.
  5. Wear Loose Clothing: Opt for loose, breathable clothing to reduce irritation.
  6. Journal Your Symptoms: Use MDandMe to track your symptoms, any products you use, and your sexual activity. This can help identify potential triggers and provide useful information for your healthcare provider.

What you should look out for

Seek medical attention if you experience any of the following:

  • Severe Pain: If the pain becomes unbearable or significantly worsens.
  • Spreading Rash: If the red spot spreads or becomes more severe.
  • Discharge or Odor: If you notice any unusual discharge or foul odor.
  • Fever or Malaise: If you develop a fever or feel generally unwell.
  • No Improvement: If your symptoms do not improve with self-care measures.

Remember, while I can provide information and suggestions, it's important to consult a healthcare professional for a formal diagnosis and appropriate treatment.

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4 mo ago

People Also Ask


What are common causes of a red, itchy, and painful spot in the genital area?

Common causes include friction or irritation from sexual activity, yeast infections, contact dermatitis from irritants or allergens, and sexually transmitted infections (STIs).


How can I differentiate between a yeast infection and an STI based on symptoms?

Yeast infections often cause itching, burning, and redness, sometimes with a thick, white discharge. STIs may also cause similar symptoms but can include additional signs like unusual discharge, sores, or systemic symptoms like fever. A healthcare provider can perform tests to accurately diagnose the condition.


What are some effective home remedies for relieving itching and irritation in the genital area?

Home remedies include avoiding sexual activity to allow healing, using water-based lubricants to reduce friction, keeping the area clean and dry, wearing loose clothing, and applying over-the-counter anti-itch or antifungal creams.


When should I see a doctor for a persistent itchy and painful spot in the genital area?

You should see a doctor if the pain becomes severe, the rash spreads, you notice unusual discharge or odor, develop a fever, or if symptoms do not improve with self-care measures.


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