How to look after your genital skin?

Almost all conditions affecting genital skin will benefit by simple changes to routine skin washing:

• avoid soap (see soap substitutes) 
• keep to short, warm, not hot showers, and bathing (too hot will increase itch, too long causes more dryness) 
• plain or salt water (1/4 teaspoon/1 cup or 1-2 teaspoons/litre of warm water). This is especially good if various creams and lotions have irritated the skin.

Genital First Aid

• Salt water baths, 1 handful in a shallow bath, soak for 10-15 minutes, 2-3 times a day. Use if the skin is split, ulcerated, weepy or tender and swollen. 
  
• If urination is very painful, try passing urine in the bath, otherwise, coat the skin with zinc and castor oil cream or Vaseline and then try. 
• Pat dry gently and apply the medication or moisturiser immediately afterwards. 
• Bathing /soaking should usually stop after 3-4 days. Excessive soaks can over-dry the skin.

Soap substitutes

Soap substitutes can be used for otherwise intact but dry or irritated skin. Aqueous or Sorbolene creams are cheap and effective. Apply before the area is wetted and rinse off lightly. A slight greasy film should remain. Both are excellent moisturisers to be applied any time and very soothing if applied cold (refrigerated). 
 
Specific shower/bath lotions or oils are more expensive but easier to apply. Examples include: Cetaphil; QV; Alpha-Keri.

Generally dry skin

Generally dry skin can be caused by:

• increasing age
• family tendency
• low humidity 
• heaters/air conditioners 
• baths/showers - too long, too often, too hot 
• some diseases - diabetes, thyroid, kidney, liver.

 Avoiding the following can also help:

• shampooing in the bath or shower (washing hair over a basin is best) 
• hot or restricting nightwear / bedding / clothes /underwear 
• electric blankets 
• wool, nylon against the skin.

Barrier creams

Barrier creams can be used when the skin is exposed to excessive moisture. Watery perspiration or menstrual blood can eventually cause rubbing and irritation. Zinc and castor oil cream, or Vaseline will protect and lubricate the area, especially if pads are required. This can also be good when jogging, swimming, bicycling, etc, or if moisturisers do not provide long-lasting lubrication.

Sexual lubrication

• Dry sexual activity inevitably worsens most genital symptoms. Until confidence increases and pain decreases, discuss and plan that penetration will be brief, if at all. 
• Many conditions can reduce natural lubrication and sometimes extra lubrication may be needed. 
• If condoms are used it is important to use a water-based lube such as Astroglide, Wet Stuff or similar. These are all water-based and may dry out. 
• Where pregnancy and sexually transmitted infections are not a concern, and you are unable to tolerate other proprietary brands, a vegetable oil (eg. Olive oil) or a pure almond oil are more effective and longer lasting than a water-based gel or saliva. (Pre-test on a small area before using during sexual activity). These oils should not be used with condoms as they can weaken latex and cause the condom to break.

General information & products

• toilet paper — use unbleached and unperfumed 
• baby wet wipes (no perfume or alcohol) may be useful for wiping after a bowel motion 
• increase fluids (water, cranberry juice, herbal teas) to produce a less irritating and dilute urine. (Limit caffeine, cola & chocolate which act as diuretics. Excess chilli can cause perianal irritation) 
• avoid constipation or excessively soft bowel actions 
• try hypoallergenic washing detergents for underwear or use pure soap flakes and use an extra rinse cycle
• cotton underwear is best 
• avoid G-strings
• try stockings / knee highs instead of tights 
• avoid tight trousers.

For more information on skin conditions, see everybody's Skin Centre and the NZ Dermatological Society website, DermNet

Original material provided by Auckland Sexual Health Service. Reviewed by everybody, June 2008.