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Long Text Incoming. I'd Appreciate Any Thoughts And Ideas Here.

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Posted on Wed, 24 Jun 2020
Question: Long text incoming. I'd appreciate any thoughts and ideas here.

TLDR; I've been having issues with chronic redness of the skin between the outer and inner labia, sometimes these areas itch extrmely. So far all probes taken by my gyn showed nothing that substantial, I had bacterial infections and UTIs, and a ringworm infection in the past, those were all treated successfully. I started psychotherapy (mainly to deal with some trauma and issues with romantic/sexual relationships) and the redness appeared pretty much around the time I started dealing with these issues in therapy.

My symptoms have not changed so far. If increased itching occurs, I treat it with a "dequalinium chloride preparation" for 3-4 days. This generally tends to relieve the itching, but the redness itself never disappears, it also never feels fully "okay".

Here are two photos of the issue (NSFW): https://imgur.com/a/TkVOGbx

Long version:

For about 2 years I'm having issues with chronic redness of the skin between the outer and inner labia. The redness reaches up to the clitoris, but does not affect it directly. (See pictures, NSFW). Symptoms such as itching, dryness and abnormal heat of the reddened areas and neighbouring regions occur every few weeks. I've tried a number of things so far, but really with no lasting effects.

Serious problems in my intimate area started 9 months before the redness appeared:

In mid-October 2017 I was diagnosed with anal and vaginal infestation by an Ascaris lumbricoides (roundworm). I underwent two cures. A few weeks later I went to a gyn for the first time with cystitis. She also gave me some fungicides. The recurrent urinary tract infection returned 4-5 times, each time treated with antibiotics. A urologist finally helped me in January 2018, recommending methionine, strict fasting from alcohol and coffee, lactic acid bacteria build-up cure and a longer vitamin build-up cure. A doctor also explained to me that the roundworms could cause permanent changes in the intimate area. During the whole time I was sexually active with the same partner.

In July 2018 the described reddening of the skin between the inner and outer labia appeared for the first time as well as severe itching. After several prescribed Clotrimazole-based cures, a probe was taken. They found "Klebsiella pneumoniae" and "Enterococcus faecalis". An antibiotic was prescribed (Tavanic). In August 2018 another probe was taken, this time they found "Escherichia coli" and once again "Enterococcus faecalis". "Enterococcus faecalis" was found again in September 2018 in another vaginal probe which was diagnosed as bacterial vaginosis, it was then treated vaginally with dequalinium chloride in tablet form. In November 2018 I had sex and had an UTI afterwards.

In the swab cultures of December 2018 and February 2019, "Escherichia coli" and "Enterococcus faecalis" are always detected in moderate to sporadic numbers in culture samples of the vaginal flora. My gynaecologist tried various preparations - an estrogen cream to improve the flora, cortisone cream to exclude lichen sclerosus... Nothing changed my symptoms.

In August 2019, a test for chlamydia, syphilis and ganarrhoea was carried out, but it also came out negative. In the course of the probe test again a small number of "E. coli" and "Klebsiella pneumoniae" were detected, with the indication that this is a normal flora after an antibiotic treatment.

My symptoms have not changed so far. If increased itching occurs, I treat it with a "dequalinium chloride preparation" for 3-4 days. This generally tends to relieve the itching, but the redness itself never disappears, it also never feels fully "okay".

Additional aspect: In XXXXXXX 2018, I started a psychotherapy based on depth psychology, with the diagnosis of adjustment disorders, which mainly occur in the form of cleavage defence in the area of partnership and erotic relationships. I understand from my own handling of the vaginal symptoms that their occurrence (increased itching) also has a psychosymptomatic component. However, I cannot say exactly how large this component is and how it relates to the redness.
doctor
Answered by Dr. Olgeta Xhufka (1 hour later)
Brief Answer:
It can be a yeast infection.

Detailed Answer:
Hello dear, welcome to Ask a doctor's service.
I read all your long history and yourr concerns and here is my advice.

I believe it can be a yeast infection ( candida) reoccurrence .
It would be better it I see the pictures but I can't see them so you upload them on reports or send them on YYYY@YYYY .
Being overweight, sweating often and having increased moist in that area can cause the reoccurrence. I don't find it related to any other previous parasitic or bacterial infections you have had on past.
Having anxiety may increase the itching and discomfort but I believe the yeast infection is real and needs to be treated.
You can wash the area with gentle soap and dry it well. Use cotton underwear and talcum.
You may need to take oral antifungals such fluconazole (diflucan) single dose to treat it.
Hope I have answered the question.
Let me know if I can assist you further.
Above answer was peer-reviewed by : Dr. Nagamani Ng
doctor
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Follow up: Dr. Olgeta Xhufka (30 minutes later)
Hello,

Thank you for your answer.

I have uploaded the images now.

I had yeast infections in the past, and those have been resolved by taking antifungals. My gyn took probes and those showed no other problems afterwards. The redness is there all the time though.
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Follow up: Dr. Olgeta Xhufka (2 minutes later)
I am in a normal weight range and normal BMI, I don't sweat more than I did before these issues started. I've been extremely hygenic for the past 2 years now, using only unparfumed gentle soap, only wearing cotton, etc. So I am not sure if it's really yeast.
doctor
Answered by Dr. Olgeta Xhufka (11 minutes later)
Brief Answer:
Looks like fungal infection.

Detailed Answer:
Hello dear and thank you for asking again.
I see the photos you attached and labia of your vagina and clitoris are red. Taking count of the itching together with redness makes it seem as a yeast infection.
You had it in the past and cured it but the yeast infection can happen again as a reoccurrence.
Continue to use gentle soap and use cotton underwear to reduce excessive moisture.
You can use clotrimazole cream for 7 days or diflucan tablet as a single dose.
I believe that anxiety is making it seem worse so treating anxiety also may affect the itching.
Note: Hope the answers resolves your concerns, however for further guidance of skin related queries consult our Dermatologist.Click here to book a consultation

Above answer was peer-reviewed by : Dr. Nagamani Ng
doctor
Answered by
Dr.
Dr. Olgeta Xhufka

General & Family Physician

Practicing since :2011

Answered : 10166 Questions

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Long Text Incoming. I'd Appreciate Any Thoughts And Ideas Here.

Brief Answer: It can be a yeast infection. Detailed Answer: Hello dear, welcome to Ask a doctor's service. I read all your long history and yourr concerns and here is my advice. I believe it can be a yeast infection ( candida) reoccurrence . It would be better it I see the pictures but I can't see them so you upload them on reports or send them on YYYY@YYYY . Being overweight, sweating often and having increased moist in that area can cause the reoccurrence. I don't find it related to any other previous parasitic or bacterial infections you have had on past. Having anxiety may increase the itching and discomfort but I believe the yeast infection is real and needs to be treated. You can wash the area with gentle soap and dry it well. Use cotton underwear and talcum. You may need to take oral antifungals such fluconazole (diflucan) single dose to treat it. Hope I have answered the question. Let me know if I can assist you further.