Persistent Perineal Tears
Hello everyone, I'm a 20-year-old woman standing at 5'3" and I have an allergy to amoxicillin. Since October 2024, I've been facing a puzzling and ongoing issue involving my perineum that I haven't seen described elsewhere, leaving me quite perplexed. It began with what appeared to be a small rash on my perineum, which I initially attributed to dryness. I treated it with vitamin E oil and thought it would resolve on its own. Approximately ten days after undergoing a Brazilian wax, the rash began to develop into something resembling warts, presenting as raised scabs that wouldn't come off. This led me to speculate that it might be HPV. In December, I stumbled across information online that suggested apple cider vinegar could assist with warts. I decided to soak a tissue in it and applied it to the area for several hours, sometimes even overnight. To my delight, the bumps vanished completely. I believed I had found a solution, but shortly thereafter, around Christmas, I noticed the area starting to crack and tear. Additionally, I experienced inflammation and soreness around my anus. Due to the holiday season, I was unable to secure a doctor's appointment, so I returned to using vitamin E, although it provided little relief. The tear would heal, only to reappear in precisely the same location. By March 2025, I finally had a swab taken, which came back negative for HSV. While I do possess HSV-1 antibodies from childhood cold sores, it has been years since my last outbreak. My doctor prescribed a 5% lidocaine cream, and my mother suggested Desitin. This combination proved helpful, allowing the lesion to heal within a day or two without recurring for several weeks. Nevertheless, the issue persists. My gynecologist indicated that it might be a fungal infection and prescribed oral fluconazole, but that treatment did not yield any results. Currently, I’m writing this while dealing with yet another tear in the same spot. The affected area isn’t particularly itchy but has a stinging and burning sensation akin to a raw cut, and the lesions consistently emerge in this particular location. The condition worsens after long working hours, heavy sweating, or prolonged sitting. There's never been any blistering, scabbing, or oozing; it resembles more of a shallow canker sore than anything else. I have also tested negative for all STDs. Has anyone else experienced a situation like this? Could it be fungal, chronic irritation, lichen, or possibly something else altogether? I'm simply seeking some clarity.
Answers (1)
7/13/2025, 4:30:47 AM
OpenHealth AI
It sounds like you’re experiencing a frustrating and uncomfortable condition involving persistent perineal tears and irritation. These symptoms can stem from multiple causes, including persistent skin irritation, friction, and possibly even underlying dermatological conditions. Let’s break this down.
Main Points:
- Your symptoms could be due to chronic irritation or friction rather than an infection since treatments for infections have not helped.
- You may need to enhance protective measures for the area and consider lifestyle changes to reduce irritation.
Explanation:
Your initial rash and subsequent developments indicate a possible cycle of irritation or trauma, particularly after activities like waxing or prolonged sitting. The fact that treatments for fungal infections and herpes simplex have not improved your symptoms suggests that this may not be an infectious process but instead a reaction to friction, dryness, or skin sensitivity. Your use of vitamin E oil and Desitin shows proactive measures, but the recurring nature of the tear hints at the need for a more robust strategy.
Next Steps:
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Optimize Moisture and Protection:
- Barrier Cream: Continue using your 5% lidocaine cream for pain relief, and consider applying a physical barrier cream like Aquaphor or a zinc oxide cream (like Desitin) after cleaning the area, especially before extended sitting or activity.
- Hydration: Ensure the area remains well-hydrated and avoid using highly fragrant products or soaps that can further irritate the skin.
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Reduce Friction and Irritation:
- Loose Clothing: Wear loose-fitting, breathable cotton underwear and pants to minimize friction in the perineal area.
- Sitting Even for Long Hours: Consider using cushioned seating or standing breaks during long periods of sitting to alleviate pressure on the area.
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Track Symptoms:
- Keep a diary noting any changes in your symptoms, activities, and products used to identify potential triggers or patterns. This may help when discussing the issue with a healthcare provider in the future.
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Follow-Up Appointments:
- Since your symptoms are persistent, consider seeking a referral to a dermatologist who specializes in skin conditions. They can assess for other possible diagnoses such as lichen sclerosus or other dermatoses and may recommend management strategies such as topical corticosteroids.
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Consider Dietary Changes:
- If the issue worsens with sweating or after eating certain foods, consider evaluating your diet to rule out potential allergens or irritants that might contribute to inflammation.
Always remember that your body’s response is uniquely yours, and sometimes conditions can take time to resolve. If symptoms worsen or new ones develop, seek medical attention promptly. Don't hesitate to reach out if you need further clarification or support!
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