Genital Dermatoses2019-11-08T17:40:17+00:00

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Genital dermatoses (or skin conditions that affect the genital area) can cause much discomfort and sometimes embarrassment

THESE CONDITIONS INCLUDE LICHEN SCLEROSUS, LICHEN PLANUS, ECZEMA AND PSORIASIS. IN THIS PAGE, I EXPLAIN THE SYMPTOMS AND CAUSES OF GENITAL DERMATOSES – AND HOW I TREAT THEM

Treatment helps people of all ages take control of their skin condition and get their life back.

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How do genital dermatoses impact people on a day-by-day basis?

THE DISCOMFORT CAN NOT ONLY BE PHYSICAL, BUT CAN ALSO IMPACT YOUR PERCEPTION OF YOURSELF AND YOUR SOCIAL LIFE

Symptoms of skin problems affecting the genitals include…

In some conditions, such as lichen sclerosus and lichen planus, the skin can progressively scar and lead to the fusion of the labia in women and phimosis (difficulty in retracting the foreskin) in men. Lichen planus can result in ulceration in the affected areas in both the vulval and vaginal region in women and the glans penis in men.

How does it feel?

You might experience itching, pain and inflammation of the affected skin and mucosal surfaces. You might feel pain when urinating and opening your bowels. You might experience pain during and following sexual intercourse, often resulting in trauma and small cracks to the affected skin.

Certain individuals may experience psychosexual difficulties

These can be due to either anticipation of pain and discomfort during sexual intercourse, or due to concerns regarding the appearance of the affected skin.

It can affect your mood and social life

Some people may experience an impact on their mood and social life due to the perception of stigma because the condition affects the genital skin.

Is there a cure?

Unfortunately, these types of skin problems are chronic. That means that they can flare up from time to time. Therefore, we need to treat them appropriately. Careful management of the condition should allow you to be symptom-free and reduce the number of flare ups you get in future to a minimum.

What my patients love about my service

MY PATIENTS ARE MY BEST PROMOTERS

Please pass on my thanks to Dr Pratsou for her assessment on my continued taking of roaccutane.

She was completely right, I didn’t need a new course, I needed to move away from the drug. The creams she gave me and Cetaphil recommendation have meant my skin has been the best it’s ever been (ongoing and since I saw her) ALL SUMMER :))))) I’ve had zero problems…and I’m loving it.

Thank you once again.


Phillip, Acne

“Dear Dr Pratsou,

Following the consultation today I feel it appropriate to say thank you for your help in dealing with my rosacea.

On each occasion, I have visited your department I have noticed the kindness and cheeriness of all the staff I have encountered and particularly wanted to say that you made me feel at ease with your calmness and excellent manner.

All is much appreciated.”


Anne, Rosacea

“Thank you very much!!

You three were (and are) a great team!

I will remember you.

You made me feel comfortable.”


Ellie

“Tania,

Please pass to Dr Pratsou my thanks for her skilled work.

The wound is healing beautifully and now the stitches are out it looks as though it will be almost invisible once fully healed.”


Graham, Skin cancer removal

“Dear Dr Penelope, Rena & the team, (I can’t remember the nurse’s name who helped me during my 2 procedures at the Spire!)

I wanted to thank you for your support and help during a very difficult time. You guys do a wonderful job – and we are eternally grateful for your help.”


Clarissa, Skin cancer

“I would like to put on record how impressed I was with the operation you performed for the removal of the SCC on my neck. I cannot even see where the cut or the stitches were! I am indeed very grateful for the excellent work you do.”


Harry, Squamous Cell Carcinoma

“Dear Dr Pratsou,

I am very grateful to you for your diagnosis, recommended treatment and advice. Your letter to my GP sets out both the course of events, and your own analysis of probable condition and possible cause, clearly summarising our discussion.

I hope there will be no recurrence but I will certainly come back to you if there is.”


Ryan, Skin rash

“Dear Tania,

Please pass on my thanks to Dr Pratsou. I saw her this morning for a mole check. She was so lovely and reassuring. Please also thank the two nurses who assisted her during the mole removal procedure. I was very nervous, but they were very efficient, which meant I did not have too long to think about it, but most of all they were very kind. They kept me distracted and calm, which made a huge difference. Thank you also for your efficiency in both booking me in so quickly.”


James, Mole removal
Dear Ms. Pratsou,

I am writing to thank you for the care you have given me in the past few months. From the moment I walked into your consulting room with a lesion on my cheek, a lesion that I fully expected to be some sort of skin cancer (and it was), you have been thorough, reassuring, respectful and in every way professional.

You recognised that I had some insight into the condition of my skin and the procedures required to treat me. You listened to me. You projected expertise and compassion.

During the procedure to remove the growth you ensured that the atmosphere in the treatment room remained not only calm, but actually pleasant. Had it not been that you were excising a growth and sewing me up, I almost felt as if you, me and the nurse were at some sort of women’s discussion group. The time flew by. I had zero anxieties about the procedure and as we both know now, the wound healed flawlessly.

Thank you for your expertise and your communication skills and all round good nature. I feel very lucky.


Karen Tatom, Skin cancer removal

We have replaced the images and names of real patients who provided these testimonials to protect their privacy.

The first step to feeling in charge of your skin is to book an initial consultation

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How it works

FEEL IN CHARGE OF YOUR SKIN IN 3 EASY STEPS

STEP 1 – CALL US
STEP 2 – LET’S MEET
STEP 3 – RESOLUTION
CONTACT MY STAFF

Give us a call on 441183735198 and we’ll help guide you towards a first appointment.

MEET WITH ME

I’ll see you and examine your skin before I recommend treatment. In some cases, I can begin treating your condition on the same day.

FEEL IN CHARGE OF YOUR SKIN

I’ll guide you down the road towards a resolution of your skin condition so that you can get back to normal life.

More information about genital dermatoses

FOR THOSE WHO WANT THE DETAILS

We use the term genital dermatoses to describe a group of inflammatory skin problems that can affect the male and female reproductive organs. These problems range from eczema and psoriasis to conditions such as lichen sclerosus and lichen planus.

Unfortunately, these conditions can cause much discomfort and sometimes embarrassment. Their effects can not only be physical but also impact on your perception of yourself and your social life.

Symptoms of skin problems affecting the genitals include:

  • Itching, pain and inflammation of the affected skin and mucosal surfaces
  • Pain when urinating and opening your bowels
  • Pain during and following sexual intercourse, often resulting in trauma and small cracks to the affected skin
  • In some conditions, such as lichen sclerosus and lichen planus, the skin can progressively scar and lead to the fusion of the labia in women and phimosis (difficulty in retracting the foreskin) in men
  • Lichen planus can result in ulceration in the affected areas in both the vulval and vaginal region in women and the glans penis in men
  • Certain individuals may experience psychosexual difficulties, due to either anticipation of pain and discomfort during sexual intercourse, or due to concerns regarding the appearance of the affected skin
  • Some people may experience an impact on their mood and social life due to the perception of stigma because the condition affects the genital skin.

Lichen sclerosus is thought to be an autoimmune condition, though there can be an environmental trigger. In women, lichen sclerosus occurs before puberty, and after the menopause. Therefore, we believe hormonal factors play a part. Additional causal factors in lichen sclerosus in men include irritation and trapping of urine under the foreskin. Lichen sclerosus almost never occurs in men that have undergone circumcision.

Lichen planus is an autoimmune condition that can occur at any body site. It can be erosive with ulcerations when it affects the genital area of both men and women.

When eczema affects the genital skin, the causes are much the same as when it affects any other part of the skin. These consist of genetic causes, irritation and allergy.

Genital psoriasis can appear differently to psoriasis on other body parts. Unlike body psoriasis, genital psoriasis is not scaly but can consist of well-defined patches of glazed erythema affecting both the groins and labia in women or the penis and scrotum in men. Psoriasis can extend to the perineum and the perianal area as well as the buttocks.

In addition to taking an extensive history on the onset, duration and nature of your symptoms, I would be interested in establishing whether you have had any prior problems with skin rashes and if you have any other medical history of note.

I then examine you with the aid of a chaperone. The examination can be daunting for some patients, but I take great care in ensuring that you feel at ease and that you feel that you maintain your dignity.

In addition to examining the affected area, I sometimes need to have a look at the rest of your skin to check for other physical signs of the condition. You may require to have some blood tests, and in some cases, you may need a biopsy from an affected area to confirm the diagnosis and guide us towards the best management.

Treatment depends on the type of genital skin problem I diagnose. Often, my advice consists of telling you to avoid soap in the affected area and to use a regular moisturiser to keep you comfortable.

Furthermore, I’ll likely recommend an anti-inflammatory agent to calm down the inflammation. This inflammation can cause a lot of the redness, itching and pain.

The anti-inflammatory agent consists typically of topical steroid cream or ointment. Its potency will vary depending on the severity of your symptoms and the condition I am treating.

Conditions such as lichen sclerosus and lichen planus require an ultra-potent steroid ointment such as Dermovate ointment. I typically recommend you use this ointment for up to three months in the first instance. Then, I usually introduce a reducing dose regime to shut down any inflammation, resolve ulceration and prevent progression and scarring.

In men with lichen sclerosus that have difficulty retracting the foreskin (phimosis), sometimes I will ask them to consider circumcision with a referral to a Urologist.

Women with lichen planus and lichen sclerosus may benefit from a gynaecological review as I often would manage this condition in coordination with a gynaecologist.

I can also discuss specific measures to address the discomfort that sexual intercourse can bring on. This activity can be particularly problematic if you have lichen sclerosus and lichen planus.

For eczema and psoriasis. I often suggest a moderately potent steroid ointment for you to use in the affected areas. Usually, you’ll use this ointment for 2-3 weeks at a time, then either as needed or as twice weekly maintenance therapy.

“Is my genital skin problem infectious?”

None of the skin complaints I discuss above are infectious. Instead, they are inflammatory skin problems that we need to address in much the same way as a skin complaint in any other part of the body. With that said, I give special consideration to ensure treatments are gentle enough for the affected area.

“Can you cure my genital skin problem?”

Unfortunately, these types of skin problems are chronic. That means that they can flare up from time to time. Therefore, we need to treat them appropriately. Careful management of the condition should allow you to be symptom-free and reduce the number of flare ups you get in future to a minimum.

“What type of medical speciality is it best to see for my problem?”

It can be tricky to decide what type of medical specialist you should see for advice on your skin problem when it occurs in this delicate area.

In some cases, the problem is purely dermatological, for example, in cases of eczema and psoriasis. In these cases, you should see a dermatologist.

However, I can manage some conditions in conjunction with other specialists such as gynaecologists, urologists or genitourinary medical specialists. I often guide patients in collaboration with colleagues from the above specialities and can advise if another specialist should be involved in your care.

“What other sources of information can you suggest?”

For further information, please see these PDF documents on the BAD site:

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About the author

Dr Penelope Pratsou | Consultant Dermatologist

MBChB, MRCP (UK) (Dermatology)

I’m Dr Penelope Pratsou, a skilled independent Consultant Dermatologist based in Berkshire. I have specialist expertise in the diagnosis and management of all skin cancers, and in performing mole checks. I’m a trained skin surgeon and remove skin cancers, moles, skin tags, cysts and warts.

I also have invaluable experience in dealing with all skin conditions, from the common skin complaints of acne, rosacea, eczema and psoriasis, to the rarer and more complex skin problems, having seen it all through years of NHS work.

After I obtained my Membership to the Royal College of Physicians, I undertook rigorous specialist training in dermatology, before being appointed as a Consultant Dermatologist at the Royal Berkshire Hospital, Reading. There, I helped set up and lead a busy clinic for the diagnosis and treatment of suspected skin cancer. I was also actively involved in supervising and training both dermatology and GP trainees.

Alongside my increasingly busy private practice, I have maintained an NHS practice in Oxford in order to continue to engage with challenging cases and to develop my specialist interest in skin allergy.

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