contact dermatitis

Symptoms affecting the genitalia as a result of vaginally penetrating intercourse are not uncommon.  Today we are going to talk about allergic and irritant reactions to products. There are other kinds of symptoms to vaginally penetrating intercourse that we will get to later on in this series.

It is not unusual for people to use specific products only in advance of having sex.  This includes things like lubrication, pleasure creams, and products for shaving and removal of hair.  Contact dermatitis can arise as a result of these products.

Contact dermatitis is inflammation of the skin following contact with a substance that irritates or generates an allergic reaction.  In case it’s not obvious, genital tissue is much more sensitive than other parts of the body.  Irritant contact dermatitis of the vulva is more common than true allergic dermatitis there.

Common irritant triggers include hygiene products like soap, shower gel, and sanitary napkins, spermicides, diaphragms, and sexual lubricants.  In some people, these triggers can also generate a true allergic dermatitis.  Additional triggers commonly associated with allergic contact dermatitis regularly include neomycin, -caine anesthetics and nickel.

Contact dermatitis of the genital (and other) areas can cause a wide range of reactions from mildly irritating to very severe.  Symptoms can include redness, swelling, itching, burning and pain, and can cause chronic thickening of the skin, fissuring of the skin, weeping of the skin and blistering.  In most patients, the substance responsible for the reaction is identified via skin patch testing.  I would not expect this to be reliable in mast cell patients given the inherently reactive nature of our skin.

Irritant contact dermatitis often shows symptoms shortly after product use. True allergic contact dermatitis is a delayed type IV hypersensitivity reaction and can take 2-3 days to appear. Many patients are able to identify the trigger by removing products and symptom resolution upon doing so. Some genital hygiene products include alcohol.  Many more include propylene glycol, a well defined trigger for vulvar dermatitis.  Products that contain sugar and/or change the pH of the internal vaginal environment disturb the natural microbial flora, causing inflammation and increased risk of infection later.

It is also possible for products used by the partner to transfer during vaginal penetration.  If the penetration is made by part of the body and not a toy, transfer can happen in either direction. For persons using toys for external or internal stimulation, it is also possible to react to the material of the product. Something to consider is that many companies sell products to clean up after sex, either to clean genitalia, toys or both.  Please look carefully at the ingredients included in those products.  Additionally, please ensure that any toys used are cleaned before and after use.

 

References:

Schlosser BJ. Contact dermatitis of the vulva. Dermatol Clin 2010: 28; 697-706.

Moraes PSA, Taketomi EA. Allergic vulvovaginitis. Ann Allergy Asthma Immunol 2000; 85: 253-267.

Chen WW, Baskin M. A 33-year-old woman with burning and blistering of perivaginal tissue following sexual intercourse. Annals of Allergy, Asthma & Immunology 2004; 93: 126-130.

Harlow BL, He W, Nguyen RHN. Allergic reactions and risk of vulvodynia. Ann Epidemiol 2009; 19: 771-777.

Liccardi G, et al. Intimate behavior and allergy: a narrative review. Annals of Allergy, Asthma & Immunology 2007; 99: 394-400.

Sonnex C. Genital allergy. Sex Transm Infect 2004; 80: 4-7.