itchy perineum on little girl age 6

My 6 yr old daughter occasionally has an itchy perineum area. It appears a little red but not really bad. It usually bothers her at night. It doesn't happen all the time, but on occasion it does. I have washed the area thoroughly and put baby powder on it. I have read that a diaper ointment with zinc might help relieve the pain. Any suggestions on what is causing it and what is the absolute best to put on it? Does she need to see the family doctor? I hate to put her through that embarrassment since our doc is male.,so if I can prevent her having to see him for that reason, that would be preferred. However, if its serious, I will sure take her. Suggestions and answers???

[Angebelle]

A family doctor is great, but you could also see a pediatrician or an internist for a digital rectal examination.  They go through a few more years of specialized training on this very subject.  There could be a number of reasons that there's itching/pain/redness, ranging from pinworms to anal fissure to dietary sensitivity (acidic tomatoes for instance).  I hope she finds relief soon!    

[Bhupinder Kaur, MD]

Hello,
At this age group, pinworms is a common cause of itchy perineum. For this, you need to get her stool examination done. Apart from that, it can be due to moisture(due to sweating or frequent washing), the abrasion caused by clothing, the pressure of sitting, chemical irritants like laundry soaps, colognes and scented toilet paper, certain food irritants, medicines like some antibiotics and laxatives, anal abrasions and fissures and skin problems such as psoriasis, seborrhea and eczema.

All these causes need to be ruled out and then specific treatment started. Till then she can take oral antihistaminics which will help in her itching.

It is very difficult to precisely confirm a diagnosis without examination and investigations and the answer is based on the medical information provided. For exact diagnosis, you are requested to consult your doctor. I sincerely hope that helps. Take care and please do keep me posted on how you are doing.