peeling

i have a friend who complains about peeling and blisters in the space between her anus and vaginal area. she is sexually acitive. what does that mean?

[Bhupinder Kaur, MD]

Hello,
From the symptoms the first possibility is definitely of ingrown hair or folliculitis. The second possibility is of herpes sores. Most individuals have no or only minimal signs or symptoms from HSV-1 or HSV-2 infection. When signs do occur, they typically appear as one or more blisters on or around the genitals or rectum. The blisters break, leaving tender ulcers (sores) that may take two to four weeks to heal the first time they occur.

The only way of ruling it out is by getting yourself tested for genital herpes. Laboratory tests include: culture of the virus, direct fluorescent antibody (DFA) studies to detect virus, skin biopsy, and polymerase chain reaction (PCR) to test for presence of viral DNA. I sincerely advise you to consult a dermatologist and get it ruled out.

Till that time, keep the area clean and apply some topical antiseptics. Also wear loose-fitting cotton clothing and use an antibacterial soap or mild soap like dove. Avoid any kind of cosmetics. Topical antibiotics such as mupirocin or neomycin containing ointment are also useful. In case the symptoms persist then oral antibiotics may be needed. Please consult a dermatologist in that case.

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 dermatologist. I sincerely hope that helps. Take care and please do keep me posted on how you are doing.