Genital itching, no rash or sores

Ever since I got pregnant w/ my last son who was born in Jan '09, I've had this itch that started just in the crease of the leg/labia area where your underwear line is.  Over the last year it's spread slightly.  I only have itching on the outside and there are no sores or rash or discharge.  I'm overweight and it stays hot down there so there's usually moisture.  Not sure it that is actual sweat or if I am leaking urine (I've had 3 kids).  Sometimes it itches so bad, I scratch til it's raw and then when I urinate, it's unbelievably itchy.  When I shower, it's not so bad, but as the day goes on and I'm active, the moisture starts and then so does the itch.  I thought at first I had an allergy to maybe the underwear lining (like the rubber), but I've switched underwear w/o the elastic there.  I googled the itching and was thinking maybe I had low estrogen or allergies and then I've also read about how it could be liver related. ( I recently over the last few weeks started itching everywhere, my arms, legs, feet, head, etc., but they don't itch til I scratch it raw, so I'm sure this is something unrelated.)  I don't have any discharge or itching or pain inside the labia or vagina.  Could it be yeast or some kind of fungal infection?  Maybe my PH is messed up and my sweat/urine irritates me?  Please help!

[Elaine Brown, MD]

Hi!
Your symptoms sound fairly classic for candida.  This often occurs in the groin area and under the tummy pooch.  Often there is some discoloration associated such as darkening or redness of the skin in the areas.  Under the breasts and underarms can be problem areas as well.  If you were my patient, I would do a couple of things.  I would test for diabetes--this problem is more common in diabetics, but can also occur in people with normal blood sugars.  I would probably do a skin biopsy to rule out something like lichen sclerosis or eczema, and I would probably treat for yeast.  Some things that can help:  Antifungal shampoo used as a body wash, antifungal powder to help reduce the moisture, going naked whenever possible.

I would probably also prescribe diflucan for at least two treatments, and possibly a steroid cream to alleviate the inflammation.  One more thing to try while you are waiting to see a gynecologist or dermatologist--Crisco applied to the skin in the itchy areas is very soothing.

Hope this helps!
Dr B