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perineum cuts

I've had perineum(between vagina and anus) cuts that have lasted around six months...sometimes I can get them to a point where I'm comfortable, but they won't heal! I've tested negative for STDS by blood and culture test several times.  I went to the ER the other night for the pain and 4 different people had no idea.  They're referring me to a dermatologist...My questions are: 1. Anyone else had this problem? 2. Anyone ever had a biopsy on this area? 3. Any ideas on what it might be? They're 1/4 in. to an inch long and look like paper-cuts.
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Avatar universal
I suffer occasionally from these same slits. I purchased fresh aloe from the a supermarket, cut it open, and applied it directly to the slits. I experienced relief within a few minutes, and I continue to feel better even hours later.

I'm not professing it is a cure, but I am no longer in pain!
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Avatar universal
I'm not a doctor, but I think this might be caused by something environmental. My platonic friend started having all of these symptoms (swollen perineum, little tears, something that presented like a yeast infection and then small red bumps surrounding her rectum) a couple of weeks ago. I stayed at her house about a week and a half ago and started having all of the same symptoms. I went to the doctor and was diagnosed with a yeast infection. I think at the beginning I did have a yeast infection. I had a red ring around my rectum which has since gone away and been replaced by these little red bumps. While I was using the antifungal cream (terazol 7) the tear on my perineum stopped bleeding, but I stopped putting on the cream yesterday and the tear started bleeding again, although the bumps have gone down.

What in someone's home could cause a reaction like this?
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Avatar universal
I'm a man and I've been dealing with the same thing. About a month and a half ago, it started out as a slightly stinging sensation whenever I'd sit down to use the bathroom. About a week later, I felt a tear and then it started bleeding. I've been going to the dermatologist for these cysts that I keep getting, so I thought that this was what it was. The cysts usually heal about a day after they rupture, but this has been burning stinging, bleeding for about a month now. I'm taking Acticlate for the cysts (I have about 3 doses left) and I've been applying Neosporin to the area. The Neosporin seemed to help until about 2 days ago. There was no bleeding, stinging, or burning, so I thought that it had healed. Now, it seems to be back at square one. I have a followup with my dermatologist in about a month, so I wanted to know if I could hold out until then, or if this was serious enough that I needed to visit urgent care in the meantime.
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Avatar universal
I know a lot of these posts are old, but I need to say this...

It's most likely lichen sclerosis. I am in my 4th year of medical school and have the disease myself. It took me over 3 years to get a proper diagnosis and since then I have begun extensive research into the disease. It is very very underdiagnosed and yet also very prevalent- anything with steroids should help in theory. If anyone has these symptoms, it does not matter if you go to a gyn or derm- neither speciality wants to claim the disease which is why getting a diagnosis is hard. REQUEST A BIOPSY- either specialist can do it. Please, please, please do not accept a diagnosis of a yeast infection or something of that sort- a lot of the topical creams contain steroids (like triamcinolone) which, although helpful, will mask the actual diagnosis. LS carries a risk of cancer, so women need proper monitoring and LIFE LONG treatment even when flairs stop. So again, anyone with these symptoms- get a biopsy. I can't stress that enough... it could save you years of suffering and possibly vulvular cancer down the road.

Here is a great clip with more information- hope it helps!!

https://m.youtube.com/watch?v=Pt7iuZXkXVg
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Avatar universal
I have all of the above symptoms. It has been quite some time now and I so desperately want to get back to my normal life. Can someone please suggest which direction is best to go in, Dermatologist? Gynecologist?  Or Proctologist? In order to get that cream? Thanks
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Avatar universal
How long has this cream worked for you? Do the fissures return or has the problem been resolved?
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Avatar universal
Have y'all tried diflucan? It seems to heal mine up.. That, the nystatin cream, and lidocaine gel to take the pain away
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Avatar universal
As a nutritionist, I believe that much of this is coming from Candida. Are you eating or sensitive to wheat, white sugar, white flour, wine and other sugars.  I believe that when we have Candida, yeast overgrowth; it throws our ph-balance levels off and makes our discharge acidic.

This acidic, yeasty moisture on the skin can irritate and create the cracks. To me it's more stingy than itchy.

I also can not handle ANY fabric softener or scented tampons or laundry detergent or perfumed body wash. Consider using unscented everything and get off sugar, alcohol, coffee and white stuff for a while and see if that helps. Since women detox "down there" the problem COULD get worse before it get's better.

I have had this problem off and on for years and i usually take it as a sign to clean up my diet.  In the meantime, wash your perineum with Cetaphil or other mild cleanser. Then pat dry til VERY DRY and apply Caldesene Powder to create a breathable moisture barrier. Reapply as needed and let things air out at night when you sleep.

And take a good Probiotic to help combat the Candida.
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Avatar universal
I too have had all the symptoms the above people have had. One thing I can take away from the discussion is that I am NOT alone and I probably DO NOT have any form of cancer which was always on my mind! I also have the little slits on other areas most notable on my hands and the upper eye lids. I am going to get the nystatin and triaminolosone cream. Thank you everyone, for their very personal input.
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Avatar universal
I am going through exact same thing, I went through all the creams and prescriptions, but it seems to come right back. I just recently changed my bath soap and lotion to very mild Dove and I stopped using my skin toning lotion. I have found a great relief. try changing your soap and body lotion, this could be irritating the sensitive skin down there by causing it to be too thin that it cracks.
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Avatar universal
I had those paper like cuts on my perineum forever. Probably since last November or so. It's now April and last month I finally found out what works. I would look on google ALL THE TIME to see if anyone had any ideas what I could do!!! While reading I thought I had something like herpes the way people were talking!!! The cream you need for the doctor has worked MIRACLES for me. It's called nystatin and triamcinolone acetonide cream. I tried perineum lotion, diaper rash cream, neosporin, etc. etc. This stuff works.
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Avatar universal
Hi

I have also been suffering from a similar thing. For the past three months i've been suffering from splits, also papercut looking splits on and around my perineum. I first noticed it when i saw light coloured pacthes on my perineum and that have now progressed into darker patches, which i can only assume are scars from the splits. The splits seem to heal but then tear on the same places again; they also sting. I went to my doctor and she had no explanation of what it could have been and fobbed me off with a steriod and anti-biotic cream which hasnt helped. The area has been itchy once and i did scratch, when i did i must have torn an old scar which is now a split again. I dont know what to do as I have lost faith in medical professional help.
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Avatar universal
I was itchy about a year ago when it first started around the perineum and anal area. I assumed this was due to the anal fissures trying to heal or wearing thongs(which I will never wear again.) I was working 2 jobs at a hot factory and as a trainer so I was wearing the same damp, sweaty clothes all day long. After initial itchiness, I was in so much pain and had a burning red rash all the way from perineum to top of butt crack. The steroid and antifungal cream cleared up almost everything, but didn't heal the cuts and they became more red and inflamed 2 days ago. I will definitely not put the Triple Antibiotic on again. I will also discontiue the witch hazel wipes as the fissures seem to be almost healed and a very small amount of blood on tissue after BM. I didn't realize the witch hazel could be harmful because I thought they were not only for anal fissures, but for vaginal lacerations as well. I mentioned the cuts to the doctor who prescribed me them and he said it would be okay. But I will defintely stop using everything except what the ER gave me. Thank you again and I will pursue my consultation with the dermatologist.
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Avatar universal
MEDICAL PROFESSIONAL
Hi,

This seems to be a fungal infection with a dermatitis component to me.Fungal infections may prefer the groin and intertriginous areas as these areas are usually moist and harbor the growth of these organisms.

Has this been itchy before?

Contact or allergic dermatitis may present with excoriations and thinning of the skin due to repeated scratching. Has this been the case with you?

Pursue your consultation with a dermatologist.Continue with current medications. Do not use other products not recommended by your physician as this may cause further irritation and may aggravate the rash.
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Avatar universal
Thank you so much for commenting...The area is not itchy. The area is moist to the touch, but feels dry to me as in  there is no elasticity, feels like I'm ripping if i'm in the wrong position or trying to examine myself, and burns when water or urine touches it. I never scratch the area and hardly ever look at it anymore because it seems to irritate it and causes the cracks to split more. A month ago my gyno said it was due to yeast and gave me a steroid and antifungal cream which helped, but didn't cure. The other night at the ER they told me that was the worst thing she could've given me because it could've gotten in my bloodstream and thins the skin.  They gave me heavy painkillers and Bacitracin to apply to the cuts a few times a day with these lovely gauze panties to help air it out. Other than what my docs give me, the only things I've used on the cuts are a dab of Triple Antibiotic when really red and I started using Witch Hazel wipes a few weeks ago for anal fissures which I'm wondering now if they are connected.  I will definitely follow up with the dermatologist and thank you so much again for replying. If you think of anything else after reading this, I really do appreciate your input and advice. =)
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Avatar universal
MEDICAL PROFESSIONAL
Hi,

Just a few questions:

Is the area itchy?

Do you usually scratch the area or apply any medications or substances on the area?

This may be due to persistent dryness of the involved skin.It is also possible that if the area is not dry,it may be constantly moist as one may experience during extreme heat or when engaging in certain exercises and activities.

I suggest that you pursue your consult with your dermatologist.This may be a case of irritant dermatitis or a contact dermatitis.A fungal infection may also be a differential.

Wash only with a mild and bland soap.After urinating, dab the area gently to dry it rather than rub it vigorously. Keep the area clean always.
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