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Everything You Wanted to Know About Skin Irritation "Down There" But Were Afraid to Ask

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A bump or rash on your face is embarrassing, but skin irritation between your legs is just plain scary. But fear not! From urethral bumps and rectal rashes to menopausal causes and topical treatments, you can get the answers you need below.

I have a bump on my urethra, should I be worried?

Q: I’m 56, and yesterday at my annual exam, my doctor found a small flesh-colored growth sticking out of my urethra. She gave me a mirror so I could see it, and it looks awful! But all she recommended was applying estrogen cream to the growth. Shouldn’t it be removed?

A: Not necessarily. What you’re describing sounds like a urethral caruncle. These benign growths are common after menopause since drop-offs in estrogen levels at this stage can cause a weakening of tissue, which allows the lining of the urinary tube to drop down and “pouch out,” forming the pink or red polyp your doctor showed you.

Caruncles can sometimes be tender and cause mild bleeding or pain during urination, but many don’t produce any symptoms at all. In fact, many of my patients share your experience: They aren’t even aware that they have a urethral caruncle until it’s discovered during a routine pelvic exam. If the harmless growths are found when they’re small (about 1⁄4 to 1⁄2-inch in size) they typically respond well to treatment with estrogen cream, which restores elasticity to tissues, causing the “pouch” to pop back into place in as little as three to six weeks.

Since your caruncle doesn’t seem to be causing you any discomfort, I’d advise following your doctor’s recommendations and using the estrogen cream as she directed. But I’d also suggest scheduling a follow-up appointment with your doctor in about four weeks to monitor the growth. If it doesn’t resolve within two months, or if you begin to develop symptoms such as urinary discomfort or bleeding, your doctor may refer you to a urogynecologist, who can remove the growth via outpatient surgery.

What’s causing this uncomfortable rash on my bottom?

Q: After a pool party last week, I broke out in an itchy red rash between my buttocks. It’s getting worse despite the anti-itch cream I’m using. What’s going on?

A: I suspect you have a rectal yeast infection, which can be caused by the same Candida that produces vaginal infections. Candida thrives in warm, moist environments, so wearing a wet bathing suit for long periods of time is a common culprit.

I advise treating your rash with a twice-daily application of a cream containing clotrimazole, an antifungal that can eradicate Candida (like Lotrimin AF Cream, $9, Amazon.com). I also suggest avoiding harsh soaps and perfumed products, which can irritate the skin, worsening inflammation and itching. And to control the moisture and heat that fuels yeast growth, try wearing cotton underwear and dusting the area with cornstarch. Your outbreak should resolve within a week of using these strategies. If it doesn’t, see your doctor, who can prescribe stronger anti-fungal treatments.

This story originally appeared in the August 2017 issue of First for Women magazine.

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