Umbilical Itching and Discharge: A Patient's Guide

Itchy around the navel and suspected clear discharge (continued 1)

Hello Dr.
Chen, I am the patient who inquired yesterday about a suspected secretion in my navel.
There should be no wounds in the navel, as I do not have a habit of digging at it; the initial symptom was itching.
Currently, I am in Indonesia and am hesitant to visit a local hospital due to concerns about the risk of other infections.
However, I have asked the nursing staff in my company's medical office for assistance in cleaning it.
This morning, she first disinfected a cotton swab with alcohol and used it to remove dirt from inside the navel, then sprayed alcohol for disinfection and applied the available ointment "HYDROCORTISONE CREAM 2.5%" inside the navel.
She also administered medication "mefenamic acid 500 mg" and "dexamethasone 0.5 mg."
Tonight, I noticed that the inside of the navel has started to become red and feels itchy and prickly.
There is now a white, sticky secretion with a slight odor, and there are white, dried substances around the navel (though I'm not sure if this is residue from the ointment).
Could you please advise if the current treatment approach by the company nurse needs to be adjusted? Thank you, Dr.
Chen.

Jessica, 30~39 year old female. Ask Date: 2020/12/28

Dr. Chen Jiaming reply Surgery

The method for disinfecting the umbilical cord involves maintaining alcohol disinfection, keeping the area dry, and covering it with gauze to avoid contact with unsterilized water.
The use of the ointment "HYDROCORTISONE" is not recommended, as it is a steroid ointment.
The medication "mefenamic acid" is an anti-inflammatory pain reliever (can be considered for use), while "dexamethasone" is a steroid (not recommended for use).

Reply Date: 2020/12/28

More Info

Hello,
It sounds like you are experiencing some concerning symptoms related to your umbilicus (belly button), including itching, discharge, and redness. Based on your description, it appears that you may be dealing with an infection or irritation in that area, which can occur for various reasons, including poor hygiene, skin conditions, or even an underlying infection.

Understanding Your Symptoms
1. Itching and Redness: These symptoms can indicate inflammation, which may be due to irritation from moisture, sweat, or even the application of topical medications. The use of hydrocortisone cream, while it can help reduce inflammation, may not be suitable if there is an active infection.

2. Discharge: The presence of white, sticky discharge with an odor is particularly concerning. This could suggest a bacterial infection, especially if the discharge is purulent (pus-like). The odor is often a sign that bacteria are present, which may require more than just topical treatment.

3. Dry, White Residue: The white, dried material around the umbilicus could be remnants of the hydrocortisone cream or it could be dried discharge. If it is discharge, it may indicate that the area is not healing properly and could be worsening.

Recommendations for Treatment
Given the symptoms you are experiencing, I would recommend the following steps:
1. Discontinue Hydrocortisone Cream: While hydrocortisone can be beneficial for certain inflammatory skin conditions, it may not be appropriate for an infected area. It can sometimes exacerbate infections by suppressing the local immune response.

2. Clean the Area Gently: Continue to keep the area clean, but do so gently. Use mild soap and water to cleanse the umbilicus, avoiding harsh scrubs or irritants. After cleaning, pat the area dry with a clean towel.

3. Avoid Irritants: Refrain from applying any creams or ointments until you have a clearer understanding of the condition. This includes avoiding any products that may contain alcohol, as they can further irritate the skin.

4. Seek Medical Attention: Since you are currently in Indonesia and are hesitant to visit a local hospital, consider consulting a healthcare professional remotely if possible. Telemedicine services can provide you with guidance without the need for an in-person visit. If your symptoms worsen or if you develop fever, increased pain, or swelling, it is crucial to seek immediate medical attention.

5. Monitor Symptoms: Keep a close eye on your symptoms. If the redness spreads, the discharge increases, or if you experience any systemic symptoms like fever or chills, these could be signs of a more serious infection that requires antibiotics.

Conclusion
In summary, while the initial treatment provided by your company’s medical staff was well-intentioned, it may need to be adjusted based on the new symptoms you are experiencing. It is essential to prioritize your health and seek appropriate medical care, especially if the situation does not improve or worsens. Remember, infections can escalate quickly, and timely intervention is key to preventing complications.

Take care, and I hope you find relief soon.

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