and Managing Itching in the Genital Area for Diabetic Patients

Genital itching

Hello Doctor: I have been diagnosed with type 2 diabetes for four years and have no sexual experience.
Recently, I have been experiencing frequent itching in my private area, especially at work, which makes it awkward to scratch in public.
I often squeeze my legs together to alleviate the itch.
While showering, using the showerhead to rinse the area provides temporary relief.
After bathing, my family has given me a cream to apply (Quadricream), which helps reduce the itching for a few days, but it returns after a short time.
I have cats at home, and I wash my hands after petting them.
I want to see a doctor but feel embarrassed, fearing an internal examination.
I have scratched my labia to the point where it feels a bit loose and sagging (it was slightly so before, but the frequent itching has made it worse).
I am aware that diabetes can lead to urinary tract infections, but this itching has only started recently, and I seem to have scratched to the point of creating a wound, which causes pain when rinsing.
Should I see a doctor? Should I go to a clinic or a larger hospital, and should I see a gynecologist or an infectious disease specialist? Thank you.

Ling Er, 20~29 year old female. Ask Date: 2023/07/30

Dr. Cao Guotao reply Obstetrics and Gynecology

Hello, it is recommended to see a gynecologist for an examination.
Wishing you good health.

Reply Date: 2023/07/30

More Info

Itching in the genital area can be a common issue, particularly for individuals with diabetes, due to various factors including skin changes, infections, and irritations. Given your situation, it’s essential to address both the symptoms and the underlying causes to ensure effective management.

Understanding the Causes of Itching
1. Diabetes and Skin Changes: Diabetes can lead to changes in skin integrity and moisture levels, making the skin more susceptible to irritation and infections. High blood sugar levels can also contribute to yeast infections, which are a common cause of itching in the genital area.

2. Infections: As you mentioned, individuals with diabetes are at a higher risk for urinary tract infections (UTIs) and yeast infections. Yeast infections, in particular, can cause significant itching and discomfort in the genital area. Symptoms may include a thick, white discharge, redness, and swelling.

3. Irritation: Irritation from soaps, detergents, or even clothing can exacerbate itching. If you have recently changed any personal care products or laundry detergents, this could be a contributing factor.

4. Skin Conditions: Conditions such as eczema or contact dermatitis can also lead to itching. If you have a history of skin issues, this could be relevant.

Recommendations for Management
1. Consult a Healthcare Provider: Given that you have already experienced persistent itching and have developed some skin changes (like the loosening of the labia), it is advisable to see a healthcare provider. While it may feel uncomfortable, a gynecological examination can provide valuable insights and help rule out infections or other conditions. If you are concerned about the examination, you can express your worries to the healthcare provider beforehand.

2. Choose the Right Specialist: For your symptoms, starting with a gynecologist would be appropriate. They can assess for any infections, skin conditions, or other gynecological issues. If necessary, they may refer you to an infectious disease specialist if an infection is suspected.

3. Maintain Good Hygiene: Keeping the genital area clean and dry is crucial. Use mild, unscented soaps and avoid douching or using perfumed products that can irritate the area further. After bathing, ensure that the area is thoroughly dried.

4. Monitor Blood Sugar Levels: Since you have type 2 diabetes, maintaining good glycemic control is essential. High blood sugar levels can exacerbate skin issues and increase the risk of infections. Regular monitoring and management of your diabetes can help reduce these risks.

5. Topical Treatments: While you mentioned using Quadricrem cream, which can provide temporary relief, it’s important to identify the underlying cause of the itching. If a yeast infection is suspected, antifungal creams or medications may be necessary. Your healthcare provider can prescribe the appropriate treatment based on their assessment.

6. Avoid Scratching: Although it can be difficult, try to avoid scratching the area as it can lead to further irritation and potential infections. Keeping your nails trimmed and wearing loose-fitting clothing can help reduce the urge to scratch.

7. Follow-Up: If you do see a healthcare provider, ensure that you follow up on any recommended treatments or tests. If symptoms persist or worsen, further evaluation may be necessary.

Conclusion
In summary, while itching in the genital area can be uncomfortable and embarrassing, it is important to seek medical advice to address the issue effectively. Given your diabetes and the symptoms you are experiencing, a thorough evaluation by a gynecologist is warranted. They can help determine the cause of your itching and recommend appropriate treatments to alleviate your discomfort. Remember, taking care of your health is paramount, and addressing these symptoms early can prevent further complications.

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