Pain and Skin Thinning in the Coronal Sulcus Area

Q: Pain and Skin Thinning in the Coronal Sulcus Area

Qiu Bao： Hello, I recommend changing the local cleaning method for the glans as follows： 1. Use cold water. Do not use hot water. 2. Do not use any cleaning products; just use plain water. 3. If convenient, during the inflammation period, rinse with water

The skin on both sides of the coronal sulcus is thin?!

Hello Doctor, I was diagnosed with glans dermatitis two months ago, and I was prescribed Clobetasol to apply.
After feeling a bit better, I started having sexual intercourse, but right at the beginning, I experienced significant pain on both sides of the coronal sulcus, along with redness and slight bleeding.
It eventually improved...
However, last week I felt a recurrence of symptoms on the glans, so I applied Clobetasol for another week.
Unfortunately, during sexual intercourse this week, the pain on both sides of the coronal sulcus returned, along with redness and slight bleeding, making it impossible to continue.
I would like to ask if the skin on both sides and beneath the coronal sulcus has become thinner and the subcutaneous tissue atrophied due to the use of Clobetasol, which is causing the pain and bleeding upon friction.
How long will it take for the skin to return to its normal thickness after stopping the medication? I am planning to have a child, and this situation is really distressing.
I'm unsure if I should see a doctor again.

Qiu Bao, 30~39 year old female. Ask Date: 2012/01/07

Dr. Xu Weikai reply Urology

Qiu Bao: Hello, I recommend changing the local cleaning method for the glans as follows: 1.
Use cold water.
Do not use hot water.
2.
Do not use any cleaning products; just use plain water.
3.
If convenient, during the inflammation period, rinse with water after each urination.
4.
After showering at night, apply petroleum jelly locally.
As for whether to use a steroid ointment, it can be assessed based on the situation.
However, topical ointments may cause thinning of the skin and may take several months to show effects.
This advice is provided by Dr.
Hsu Wei-kai, Director of the Urology Department at Taitung Hospital, under the Ministry of Health.
Please note that online consultations differ from regular outpatient visits and cannot provide a definitive diagnosis; if you have concerns, you should seek medical attention.
Taitung Hospital cares about your health.

Reply Date: 2012/01/07

More Info

It sounds like you're experiencing significant discomfort and pain in the coronal sulcus area, particularly after applying a topical medication (likely a corticosteroid) and engaging in sexual activity. Your symptoms of redness, swelling, and bleeding indicate that there may be an underlying issue that needs to be addressed.

First, let's discuss the potential causes of your symptoms. The coronal sulcus is a sensitive area, and irritation can occur due to various factors, including:
1. Dermatitis: This can be caused by contact with irritants or allergens. If you have been using a topical medication like Clobetasol (臨得隆), which is a potent corticosteroid, it can lead to skin thinning (atrophy) if used excessively or for prolonged periods. This thinning can make the skin more susceptible to injury and irritation, leading to pain and bleeding.

2. Infection: Conditions such as yeast infections or bacterial infections can also cause redness, swelling, and pain in the genital area. If the skin barrier is compromised due to thinning, it may increase the risk of infections.

3. Friction: Engaging in sexual activity can cause friction, especially if the skin is already sensitive or compromised. This can exacerbate any existing irritation or lead to new injuries.

4. Inflammatory Conditions: Conditions like balanitis (inflammation of the glans) or other dermatological issues can also contribute to your symptoms.

Regarding your concern about the thinning of the skin due to the use of Clobetasol, it is indeed possible that prolonged use of potent topical steroids can lead to skin atrophy. If you have been using it frequently, it may take some time for your skin to recover after discontinuation. The duration for skin to return to its normal thickness can vary based on individual healing rates, the extent of atrophy, and overall skin health. Generally, it may take several weeks to months for the skin to regain its normal thickness after stopping the medication.

Here are some recommendations for managing your symptoms:
1. Discontinue Use of Potent Steroids: If you suspect that the medication is causing your symptoms, it may be wise to stop using it. However, do this under the guidance of a healthcare professional.

2. Consult a Dermatologist: Given the complexity of your symptoms and the potential for skin atrophy, it is crucial to consult a dermatologist or a urologist who specializes in genital skin conditions. They can provide a thorough examination and recommend appropriate treatments.

3. Gentle Care: Avoid any harsh soaps or irritants in the area. Use mild, fragrance-free cleansers and avoid tight clothing that may cause friction.

4. Moisturization: Consider using a gentle, hypoallergenic moisturizer to help maintain skin hydration and barrier function.

5. Monitor Symptoms: Keep track of any changes in your symptoms, including the frequency and severity of pain, redness, and any discharge. This information will be helpful for your healthcare provider.

6. Avoid Sexual Activity Until Healed: To prevent further irritation and allow the area to heal, it may be best to avoid sexual activity until your symptoms have resolved.

In conclusion, your symptoms warrant further evaluation by a healthcare professional to determine the underlying cause and appropriate treatment. It is essential to address these issues, especially if you are planning to conceive, as genital health can impact fertility and overall well-being.

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