Ask a doctor on the topic of Urology

Itching of the skin in the intimate area without a visible cause, partner infection

December 22, 2011 | 20,00 EUR | answered by Dr. med. Ralf Berg

Hello,

I have been experiencing itching in the genital and anal area for a long time (between the buttocks and also on the skin, but especially strong in the area between the testicles and the rectum, and in the other direction towards the deepest area of the crack), as well as in the entire genital area, testicles, the area above the penis, occasionally also on the glans, but very rarely (this could also be attributed to irritation during sex, as it usually occurs on days after sex or condom use or masturbation), but most strongly in the groin at the lowest point of the skin fold. With 1-2 days of Multilind, the symptoms were usually gone, but they regularly come back, always exclusively in the intimate area but always in different places. It particularly itches when I haven't showered for a day. After showering, it usually disappears for a short time. I have always attributed this itching to sweat formation and friction, and therefore thin/stressed skin. There is nothing visible on the skin, even with a magnifying glass, no redness, no mite burrows, no lice, nothing.

Now, my girlfriend, with whom I had unprotected intercourse, also experienced this itching (exclusively on the skin and in the groin in the intimate area, not in the vagina) and went to the gynecologist to get prescribed the pill. During a general examination there, a "bacterial vaginosis" was diagnosed, unfortunately my girlfriend did not remember the name of the unusually increased bacterium (except for the note that it can also affect the intestines). Lately, she has noticed a different smell, slightly fishy, which worsened after her period. She was treated with the antibiotic metronidazole and an additional vaginal insert and now has to take capsules for 30 days to rebuild her flora.

The gynecologist advised me to get checked as well to avoid a ping-pong effect, so I went to the urologist, but unfortunately he hardly let me speak. He did a urine rapid test and briefly examined my genital area, saying I had a few bacteria in my urine and prescribed me Ciprofloxacin 250mg. 5 days of 2 capsules per day. After 5 days, I went back, urine rapid test, no more bacteria, so I told him that my girlfriend and I noticed that the Ciprofloxacin works against completely different bacteria than her antibiotic. He just said that I have no bacteria in my urine, everything is fine. He did not address the fact that metronidazole works against anaerobic bacteria, which ciprofloxacin does not. When I mentioned that the itching remained unchanged, he said it would go away over the weekend, which did not happen.

Now we are worried that my girlfriend may have to repeat this 30-day treatment (and therefore only have protected intercourse and not yet be prescribed

Dr. med. Ralf Berg

Good evening,

you have quite a lot of questions. Fortunately, you provide possible explanations and answers, which mostly seem to be correct! Let's start from the beginning:

You ask about the possibility that your complaints in the groin area could be caused by athlete's foot. This can clearly be answered with yes. Also, the fact that the infection did not spread too much due to the temporary use of Multilind and only flared up here and there is plausible. The likelihood that it is a fungus and not bacteria is high, so your conclusion to now consistently apply Canesten for several weeks is correct. Canesteen is a fungal cream and does not have any special care properties. If you achieve a reduction in your complaints by using it, it means that your fungus is apparently sensitive to this treatment.

I don't know of any bacteria that cause skin infections without any other symptoms. There is always redness, swelling, or pain involved.

For your complaints in the groin area and other skin issues, a dermatologist or an experienced general practitioner is the right person to talk to. The urologist only treated your urinary tract, not the skin. Since you unfortunately do not know which pathogens were found in your girlfriend, I must speculate a bit at the end. Based on your description, your girlfriend probably suffered from an infection with Giardia (these are technically not bacteria but parasites from the large group of flagellates). The symptoms and treatment would match. Another possibility is that it was Gardanellae (which can also occur in the intestines). The treatment is the same.

Transmission can occur, but is not guaranteed. Please find out which pathogen was found in your girlfriend, write it down, and after completing your fungus treatment, have a urethral swab taken by a urologist you trust, specifically looking for this germ. If nothing is found, then the issue is resolved. For your skin complaints in the genital area, please also consult a dermatologist until the fungus is no longer detectable there and on your feet.

I hope everything is clear now. Once again, congratulations on your very good self-analysis, but especially with skin issues, the opinion of a dermatologist can't hurt. Or are you afraid of dermatologists? (Just kidding). In such persistent cases, a dermatologist can help by trying to determine the type of fungus by examining skin flakes before starting treatment. After that, the therapy can be tailored. If you decide to start treatment right away, it is too late for these examinations. However, after completing the treatment, you can check again to see if everything is truly clear, just like the urologist.

With warm regards,
Dr. R. Berg