Kiss of Death? Try a Kiss of Itch
When generations shift, societal mentalities often switch up, too. For example, with more information about how and why our bodies do what they do, we may begin to pay more attention to what we put into our bodies. This includes anything that gets absorbed by our skin, too.
There are now whole markets dedicated to challenging skincare and makeup products in a broader attempt to avoid toxic and aggressive ingredients that can bring trouble when absorbed over months or years.
Ingredients prone to causing allergic reactions are under heavy scrutiny, too, heavier still because allergens can easily be passed on to another person by skin-to-skin contact. This is called consort allergic contact dermatitis.
Contact dermatitis occurs when your skin comes in contact with a chemical or product that triggers an allergic reaction. With consort allergic contact dermatitis, the agent isn't self-supplied but rather given to you by someone else.
Yes, even down there
Beth Goldstein, M.D., a board-certified dermatologist and founder of Central Dermatology Center in Chapel Hill, North Carolina, explained this circumstance with an anecdote from her own clinic: "A wife was allergic to her husband's aftershave, and it took a bit to figure it out. She was changing her makeup, shampoos, lotions, moisturizers...a bit of sleuthing!
"Sometimes it can happen with a substance or medication like a steroid inhaler or oral antibiotics," she added. "The majority of causative agents are fragrances, cosmetics or topical nonsteroidal anti-inflammatory agents such as diclofenac. [They're also possibly in] personal care products as well as benzoyl peroxide, a common acne medication."
The transfer of allergens can happen during any interaction or exposure to another person's body. Oral sex, for example, can transmit allergens directly to the thin skin of genitals—the groin is never exempt from reactions.
"The allergen can obviously produce a rash on the genitals if the skin comes in contact with an agent," said Len Kliman, M.B.B.S., a gynecologist in Melbourne, Australia.
The common symptoms of contact dermatitis in the genital area include redness and inflammation, sometimes leading to ulceration in the skin that becomes more fragile, which can cause a split. This typically results in itching, burning and even pain. While swollen, excessive scratching can result in the thickening of the skin.
"Heating the skin with hot showers or being under blankets tends to exacerbate the symptoms," Kliman said.
STD or dermatitis?
Besides the discomfort and wounding, one of the complicated aspects of a transferred allergic reaction in the genitalia is how it can look similar to and, therefore, be confused for a sexually transmitted infection (STI) or another disorder.
"A sexually transmitted disease can certainly cause skin lesions," Goldstein said. "However recurrent, herpes can present with itching and small blisters. Syphilis can certainly give you a rash, but usually, it is asymptomatic and does not itch like an allergic reaction."
Kliman expanded on the possibilities, using the vulva as an example.
"These symptoms of burning and irritation can also be found with candida albicans [thrush], psoriasis, eczema, lichen sclerosus or lichen planus, and even rarely, malignancy of the genital skin," he explained.
As discouraging as these similarities may sound, there are visible differences in morphology. For example, recurrent herpes simplex virus tends to happen in the same place, sometimes causing discomfort before it's visible, which often results in a grouping of small red bumps or blisters. Contact dermatitis tends to be more irregular-shaped and splotchy.
A time factor must also be considered because allergic reactions can happen within minutes after contact, though they can also form via a slower process.
"If there has been previous exposure, the rash can appear within a day or two and be severe," Goldstein said. "If not, the immune system may usually need seven to 10 days to process and react. People often assume the rash is spreading, but the amount or concentration of allergen is a variant, [as is the] thickness of the skin. It will show up quickly on the genitalia, but slower on the back."
Try patience and communication
A silver lining to this allergic reaction is that it isn't as dangerous as a type I reaction—an immediate hypersensitivity—that would cause swelling of the throat, shortness of breath and an anaphylactic reaction. Type I reactions can arise from latex or penicillin allergies, or even a bee sting. Dermatitis is a type IV reaction, with a completely different immune response, similar to what happens when your body has contact with poison ivy.
"If you see streaks or irregularly shaped edges, then an outside source is likely the cause," Goldstein said. "When searching for it, think about the location and what or how there could be an exposure. Facial and neck rashes are more prone to be caused by a partner's product. When there is swelling, itching or rashes in the groin, asking about personal care products of your partner can give you clues that there may be ingredients like fragrance and preservatives that may be causing an issue."
Patience, communication and a specialized allergen doctor often pave the quickest route to uncovering the potential ingredients giving you problems.
"The condition can resolve itself if you avoid contact with the allergen, however, resolution may take some time, and treatment with local steroid creams will hasten the improvement of these signs and symptoms," Kliman advised.