The main goals of therapy are to eliminate the symptoms, limit further patient contact with the allergen, and prevent possible complications.
To relieve the patient’s condition, antihistamines are used – in drops for children or in the form of tablets for adults. Reduction of inflammation and itching can be achieved using glucocorticoid-based soothing ointments.
In severe cases, with severe damage to the skin prescribed means, activating the process of epithelialization.
To eliminate contact with the provoking allergen, its precise determination is necessary. If this was not possible at the stage of diagnosis, the patient is not recommended to use latex-based products (condoms, underwear), to use any unknown ointment and care products. If a woman is hypersensitive to the components of seminal fluid, she is shown to use barrier contraceptives.
Patients with genital allergy of unclear origin for intimate care should choose products with a minimum amount of aromatic and emollient additives or hypoallergenic soap. If there are signs of secondary infection, antibacterial drugs are prescribed.
Genital allergy is a fairly common condition, however, it is often confused with venereal or gynecological diseases. Pathology approximately with the same frequency affects both males and females. The disease can have an isolated character (manifest itself only on the genitals) or be part of a wider symptom complex – for example, Lyell’s syndrome, dermatitis, urticaria. The difference of this allergy is the probability of damage to the urinary and reproductive systems (urethritis, balanoposthitis and vulvovaginitis).
Causes of genital allergy
Like other allergic pathologies, this violation occurs in response to ingestion of special substances-allergens – compounds that provoke unusual reactions of immunity. The pathways of penetration of antigens are different, can be local and systemic. In the first case, the symptoms are observed by direct contact of the mucous membranes and skin with provocative compounds. In systemic forms, the allergen penetrates parenterally, through the digestive tract or respiratory tract, and potentiates local changes through a cascade of pathogenetic reactions.
The following main sources of substances dangerous in terms of genital allergy are distinguished:
- Contraception. Mechanical protection against unwanted pregnancy and STDs often provoke allergic reactions due to close contact with the genitals. The use of condoms, spermicidal agents in the form of ointments, gels and vaginal suppositories is capable of causing manifestations of pathology in women and men. In the role of the allergen can be latex or contraceptive auxiliary components.
- Male sperm. In some women, itching and redness of the vulva, labia, pubis skin occur when semen gets on them during sexual intercourse. It has been established that the cause of such reactions is hypersensitivity to sperm glycoproteins.
- Medications. Various drugs can provoke genital allergies, both with local and systemic use. Intolerance reactions are often noted in the case of local application of antiseptics in the form of solutions or ointments. Oral or parenteral sulfanilamide and iodine-containing drugs also sometimes show lesions in the integument of the genital organs.
- Cosmetic and hygiene products. A variety of shampoos, shower gels, cosmetics for intimate hygiene have a complex chemical composition and may contain allergens. Pathological symptoms develop after using these tools.
- Underwear. The poor quality of the materials, the presence of synthetic or latex in the fabric may provoke allergies. As a rule, it has the character of contact dermatitis, proceeding according to the mechanism of the reaction of the delayed type. A large amount of synthetic materials also impedes the ventilation and evaporation of fluid, impairing skin breathing.
Pathogenesis of genital allergy
Basically, the pathogenesis of genital allergy corresponds to the first and fourth types of immune responses (according to the classification according to Jell and Coombs). The most common is the reagin variant (the first type), sometimes the disease occurs due to delayed cellular reactions (contact dermatitis).
In either case, initial contact with the allergen is necessary, during which it is recognized by the immune system and the formation of “allergic readiness”. Immunological memory cells are formed in the patient, which upon repeated contact with the provoking substance can trigger an allergic process.
In case of intolerance of the first type, repeated contact with the antigen causes accelerated formation of specific antibodies of class M and E. The latter have the ability to stimulate tissue basophils located in the skin and mucous membranes, causing their degranulation. In its course, histamine, serotonin and other compounds responsible for the development of redness, edema and itching in allergies are released in the tissue.
Delayed cell-type reactions are formed rather slowly with long and repeated contact with the allergen. In addition to non-specific symptoms, allergies in the genital area can manifest as balanoposthitis and urethritis in men or as vulvovaginitis in women.
Classification of genital allergies
There are several main clinical variants of genital allergy, differing in etiology and symptomatology. Determining the type of the disease plays an important role in identifying its causes and in the development of treatment tactics by an allergist or dermatologist.
The generally accepted classification contains the following types of pathology:
- Acute allergic dermatitis. The most common type that includes a wide range of conditions is balanoposthitis in men, redness and itching of the large labia and perineum in women. May be due to local or systemic exposure to the allergen. This group includes some forms of drug allergy – for example, a genital lesion in Lyell’s syndrome.
- Acute allergic urethritis. It is characterized by inflammation of the urethra, its symptoms practically do not differ from infectious acute urethritis. Most often occurs when intolerance to antiseptics introduced into the urethra for the treatment and emergency prevention of STDs.
- Acute allergic vulvovaginitis. The female variant of allergy, in which edema and itching of the vulva, large and small labia, clitoris frenulum develops. Common causes are topical application of spermicidal or medicinal ointments and suppositories, as well as intolerance to the components of seminal fluid.
- Fixed erythema. A rare form of allergy, accompanied by the appearance of spots of dark red color with clear boundaries. It becomes a result of parenteral or oral administration of certain drugs – most often antimicrobials from the sulfonamide group.
- Chronic forms of allergies. Long-lasting varieties of pathology, which often lead to dry skin or their lichenification. Usually occur as a result of intolerance components of products for hygiene and skin care, underwear
Symptoms of genital allergy
The main feature of the disease is the localization of skin manifestations in the area that includes the external genitalia, the perineum and the perianal region. Sometimes the changes extend to the inner thighs and lower abdomen. The most frequent symptoms are considered to be erythema, pruritus, less frequently swelling of the tissues.
In men, the skin of the scrotum is often affected, and balanoposthitis develops. Women often have swelling of the labia, vulvar itching, burning sensation in the vagina, especially after sexual intercourse.
Some types of the disease can provoke inflammation of the terminal parts of the urinary tract – urethritis. In this case, the symptoms associated with discomfort when urinating (burning, soreness), frequent false urges. Fixed erythema on the background of drug allergy leads only to a limited reddening of the skin, itching and other subjective manifestations are absent.
The duration of the course is very different for different forms of genital allergy, depending on the duration of contact with the allergen. Usually, skin disorders disappear within 2-3 days after the removal of the provoking substance.
Complications of genital allergy
Serious complications of genital allergy are extremely rare. The most frequent consequence of the disease is a skin infection caused by the ingress of microorganisms into the tissues. Balanopostitis in rare cases leads to the development of paraphimosis, requiring urgent medical intervention. As a result of allergic inflammation of the foreskin, cicatricial changes may occur, accompanied by the appearance of synechiae and phimosis.
In women, the disease is a predisposing factor for the urinary system (cystitis, pyelonephritis). An indirect threat of allergy is the fact that it can mask the symptoms of certain sexually transmitted diseases, causing misdiagnosis.
Diagnosis of genital allergy
In clinical dermatology, the definition of genital allergy is often not difficult due to the severity of symptoms. The main diagnostic measures are aimed not so much at clarifying the type of pathology, as at finding out its causes, excluding other skin or venereal diseases. Accurate identification of the allergen allows the patient to give correct recommendations for the prevention of recurrence of allergies in the future.
Assign the following diagnostic procedures:
- Survey and inspection. The specialist examines the genital area of the patient, assesses the condition of the skin, the prevalence and severity of violations. If necessary, a gynecologist consultation. By interviewing, they find out the duration of manifestations, the presence of itching and soreness, clarify the possible connection of symptoms with the use of cosmetics and food intake.
- Lab tests. It is mandatory to perform serological tests for the presence of antibodies to the causative agents of major STDs – gonorrhea, chlamydia, syphilis, which can be masked as allergic manifestations. Perform the determination of specific IgE by enzyme immunoassay.
- Allergological tests. On the basis of anamnesis data, the range of possible allergens is narrowed, then, using scarification skin allergy tests (prick-test), an exact identification is carried out. The most commonly studied body reactions to latex antigens, semen, some drugs.
Differential diagnostics is performed with venereal pathologies and some systemic skin diseases (eczema, seborrhea). With the development of urethritis, taking into account the data of the general analysis of urine and urethral smear confirm its non-infectious nature.
Exclude the presence of candidiasis (the head of the penis in men and the vagina in women), in which mixed inflammation of an infectious-allergic nature is often observed.
Prognosis and prevention of genital allergy
In most cases, genital allergy is characterized by a favorable prognosis – after exclusion of the allergen, the manifestations disappear without a trace. In some cases, cicatricial changes occur in the genital area, leading to the development of synechiae. Other consequences are problems with the conception of a child in women who are hypersensitive to seminal fluid, damage to the urinary tract.
Prevention of allergies is reduced to the exclusion of contacts with provocative products or medicinal substances, the proper selection of contraceptives and underwear.