to not really want to be brushed off about this?

[SingingSamosa]

Posting here for traffic as much as anything really.

My 6.5 year old DD (middle child) has suffered pretty much all her life with what seems like really bad nappy rash in her privates. It doesn't affect her bum, just her actual labia but all the way up and back. The doctors originally told me it was bacterial vaginosis when she was a baby and I had prescription cream for it (Timodine). Despite hourly nappy changes she'd still get it and it was so so sore. They told me it would disappear when she started potty training but she was potty trained at 2 and it still comes back periodically.

We have been back to the doctors numerous times - she was even referred to a paediatrician at one point but they've all said there's no bacterial or fungal issue (from swabs). They think the main issue is that she doesn't manage to wipe away all her wee when she goes to the loo but she tries so hard to do this yet it still comes back. I (and she) apply nappy cream when it starts to get a bit sore again but it's not that effective.

Last night I was up with her for two hours whilst she screamed in pain and her labia were very inflamed and red looking. Eventually a cold flannel, some Calpol, cuddles and lashings of nappy cream eventually soothed her enough to get her to sleep but I'm at my wits' end! Medical professionals have said that there's nothing more they can do. It's horrible hearing her sob and scream and not be able to do anything about it

Surely they can't just fob her off like this? I've watched her wipe after she's been for a wee and there's not any discernible difference in how she does to how her big sister or I do it.

She is a bit of a precious snowflake type in terms of sensitivity - she can't bear wearing certain clothes because they irritate her skin, she can't stand loud or high noises etc. I've always thought this type of 'super sensitivity' was more of a psychological thing that children had than an actual physical thing but perhaps she has very sensitive privates?

Has anyone else experienced anything like this? (Sorry for the long post!!)

My youngest had very sensitive skin generally but particularly in the nappy area. I swear if I didn't get a dirty nappy off in five seconds flat he would be raw. I used to use a cream, think it was drapolene, even if he wasn't sore, couldn't use biological washing powders or any sort of scented soap or bubble bath. I think he's grown out of it, don't think he would appreciate me asking now, he is 6'3" with a very deep voice.

Bepanthen

Or I was wondering about lichens sclerosus.

My lichens sclerosus didn't look like the pictures on Google by the way. Just looked red.

I've come late to this thread so it's already been suggested.

DD had Strep A as a baby that the twatty GP insisted was thrush for a year that was finally treated only for her to be left psoriasis. It flares up and down despite treatment and a very good dermatologist doing her very best to help

Psoriasis sounds likely then if you have it.

Moogoo do a nappy cream that is recommended by people who have psoriasis- might be worth a try?

Have you tried to give her probiotics?
No underwear at night and no tights in the day. There is a swedish cream called idomin salve which i always use on ds and myself which you can get on amazon which is fantastic.

Sounds like psoriasis, no to sudocrem, I use AquaMax cream, I use it for moisturising and washing, anything else triggers psoriasis flare up.

Im sorry your daughter is in so much oain the only thing i can suggest is get a little jug for her to wash her self with after she goes to the loo..so she can just poor water on the area and then pathe dry.

I've seen similar issues with thrush. The thrush is not detectable at all in any swabs but I know it's thrush because it responds to the thrush cream and goes away if I cut sucrose our of his diet entirely.

You could try this:

Miconazole oral gel in her mouth twice a day

Miconazole cream on the itchy skin 5 times a day (get the good cream that they give for breastfeeding thrush.)

cut refined sugar out of her diet entirely for a fortnight. Fruit sugar is okay but not glucose, or sucrose.

Also you could leave the skin bare (no pants) as keeping it dry will help a lot to get rid of thrush.

You need the GP to prescribe these but I think you could convince them if you really push and tell them what you've told us.

If that doesn't work, then it's probably not thrush, but I wouldn't trust doctors who say she hasn't got thrush. They are rubbish at detecting it and many don't seem to believe it exists.

For emergency pain relief have you considered anbesol liquid. It's an anaesthetic and makes skin go numb I think. Just a thought, anyway.

My DD gets like this but not so severe

camomile tea solution with tea tree oil - soak flannel in solution to clean and soothe
sudocrem overnight
encourage powedring after going to the toilet, talc free powder, or even just cornflour works to ensure skin very dry and no chafing

My dd took vaginal thrush when she was 11, and also a run of mouth ulcers. Her Dentist asked the Gp to take bloods and it turned out that she had very low iron stores, but was not actually anaemic. She was given extra iron and the ulcers and thrush cleared up quickly.

Has your Dd had any other investigations?

My friend's little girl gets this. Probably not recommended, but smearing the when area liberally with Vaseline gives her more relief than anything else.

Could it be reflux (of kidney or bladder not entirely sure which it is). SIL had this as a child and described it exactly like your daughter has, red and sore but not itchy.

Haven't RTFT so apologies if already covered but I think this might be psoriasis - it looks very different in the groin/genital area, much less flaky, very red.

I think you need to ask for a dermatology referral - I'm a GP - I'd refer for this

Ask for a second opinion at your hospital. Don't take no for an answer - you are entitled to it. Make a fuss if you need to.

My six year old had this just before Xmas it was awful, what really helped was using metanium, you get it in the baby nappy cream bit in tescos.

No nappy cream or suncream helped at all.

I'm sure others have mentioned it before but on the off-chance metanium zinc oxide cream is wonderful for nappy rash

OP- I hope this links helps- you need a dermatologist for a diagnosis of whatever it is. I hope you can get a referral but does this ring bells- I see others have suggested it:
www.naspag.org/?page=pediatricvulvarliche

Do you use fabric conditioner? It can be really bad for triggering skin problems.

I would try switching laundry detergent and conditioner to Surcare ones (which are fragrance-free) for the whole family. If she is sensitive then fragrances probably don't help. You might have to give it a couple of months to see if it makes a difference.

Crushed ice well-wrapped in a soft towel can give some relief. (I remember it well )

Poor lovey, it's not nice.

Has she had strep throat?

I once did a medical article extensively interviewing a psoriasis doctor/researcher and he said an incidence of strep throat, combined with other factors (genetic etc.) appears to trigger psoriasis; if people with the other predispositions never get strep, they probably never get the skin disorder either. It was fascinating.

He told me in one study people of all ages, including adults who had psoriatic outbreaks for decades, had their tonsils removed and the effects were stunning. Apparently the tonsils as gatekeepers of the body can trigger the immune response that flares up psoriasis (which is actually a normal immune response that goes into overdrive and becomes undesirable). I think you should get her to a dermatologist specialist asap.

One site I just saw said someone with the condition on her genitals had luck soothing with olive oil.

Deedeecupcake: kidney reflux. You can outgrow it, but it's a total misery until then.

Keep going back to GP until you get help. It's impossible to diagnose over the internet (not that I would be able to diagnose anything anyway!).

I have a skin condition which was a nightmare to get diagnosed, and was fobbed off a lot.

I like the idea of crotchless tights - take the seams out. You are already having her sleep without knickers on - I would have her take her knickers off as soon as she gets home, and only put them on to go out, so she spends as much time as possible without them on. I do this with my dd and it seems to help.

The trouble with these things is that there are so many variables to rule out. When you get a consultation it might have to go on for quite a long time as you try to rule things out one by one. You've already ruled out the most obvious things like washing powder, soaps, etc. But it could also be something unrelated to skin - like general oversensitiveness. It could also be a general thing in her immune system - she seems susceptible to worms (I think once or twice a year is quite a lot, even for a thumb-sucker?) and the going to the loo quite frequently at school also suggests she is sensitive to something...not sure what. Just saying that it might not be something a dermatologist can discover because it could be that the skin is just the symptom of some underlying sensitivity - even to something random like something she eats. Or could be an allergic reaction to something she encounters that is harmless to most people.

Sorry, not helpful. My dd has eczema and it's really a long process trying to rule out triggers. Since you're tried so many things and it's gone on for a long time I think the cause will lie somewhere further afield.

Your description made me worry it could be lichen sclerosis. My son's undergoing a referral for the male version (BXO) at the moment, so it's at the forefront of my mind, but can be difficult to get a diagnosis in females as its rarer in children.