An Overview of Genital Rashes

Genital rashes have many different causes, ranging from jock itch and vaginal yeast infections to sexually transmitted infections (STIs) caused by bacteria, viruses, and parasites.

Depending on the underlying cause, a genital rash can manifest with a single ulcer or sore or widespread inflamed, scaly skin or itchy, red bumps.

This article describes some of the more common causes of genital rashes and their associated symptoms, as well as how they are diagnosed and treated.

Fungal Infections

There are different types of fungi that can establish an infection on the genitals of females and males.

Yeast Infections

These are caused by the overgrowth of a fungus that naturally resides on the skin called Candida albicans. This can cause vaginal yeast infections in females and penile yeast infections in males.

If the immune system is weakened, the fungus can grow out of control.

Symptoms that can accompany a genital rash from a yeast infection include:

• Itching
• Burning
• Cheesy, foul-smelling discharge from the vagina or from under the foreskin

Jock Itch

Jock itch (tinea cruris) is an infection most commonly associated with the Trichophyton genus of fungi. It can spread from person to person through skin-to-skin contact or from a fungal infection on the feet, known as athlete’s foot.

Jock itch is characterized by an itchy, red rash on the groin, buttocks, and thighs.

Sexually Transmitted Infections

Many STIs will cause a genital rash, although they can vary by their number, appearance, and accompanying symptoms.

Genital Herpes

Genital herpes, most commonly caused by herpes simplex 2 virus (HSV-2), is spread by skin-to-skin contact.

Herpes manifests with one or more blisters on or around the genitals or rectum which break and leave painful, oozing sores.

Flu-like symptoms may also accompany the rash.

Genital Warts

Genital warts are caused by the human papillomavirus (HPV) and are spread by intimate skin-to-skin contact.

Genital warts usually appear as a small bump or group of bumps on the genitals or rectum. They can be small or large, raised or flat, or shaped like a cauliflower.

Unlike some types of HPV, those that cause warts usually do not progress to cancer.

Molluscum Contagiosum

Molluscum contagiosum is a viral STI that causes small, wart-like growths that may be painless or cause itchiness or soreness.

The virus is classified as a poxvirus (related to smallpox) and can be transmitted sexually or by contact with an infected towel or item of clothing.

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Pubic Lice

Pubic lice, sometimes known as crabs, are caused by a different species of lice (Pthirus pubis) than those that cause head lice. The lice are most commonly spread by sexual contact.

The main symptom is intense itching caused by a hypersensitive reaction to the parasite’s saliva. In addition to tiny, dark bumps on the skin, there may also be a gray-blueish skin discoloration.

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Syphilis

Syphilis is a common STI caused by a bacteria known as Treponema pallidum.

Syphilis has four stages, the first of which causes a painless, open ulcer (called a chancre) on the genitals or rectum, or in the mouth.

There will often be only one chancre, ranging in size from a tiny pea to as large as a quarter, although some people may have more than one lesion.

Other Skin Conditions

There are other skin conditions that can affect the genitals in addition to other parts of the body.

Hidradenitis Suppurativa

Hidradenitis suppurativa is an inflammatory condition that most commonly affects the armpits, groin, or under the breasts.

The cause is unknown but believed to be the result of blocked sweat glands along with certain genetic and environmental factors.

The condition causes inflamed, swollen bumps that break open and ooze fluid or pus.

Intertrigo

Intertrigo (intertriginous dermatitis) is known as diaper rash in babies. But, it can also affect adults due to poor hygiene and excessive moisture in the groin and other skin folds (such as the armpits and under the breasts).

Intertrigo cause causes a swollen, glistening rash along with scaling around the edges. Burning, stinging, or itching is also common.

Inverse Psoriasis

Inverse psoriasis is a form of the autoimmune disease psoriasis that specifically targets skin folds. The condition is most commonly seen around the genitals and armpits, under the breasts or belly folds, and between the buttocks.

Psoriasis typically appears as raised areas of inflamed skin covered with silvery-white, scaly skin. 

Lichen Planus

Lichen planus is an inflammatory, immune-related disorder that affects the skin, nails, hair, and mucous membranes.

The rash consists of raised, flat, purplish bumps that may be itchy or irritating. Genital lichen planus may affect the head of the penis and scrotum in males, and the vulva or vagina in females.

The exact cause of lichen planus is unknown.

Lichen Sclerosus

Lichen sclerosus is another immune-related disorder that can affect any body part but has a preference for the penis and vulva. Like lichen planus, it is not contagious, and the exact cause is unknown.

The condition can cause shiny, white spots on the vulva and white patches on the foreskin and head of the penis. In addition to itching, there may be bruising, cracking, tearing, and peeling.

Scabies

Scabies is caused by a microscopic mite called Sarcoptes scabiei. Scabies is spread by prolonged skin-to-skin contact with a person who has scabies or through infested clothing, bedding, or towels.

Scabies often is recognized by lines of small, pimple-like bumps between the finger and toes, in the crook of the wrist or elbow, or on the back, buttocks, or genitals. The itch is made worse by warmth.

Diagnosis

Many genital rashes are characterized by such distinct lesions and other symptoms that it’s obvious what they are. That said, if you develop any sort of skin changes on or near your genitals, see your healthcare provider—even if you think you know the cause.

A doctor will confirm the diagnosis by doing a physical exam, considering any other symptoms you’re experiencing, and reviewing your medical history.

If it’s unclear what's causing a rash, they can perform a lab test to pin down the correct diagnosis. This may be a viral culture, blood test, or, in the case of a suspected yeast infection, a KOH test to detect the presence of Candida.

Treatment for Genital Rashes

Treatment for genital rashes depends on the cause. For instance, yeast infections usually can be cured with over-the-counter (OTC) antifungal treatments.

Because genital rashes often cause itching, OTC creams such as hydrocortisone can be helpful. A physician might also prescribe a cream that soothes itching while treating the underlying cause.

Because it’s a bacterial infection, early-stage syphilis is treated with antibiotics. Genital warts are treated with a topical prescription medication such as Aldara (imiquimod), which is an immune response modifier.

Lice can be eradicated with medicated shampoos or body washes, and scabies is remedied with medicated creams. Genital herpes cannot be cured but can be effectively controlled with medication.

Coping With a Genital Rash

Some genital rashes require measures beyond medication to relieve discomfort and speed healing.

For example, rashes that are exacerbated by moisture, such as yeast infections and intertrigo, may get better more quickly if you wear loose-fitting clothing to allow for air circulation and avoid irritating soaps, detergents, or other body care products.

You’ll likely be instructed not to have sexual contact until your rash has completely cleared up. This is both for your own comfort and, if you have an STI, to protect intimate partners from becoming infected.

If you’re dealing with an STI, your healthcare provider may have other specific instructions.

In cases of excessive itching, do your best not to scratch, as this may worsen symptoms.