Pad rash (contact dermatitis of the vulva area) is a common problem that many women experience while menstruating. The skin irritation occurs when the sensitive vulva area comes in contact with the materials, chemicals, or moisture of a sanitary pad. Pad rash can cause itching, burning, redness, bumps and swelling of the tissue. It can be annoying and irritating as well as affecting hygiene and increasing the risk of infection.
What are other names for pad rash?
Pad rash is also called contact dermatitis, period rash, sanitary pad rash, maxi pad rash, napkin rash, vulvitis and intertrigo rash. It is caused because the pad is irritating the skin.
What does pad rash look like?
Color - the skin of the area may look different than normal. It could be pink or red or dotted. Because the area has a darker color than most of the skin on the rest of the body a change in skin color may not be noticeable. The darker the skin color the harder it may be to visibly detect a rash.
Itching - the area may have subtle to intense itching that may vary in intensity at times. If changing the sanitary pad does not completely remedy the itching you may have pad rash in the area.
Swelling - the area, or parts of the area, may have swelling.
Tenderness - because the skin is irritated, may have micro-openings and may be swollen, the area may be tender.
Bumps - the area may have small bumps or raised areas from the pad rash.
Blisters - the vulva may have blisters due to the sanitary pad rash.
5 elements the contribute to pad rash:
- Having a period causes menstrual fluid to flow on to the skin. Unlike after urination, this fluid is not dried off from the skin immediately. After urination, any wet areas are quickly dried off ensuring the skin does not have moisture on it for an extended period of time.
- External products that capture and absorb the period fluid stay wet or damp and are now held against the skin for a prolonged length of time.
- The chemicals in feminine hygiene products can be irritating to the sensitive vulvar skin.
- The friction of the pad materials can cause irritation to the area. This situation can occur with everyday walking and movement and can become more significant with running, jogging and other forms of physical exercise.
- The materials the sanitary pad is made from may cause an allergic reaction.
These elements can be further exacerbated in 3 ways.
- Attempting to “help” the rash with over cleaning the area with products or over-rubbing, causing further irritation, chafing or micro tears in the skin.
- Avoiding thoroughly cleaning because of pain and sensitivity in the area.
- Using speciality products that instead of nurturing and supporting the area, cause increased irritation, which is often followed by the person then using even more of the product to try to get rid of the increased problem the product caused.
Fortunately, there are ways to prevent and treat pad rash!
Here are some tips to help avoid this unpleasant condition:
- Choose unscented pads that are made of natural or hypoallergenic materials. Some pads may contain fragrances, adhesives, or gels that can trigger an allergic reaction or skin irritation. Organic cotton pads or reusable cloth pads that are more breathable and gentler on the skin are available and becoming more popular.
- Change pads frequently. Wearing pads creates a warm and moist environment that promotes bacterial and fungal growth, irritation and inflammation. Pads should ideally be changed every 3 to 4 hours, depending on flow and specific make-up of the pad. Pads that pull fluid away from the skin are preferable to pads where the fluid sits in the top layers of the pad construction. Some overnight pads are specifically designed to pull fluid into the pad. Bacterial growth in the blood-body fluid medium occurs continually and exponentially. The longer it is allowed to develop, the increased possibility of having pad rash as well as an infection. Even if the flow is light, it is important to change the pad frequently.
A large study found that there was a strong association between unhygienic menstrual management practices and the prevalence of lower reproductive tract infections.
- Wear loose-fitting cotton underwear during your period. Tight or synthetic underwear can trap heat and moisture, which can worsen pad rash.
- Cleanse the vulva area gently. Use a mild soap that is pH balanced or that preferably has clean, organic, non-endocrine disrupting ingredients. Avoid using harsh or scented products that can disrupt the natural balance of the skin. Rinse the area well with warm water and gently pat dry with a soft towel.
- Using skin protectants and healing ointments. For some women these can be very helpful and help protect and nurture sensitive skin. For other women adding more moisture to the area is counterproductive. Often users do not realize that the skin needs to be clean and dry before using products that will help provide a moisture barrier or help heal irritated tissue. Skin products that are used on regular skin like topical steroids, calamine etc are too harsh to use on the sensitive skin of the genitals. If you believe a stronger product is indicated for your rash, it is important to consult with a provider.
- Seek medical attention if needed. If the pad rash does not improve within a few days, or if you develop signs of infection such as fever, foul-smelling discharge, or increased pain, you should see your provider. You may need antibiotics or antifungal medications to treat an infection. Fungus and yeast grow in warm, moist and dark environments. During your period is an ideal time for a sub-threshold yeast infection to become worse.
- Take care with your diet. Often when women are menstruating, they tend to eat more sugar and “junk” food. These dietary choices often will cause further skin irritation as well as feeding fungus and yeast. Try to eat and drink the foods and beverages that nourish your body and support your skin even during your period. Not eating high carbohydrates all month and then “splurging” on items that suddenly increase your blood sugar can significantly increase the problem.
- Period Underwear has become more popular over the last 10 years. Although the underwear may absorb 14 hours worth of flow, it is important to remember that the bacteria is reproducing exponentially from the second it leaves the body. Bacteria now have a warm, protected, blood-fluid medium to grow. Although the blood flow may be “trapped” in the material, the bacteria is not and will continue to grow, reproduce and expand until the period underwear is changed.
Pad Rash - Hacks, Causes, Prevention, and Remedies
Experiment: wearing the pad for a few days when you are not having a period is an excellent way to determine if the specific pad is causing the issue. If you experience elements of the pad rash even though you are not having a period it is not the best product for you. If you do not have issues it does not necessarily mean the pad is not contributing to pad rash. When moisture and bloody-fluid are added to the maxi pad it may be enough to cause pad rash with that product.
Size: pads come in different sizes just like women come in different sizes. Experiment with different sized pads to discover what works better for you to help minimize friction.
Change the size to match the activity. A pad larger than the one you wear during the day may be better to use overnight. When participating in exercise, changing your pad to a smaller one for the exercise period may help decrease the friction and chaffing. When exercising there will be sweat as well as menstrual fluid. This makes it even more important to change the pad after the exercise and wash and dry the skin thoroughly.
Brands: there are significant differences in sanitary napkin brands. One brand may cause pad rash while another brand may be fine for you.
Fragrances: although it is a great marketing angle, having fragrances in pads increases the likelihood of skin reactions. When fluid contacts the material, chemicals in the material may have increased potency to negatively affect the skin.
Washing non-disposable pads: Non-disposable pads that are environmentally friendly are becoming more popular. If you are having any irritation from their use check that your laundry detergent is free from skin irritating chemicals. Softeners and dryer sheets can also coat the cloth pad in chemicals that can irritate the skin.
How do I know if I have pad rash?
One of the easiest ways to determine if you have pad rash, or something else, is to discern if you only have the rash during your period or is it throughout the month?
There are other conditions that cause similar symptoms to pad rash.
If these symptoms are present a visit to your provider may be indicated:
- Abnormal discharge that is different in color, thickness or has a foul odor
- Pain during intercourse
- Pain during urination
- Pain in the abdominal or kidney area
- Persistent vaginal itchiness
- A fever accompanying the rash.
What to know?
Sometimes women have a chronic infection that only gives them symptoms during their period when there are other limited time elements that contribute to the problem becoming worse. It is important to be aware of this possibility. If the pad rash does not go away, or improve, despite the efforts to keep the area clean, dry and without irritation from the pad or friction, you may have a chronic infection and a health provider should be consulted.
Pad rash can be uncomfortable and annoying but with a few simple steps pad rash can be prevented and addressed so there is one less problem to worry about.