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Suggest Treatment For Swelling In The Labia Majora

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Posted on Thu, 16 Feb 2017
Question: Hi. Two weeks ago I had a bartholin cyst and duct excision. 2 days after the surgery both my labia majora, minor, and my clotoris all swelled up extremely large. My whole area became so red and itchy and it was very hard to control myself not to itch. I went to the er and they prescribed me an antibiotic which brought the swelling down. Once the swelling went down there were several places on my labia majora that got sore and scabbed over from the itching. I went back to my ob/gyn a few days later who is now insisting the scabbed over places where I had itched so bad from the swelling is herpes. Is that even possible? There was no sores there when the itching occurred. But I scratched it so bad I drew blood and once the itching stopped and the swelling went down, it left a scabbed over sore. Please help!
doctor
Answered by Dr. Saul Weinreb (13 minutes later)
Brief Answer:
it is possible that it was herpes, I hope that come cultures were sent

Detailed Answer:
thank you so much for asking your question on healthcare magic. I will do my best to help.

it is possible that it was herpes. It could be that after the Bartholins cyst was drained that there was a breakout of herpes that was preexisting, and the stress of the Bartholins caused it to breakout. it is even possible that it started as a herpes infection, possibly a new infection, which resulted in the inflammation ad the Bartholins cyst in the first place.

however, it is also possible that you had the Bartholins cyst and it for superinfected with something else, maybe an STD or maybe just an ordinary infection. based on your description. it is impossible without doing any cultures or testing to really know what happened.

I hope your doctor was able to take some swabs to send for cultures for herpes and other things, and maybe even some blood tests for herpes antibodies. this way you can at least try to get some definitive answers to figure out what really is going on. it would be impossible without testing for me to be able to tell you what happened.

I hope this helps, please let me know if you have any more questions.
Above answer was peer-reviewed by : Dr. Vaishalee Punj
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Follow up: Dr. Saul Weinreb (13 hours later)
Is it possible that i had an allergic reaction to the anticeptic that was used to clean my genital area before surgery? Which then caused the swelling and itching which lead to me scratching open my skin and causing the scabbing?
doctor
Answered by Dr. Saul Weinreb (13 minutes later)
Brief Answer:
I suppose that is possible

Detailed Answer:
thank you again for your question.

I suppose that is possible, though there are several reasons which lead me to believe that this was not the case. first, you did not mention that you had any history of allergies to these topical antibiotic solutions. most probably you would've known about such an allergy from some previous exposure. however it is possible of course that you did not know yet that you were allergic.

the other thing is that the antibiotics they gave you on the ER did help the swelling. that would suggest more of an infection than an allergic reaction.

however. I also did not see it myself, so it is totally possible that your explanation is correct. I would still strongly suggest that you get tested though for herpes. a blood test done now can tell you if you were ever exposed to herpes. then you will have an answer.

please let me know if I can be of any further help.
Above answer was peer-reviewed by : Dr. Nagamani Ng
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Follow up: Dr. Saul Weinreb (31 minutes later)
The other odd symptom i had was whitening of the skin of my labia minora and majora. Which also peeled off. The dr did take a culture...it just seemed unprofessional and extremely nerve wracking for myself for such a quick diagnosis when i know for a fact there was no blister or lesion. The only reason a scab appeared was because i scratched it to the point of it bleeding and it was only one scab. The er also gave me prednisone through iv when i was there for my visit.
doctor
Answered by Dr. Saul Weinreb (11 minutes later)
Brief Answer:
it does sound like there must have been a communication problem

Detailed Answer:
I am so sorry that you had on go through that experience.

it sounds like it must've XXXXXXX quite unpleasant. however, since I didn't see it and I wasn't there, I can't really comment about the quick diagnosis. sometimes these things do look obvious. it is entirely possible that had i seen it that I would have agreed with the diagnosis of herpes. I hope that I would have been able to calm your concerns better and explain in a more clear and patient way what I was thinking and why. however, the lack of a blister doesn't really prove anything either way.

it is good that a culture was done, so you should have a diagnosis confirmed when you get the results. it may be a good idea to also get a blood test for herpes antibodies like I suggested.

in summary, it may or may not have been herpes. your explanation is certainly plausible, based on all of the things that you have told me. it is also possible that it appeared so obviously like herpes that your doctor was that confident in his/her diagnosis.

I really hope that you hear good news, and that whatever happens I am sure you will.getbproepr treatment. I am really sorry that your encounter with the physician in the ER seemed so hurried and impersonal.

please don't hesitate to ask me if you still need more information.
Above answer was peer-reviewed by : Dr. Nagamani Ng
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Follow up: Dr. Saul Weinreb (2 days later)
So the lab results came back negative today for herpes. The sores still have not gone away. Do you have any suggestions on what it could be and how to get rid of the sores?
doctor
Answered by Dr. Saul Weinreb (6 hours later)
Brief Answer:
it is extremely difficult to diagnosis a skin lesion without seeing it.

Detailed Answer:
thank you again for your question, at least you can be pretty sure that it wasn't herpes. I am sorry it took a few hours to get back to you, but I was busy at work all afternoon.

I still think that a blood test for herpes would be worthwhile just to make sure that the cultures were not a false negative. however, it seems that it probably was something else, as you suspected. a physical would be crucial for me to properly diagnose the sores and treat them appropriately. different types of lesions obviously require different therapies. if they are indeed a bacterial infection, then it would be treated with antibiotics. usually antibiotics by mouth are more effective than topical.

if it appears like an allergic reaction or a hypersensitivity reaction, then we would have to try and find the offending agent and avoid it while using topical steroids to treat it.

if it seems to be a fungal lesion, then antifungal therapy would be appropriate.

these are just some examples of possible causes and possible treatments. a physical exam and sometimes other tests should be able to identify the problem so a paper treatment can be found.

I am sorry that I can't make a recommendation for the sores that you have without being able to do a proper exam. I think you need to go back to your doctor, or find another doctor who will do a proper evaluation so that you can get relief.

please let me know if I can help you in any way. I would be happy to help guide you through this.
Note: Revert back with your gynae reports to get a clear medical analysis by our expert Gynecologic Oncologist. Click here.

Above answer was peer-reviewed by : Dr. Nagamani Ng
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Answered by
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Dr. Saul Weinreb

OBGYN

Practicing since :2000

Answered : 562 Questions

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Suggest Treatment For Swelling In The Labia Majora

Brief Answer: it is possible that it was herpes, I hope that come cultures were sent Detailed Answer: thank you so much for asking your question on healthcare magic. I will do my best to help. it is possible that it was herpes. It could be that after the Bartholins cyst was drained that there was a breakout of herpes that was preexisting, and the stress of the Bartholins caused it to breakout. it is even possible that it started as a herpes infection, possibly a new infection, which resulted in the inflammation ad the Bartholins cyst in the first place. however, it is also possible that you had the Bartholins cyst and it for superinfected with something else, maybe an STD or maybe just an ordinary infection. based on your description. it is impossible without doing any cultures or testing to really know what happened. I hope your doctor was able to take some swabs to send for cultures for herpes and other things, and maybe even some blood tests for herpes antibodies. this way you can at least try to get some definitive answers to figure out what really is going on. it would be impossible without testing for me to be able to tell you what happened. I hope this helps, please let me know if you have any more questions.