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Thank you for the information. Your history is suggestive of either Neurodermatitis
or the beginning of LSEA (Lichen Sclerosus Et Atrophicus).
Neurodermatitis is a condition where the nerves in any area of the body become hypersensitive and fire under normal conditions to produce a sensation of itching. The primary problem is itching and any skin rash, redness or excoriation is secondary to the scratching. The skin may look absolutely normal as in your case. The external genitalia is a commonly affected site in both men and women.
This leads to an 'itch scratch cycle'. As in the more one scratches the more the area itches and so on. The first step in treatment is to break this cycle by giving relief from itching and instructing the patient to avoid scratching as much as possible.
LSEA is characterized by tightening and lightening of the skin of the glans penis and foreskin. Later on there might be difficulty retracting the foreskin.
Fortunately the treatment for both these conditions is similar.
Here is what will help:
1. Clobetasol propionate cream + Mupirocin cream: Mix and apply over the affected areas twice a day for 14 days then switch to Fluticasone propionate cream once at night for 2-4 weeks. These are prescription creams and till you can see a doctor use 1% Cortizone cream and mix it with equal parts of Neosporin cream before applying.
2. Tab Claritin 10 mg twice a day for 14 days, then once a day for 6-8 weeks. Initially the dose can be increased to 2 tablets taken twice a day if there is insufficient relief in itching.
3. Sarna sensitive lotion can be used 2-3 times a day to give further relief from itching. This can be continued even when the above creams have been stopped.
4. Avoid scratching the affected areas as much as possible. This is most important. Whenever it is not bearable soak a towel in ice cold water and keep it on the affected areas or apply the Sarna sensitive lotion.
NOTE: 1% Cortizone cream, Neosporin cream, Claritin and Sarna lotion can be bought without a prescription. Clobetasol, mupirocin and fluticasone will require one (prescription).
Nothing over the counter will bring about lasting improvement though and I would strongly recommend discussing my recommendations with your GP/Family physician to get the prescription creams.
Hope this information is useful, please feel free to ask if you have any queries.