<s>[INST] I have a 4 year old daughter who grabs herself. Her primary care talked about looser underwear, no pantys after her bath, good wiping habits. W e have been doing this now for several months. She is now crying everyday about the tickle that she feels and she wants it to stop. Is there a deeper problem? [/INST] Hi... By what you quote I feel that she might be having a fungal infection in the local area. I suggest it is better you consult a pediatric dermatologist and get examined properly, and she might get better with 4-6 weeks of topical antifungal medications or mild steroids. The other possibility is that she might be having worm infestation, and she might need deforming too with Albendazole. Regards -  </s>