What is 'petticoat cancer' that doctors are warning Indian women against?

Do you love wearing sarees?

If so, you’re not alone. The saree holds a long cherished place in traditional garments in India, adored by women of all ages and cultures across the country. It is somewhat of a staple in all wardrobes.

However, recent research reveals a hidden risk that might give saree lovers a pause for thought.

A study published in BMJ Case Reports warns a snuggly saree around the waist, could lead to skin disorders and even a rare form of cancer dubbed ‘petticoat cancer ’ or ‘saree cancer’.

The report details two surprising cases involving elderly women who developed this rare cancer after wearing sarees daily for decades, pointing to a risk that’s gone largely unnoticed.

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Here’s everything you need to know about ‘petticoat cancer.’

What causes ‘petticoat cancer’?

The condition called Marjolin’s ulcers, colloquially referred to as “petticoat cancer,” is a possibly triggered when the saree’s underskirt or petticoat around the waist cord is tied very tightly.

Dr Darshana Rane, Consultant at Medical Oncology, HCG Cancer Centre, Borivali told Hindustan Times, “A rare but notable condition called saree cancer can affect women who wear sarees daily. This unique condition usually occurs in the midsection, or at the waistline."

“When this cord is fastened constantly at the same level in the abdomen, it can lead to dermatoses (skin irritation), which can become ulcers, also known as Marjolin’s ulcer, and, in very rare cases, malignancy,” she added.

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The research said that this sustained waist pressure can thin the skin, leading to erosion and ulceration that may turn cancerous.

Recent cases

Doctors have reported several cases where older women developed this rare skin cancer after decades of wearing tightly tied sarees.

In one recent case, a 70-year-old woman noticed an ulcer on her right side accompanied by pigmentation. The persistent pressure from her petticoat cord over the years led to extensive skin damage, leading to the ulcers, medically diagnosed as squamous cell carcinoma.

“I wore a tightly wrapped saree for decades, unaware it could harm my health. A minor skin change turned into a painful, non-healing ulcer, eventually diagnosed as skin cancer,” the septuagenarian was quoted by India Today as saying.

These are not isolated cases. Similar incidents have emerged over the years, with one case reported in Chennai, another in Bengaluru in 2014, and a more recent case in Mumbai in 2020, according to The Telegraph.

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One case involved a woman in her late 60s who wore a lugda, a traditional saree style tied directly at the waist without an underskirt. She eventually developed an ulcer that spread to her lymph nodes.

Reflecting on her ordeal, she shared, “This experience has been physically and emotionally taxing. I hope my story encourages others to seek early medical advice if they notice unusual skin changes."

This condition is not limited to women, men who wear dhoti are equally at risk.

Pathologist Vasant Khanolkar described it as “dhoti cancer” after he encountered the condition in eight men.

“We think the sari was wrongly blamed. The pressure on the skin and its consequences comes from the tight petticoat cord,” Madke told The Telegraph.

“We might ask why we don’t see belt cancers — one possibility is that belts have a greater width than cords in petticoats. The thinner the cord, the more intense the pressure,” he said.

Signs of ‘petticoat cancer’

In India’s hot and humid climate, particularly in rural regions, this condition can worsen rapidly.

“Irritation from the petticoat cord gets worse with the hot and humid climate of India, especially in rural areas where healthcare services are unavailable or not very accessible. Very often sweat and dust accumulate around the tightly tied cord causing itching and scratching,” Dr. Darshana Rane explained to Hindustan Times.

She added, “Unfortunately, women who stay in remote areas may not pay attention to early symptoms such as pigmentation or mild scale signs and allow the condition to develop before seeking medical help.”

Prevention

Avoid tight petticoats: Refrain from tying the petticoat too tightly, especially if you notice early signs of dermatosis, such as changes in pigmentation or mild scaling.

Choose a broader waistband: Using a petticoat with a broader waistband can help distribute pressure more evenly around the waist.

Ensure air circulation: Change the position where you tie the petticoat on the waist from time to time. At home, opt for loose trousers with an elastic waistband to allow better airflow.

Maintain good hygiene: Regularly clean the waist area, especially if you work outdoors, as dust and sweat tend to accumulate. Also, check the skin around the waist periodically for any signs of irritation.