Petticoat Cancer: Doctors in India have highlighted a rare type of skin cancer, dubbed “petticoat cancer”, which is a condition believed to be triggered by the traditional practice of wearing sarees with tightly tied waist cords. This condition, documented in a recent case study published in the British Medical Journal (BMJ) Case Reports, has brought to light a potential health risk associated with the traditional clothing practices of women across India.
Doctors, including those from Jawaharlal Nehru Medical College, Uttar Pradesh, have linked chronic friction and pressure caused by the tightly bound waist cord of saree petticoats to prolonged inflammation, leading in some cases to ulcerations and even skin cancer.
According to the study, the condition primarily results from continuous abrasion and restricted blood flow in the skin around the waist area, where the cord remains tightly fastened for long durations.
In the study, two elderly women presented with persistent ulcers on their right flanks that had resisted healing.
The first case involved a 70-year-old woman who had endured an ulcer on her flank for over 18 months, stemming from years of wearing a tightly tied petticoat underneath her saree. Upon examination, doctors noted that her skin had depigmented around the area of the ulcer, which had since developed into a Marjolin ulcer, a rare but aggressive form of skin cancer called squamous cell carcinoma.
The second patient, a woman in her late 60s, had a similar ulcer that had failed to heal over a two-year period. She reported wearing a "lugda" — another form of traditional attire similar to a saree but worn without a petticoat and tied tightly around the waist. A biopsy confirmed her ulcer had progressed to a Marjolin ulcer, with the cancer spreading to one of her lymph nodes by the time of diagnosis.
Marjolin ulcers are known to develop in chronic, non-healing wounds that have been exposed to continuous trauma or inflammation. While traditionally associated with burn wounds, leg ulcers, or scar tissue, these ulcers can also develop in areas subjected to repetitive physical stress. In the case of "petticoat cancer", the waist cord’s constant pressure reportedly leads to cutaneous atrophy — a thinning of the skin — which eventually erodes and ulcerates, creating a wound that struggles to heal and, over time, risks turning malignant.
The authors of the study noted that while "saree cancer" has been recognised in some contexts, it is specifically the tightness of the waist cord, rather than the garment itself, that is to blame for the condition.
One of the patients described how years of wearing her saree tightly tied around her waist ultimately contributed to her diagnosis. “I have been wearing a Nauvari saree, tightly wrapped around my waist, for most of my adult life. Six years ago, I noticed a small area of depigmentation on my right flank, which I initially dismissed as a minor skin issue,” she shared, as quoted by news agency PTI. The issue eventually developed into a non-healing ulcer, which became a source of intense discomfort and concern.
Her diagnosis of skin cancer marked the beginning of a physically and emotionally taxing journey, one she hopes will serve as a cautionary tale for other women. "I hope my story will raise awareness among women about the potential health risks associated with traditional clothing practices and encourage timely medical consultation for unusual skin conditions," she said.
Doctors recommend that women wear loose petticoats beneath their sarees to avoid continuous pressure and friction on the skin. For women who notice unusual skin changes, particularly around the waist, they advise seeking prompt medical evaluation. If skin issues develop, they advise switching to loose clothing to allow the affected area to heal fully.
