Vulval dermatoses are inflammatory skin conditions affecting the vulva (external genital area). They are not sexually transmitted and include:
- Lichen Sclerosus: Causes thin, white patches and scarring.
- Lichen Planus: Leads to itchy, purple bumps or erosions.
- Eczema/Dermatitis: Red, itchy rash from irritants or allergies.
- Psoriasis: Thick, scaly patches.
- Contact Dermatitis: Reaction to soaps, detergents, or latex.
Causes & risk factors
- Autoimmune Factors: Lichen sclerosus/planus may link to immune system issues.
- Skin Sensitivity: Allergies to hygiene products, perfumes, or fabrics.
- Genetic Predisposition: Family history of eczema or psoriasis.
- Hormonal Changes: Low oestrogen (e.g., menopause) can worsen symptoms.
Symptoms
Symptoms vary by condition but may include:
- Itching or burning (often severe).
- Pain during sex, urination, or daily activities.
- Skin changes: Redness, cracking, white patches, or blisters.
- Thickened or scarred skin (in chronic cases).
Diagnosis
- Clinical Exam: A gynaecologist will inspect the vulva.
- Biopsy: Small skin sample to confirm lichen sclerosis/planus.
- Patch Testing: For suspected contact dermatitis.
Treatment options
Medical treatments
- Topical Steroids (e.g., clobetasol): Reduce inflammation (key for lichen sclerosus/planus).
- Moisturizers/Emollients: Fragrance-free creams to repair skin barrier.
- Calcineurin Inhibitors (e.g., tacrolimus): For steroid-resistant cases.
- Antihistamines: To relieve itching.
- Hormone Creams: Oestrogen for postmenopausal dryness.
Lifestyle & self-care
- Avoid Irritants: Use hypoallergenic soap, wear cotton underwear.
- Cool Compresses: Soothe itching/swelling.
- Gentle Hygiene: Rinse with water; avoid scrubbing.
Severe cases
- Phototherapy: UV light for psoriasis.
- Oral Medications: Immunosuppressants or retinoids.
Prevention & daily care
- Choose Products Wisely: Avoid douches, scented pads, or tight clothing.
- Stay Dry: Moisture worsens irritation—change wet clothing promptly.
- Regular Follow-ups: Monitor for scarring or skin changes (lichen sclerosus carries a small cancer risk).
Frequently Asked Questions
Q: Is this an STD?
A: No—these conditions are not infections and cannot spread to others.
Q: Can vulval dermatoses be cured?
A: Many are chronic but manageable with treatment. Lichen sclerosus requires lifelong care.
Q: Will this affect my sex life?
A: Pain can be addressed with topical numbing creams or dilators. Discuss options with your gynaecologist.
Q: Are these conditions linked to cancer?
A: Rarely—lichen sclerosus slightly increases vulvar cancer risk, but regular checks reduce this.
eGynaecologist Advice
- You should seek gynaecological consultation if you have persistent symptoms despite self-care or if you develop bleeding, open sores, or difficulty urinating.
- Most vulval skin conditions are chronic but manageable with proper care and you should continue to use prescribed cream by gynaecologist even if symptoms improve.
- You must seek gynaecological consultation if you suspect scarring or develop complications of known vulval dermatoses.
