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).
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.
Frequently Asked Questions
Is this an STD?
No – these conditions are not infections and cannot spread to others.
Can vulval dermatoses be cured?
Many are chronic but manageable with treatment. Lichen sclerosus requires lifelong care.
Will this affect my sex life?
Pain can be addressed with topical numbing creams or dilators. Discuss options with your gynaecologist.
Are these conditions linked to cancer?
Rarely – lichen sclerosus slightly increases vulvar cancer risk, but regular checks reduce this.
