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Causes of vulval pain and discomfort — non-infectious vulval skin problems
Vulval skin problems can be difficult to diagnose and you may want to ask to be referred to a dermatologist or specialist vulval clinic. Treatment often includes using a corticosteroid cream and emollients. Emollients are bland creams and ointments that should be free of skin irritants. They can be used to soothe and hydrate sore and cracked skin and as a soap substitute to clean the vulva. They are available as creams, lotions and bath additives, and are available from chemists without a prescription. Examples are Aqueous Cream, E45 and Epaderm ointment. There are also a number of things you can do yourself to alleviate symptoms. See the vulval care section under Other issues. |
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Lichen sclerosis Lichen sclerosis (LS) is a non-infectious inflammatory skin disorder which affects the vulval and perianal skin (around the anal opening). It tends to affect women in their middle years (around 50) but young women, children and men can also get it. If it affects other parts of the body it is known as 'extra genital LS'. Symptoms include itchy, sore and inflamed vulval skin which cracks, causing additional pain and stinging. The skin becomes pale and parts of the vulva (lips, clitoris) can shrink and fuse together. Not everyone affected with LS will experience all these symptoms. Because a GP may not be familiar with this condition, it can be misdiagnosed as thrush or believed to be related to the menopause or hormonal problems. Referral to a dermatologist, gynaecologist or vulval clinic is advisable. Once diagnosed (usually after taking a small piece of skin under local anaesthetic) LS is treated with a strong steroid cream, usually greatly improving symptoms, although unfortunately it can flare up again at a later date. Women with LS should avoid anything that could irritate the vulval skin. Lichen planus Lichen planus is an itchy skin disease that can affect any part of the body but if it affects the moist skin of the mouth and genital area, it causes raw and painful patches. Treatment is in the form of steroid cream or even steroid tablets and treatment should be supervised by a specialist dermatologist. The advice on vulval care under Other issues applies. In a small percentage of cases, women with lichen sclerosis or lichen planus may develop vulval cancer so the area should be checked at regular intervals for any changes in the skin. |
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Written by Ingrid Smit and published in printed format (2001) by Women's Health
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A woman's vulva can also be affected by skin problems that are not infectious and cannot be passed on to sexual partners. Soap, disinfectants and detergents used for washing underwear can easily irritate vulval skin. It is also possible to have an allergic skin reaction to the preservatives and other ingredients in vulval creams.
