Vulvar Dermatoses

Vulvar dermatoses are common skin conditions that can affect up to 20% of women.  Symptoms may include pain, itching, burning and painful intercourse all of which can significantly impact a woman’s quality of life, health and sexual function. There are typically changes in the appearance of the skin like redness, pale patches, lesions or changes in skin texture.

Diagnosis involves a detailed history including hygiene, allergens and soaps/ detergents and a thorough examination which may  include testing such as a biopsy.

Some common dermatoses include lichen simplex chronicus, lichen sclerosus and lichen planus.

Lichen simplex chronicus causes an itch-scratch cycle that leads to thickening of the skin and changes in the color, which can appear red, pale or darkened. The skin changes occur because of chronic repetitive scratching which can be the main cause or may be due to a sensitivity to an irritant or an underlying condition like eczema.

Lichen Sclerosis is a chronic condition where the skin becomes thin leading to severe itching and pain. The skin is often pale with easy bruising of the area and splitting of the skin which leads to significant pain with intercourse and painful urination.  Over time, if left untreated there can be changes in the normal architecture of the vulva and scarring.

Lichen Planus is a chronic inflammatory skin condition that can be seen in the vulva or other areas of the body, such as the mouth.  The skin changes are deep red or purple and cause itching and burning.  Left untreated there can be scarring and narrowing of the vagina.

The chronic nature of many of these skin conditions make cure difficult.  Treatment is focused on controlling the dermatosis.  Removing irritants, hygiene and steroid ointments are the mainstay of treatment.