The external part of the female genital area is the vulva. Common symptoms for skin issues with the vulva include itching, soreness, pain or a difference in colour. These symptoms may worsen with moisture, heat or usage of products like deodorants. When meeting the doctor, they will ask about your personal and family history. This is because some of the conditions like thyroid problems, diabetes, anemia, eczema can also cause skin issues in the vulva area. They will examine the area of skin around the vulva.

The doctor may suggest a blood test or swab to check the issue. Sometimes they will be able to identify from the skin appearance. Treatment will be suggested based on the issue identified.

Different skin conditions are –

• Lichen sclerosus – It is usually found in women who have attained menopause and caused due to problems in the immunity system.
• Lichen planus –  this causes more pain than itching and can also be found in other places of skin particularly the mouth.
• Vulval atrophy – this too is found in women who have gone through menopause. It is caused due to fall in estrogen level resulting in soreness, pale skin and itching.
• Candida infection(Thrush) – This causes irritation and soreness to the vulva. There are also chances of candida to be transferred to the sexual partner so it is necessary to be checked and treated.
• Psoriasis – This causes dryness of the vulva and thickening of the skin. The nails and the scalp may also be affected.
• VIN(vulval intraepithelial neoplasia)-this can be diagnosed only by a biopsy. Some of the changes that occur may turn out to be cancerous. The doctor may suggest having the cervix and vagina examined by colposcopy. Women who have Lichen sclerosus have an increased chance of having VIN.

Treatments

• Usual measures include moisturizing the skin, avoiding irritants and using a substitute for soap.
• Antihistamines and anti-itching drugs
• For lichen sclerosus or lichen planus, ointments will be provided. For most the symptoms will improve but for a few, the colour and texture of the skin may remain the same. If symptoms do not improve long term treatment will be necessary.
• For pale skin (which indicates low estrogen levels), estrogen cream will be provided.
• If identified with candida, antifungal creams or tablets will be prescribed.
• Treatment for VIN is usually the removal of the affected part of the skin. If the affected part of the skin is large, reconstructive surgery may be required.

How to take care of the Vulva area?

• Avoid using soap which can cause skin dryness. Instead, replace soap with a substitute.
• Wash the area only once a day. Excessive washing can worsen the symptoms.
• Wear loose fitting cotton undergarments.
• Avoid skin irritants like shower gel, bubble bath, deodorants, etc.

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