Persistent vulval itching, soreness, splitting, colour change or altered skin texture can result from dermatitis, infection, lichen sclerosus, lichen planus and other conditions. Self-treatment without examination can delay the correct diagnosis.
History and examination
Assessment includes symptom timing, soaps and products, discharge, urinary or sexual symptoms, skin disease elsewhere, diabetes and previous treatments. Examination should be explained and consented to, with a chaperone offered.
Common investigations
Swabs are useful when infection is suspected but do not diagnose most inflammatory skin conditions. Biopsy provides a small tissue sample and may be recommended when the diagnosis is uncertain or the skin has concerning changes.
Treatment and skin care
A bland emollient, avoidance of fragranced products and gentle drying can reduce irritation. Prescription treatment may include a carefully instructed topical steroid regimen or antimicrobial therapy. Under-treatment of inflammatory disease can be harmful, so steroid fear should be addressed with clear guidance.
Long-term follow-up
Some conditions require periodic self-checks and clinical review because scarring, architectural change or a small cancer risk can occur. Patients should know which new ulcer, lump or non-healing area requires prompt review.
Questions worth discussing at your consultation
- What diagnosis best explains the skin changes?
- Do I need swabs, biopsy or specialist vulval review?
- Exactly how should topical treatment be applied?
- Which changes should prompt an earlier appointment?