Vaginal Dermatology

Eczema in the soft folds of skin around the vagina is known as vulvar dermatitis. Symptoms include burning or itching, weeping from the irritated skin, redness and swelling on the vulva and a ‘raw’ feeling from the vulva irritation. If you have vulvar dermatitis you may find it painful to have sex, use a tampon or accommodate a speculum, for example for cervical screening or other gyanecological examinations. These symptoms may appear suddenly or slowly worsen over a period of time.

Vulvar dermatitis can occur in response to irritants, including; perfumed soaps or bubble baths, perfumes, talcum powder, nylon underwear, sanitary pads or panty liners, lubricants or spermicides. Some women may even experience symptoms caused by their own urine, sweat or vaginal discharges.

Vulvar dermatitis can also be triggered by common allergens, such as latex (in condoms), chlorhexidine (present in popular lubricant K-Y Jelly), tea tree oil, fragrances, propylene glycol (a preservative), imidazole antifungal, benzocaine and neomycin. However sometimes the symptoms may not appear until several days after you have used them.

Sometimes it is not clear exactly what causes vulvar dermatitis.

Vulvitis is a condition that causes the delicate vulva to become irritated or inflamed. Symptoms include itching, soreness, swelling and redness. A woman with vulvitis may find sexual activity painful and find there is increased sensitivity when wiping with toilet paper.

Vulvitis can be caused by anything that irritates the vulva, including infections and allergies. These can often produce additional symptoms, such as warts, blisters, thickened or white patches, scaly skin and vaginal discharge.

The most common causes of vulvitis are; vaginal infections (including herpes, thrush and vaginitis), irritants (such as perfumed soaps and synthetic materials), vaginal douches, poor hygiene habits (for example not changing a sanitary pad or underwear often enough or not wiping properly after going to the toilet) and certain medications (including antibiotics and anti-anxiety medicine).

Women who are perimenopausal or have gone through menopause are more susceptible to developing vulvitis. This is because a fall in oestrogen levels associated with menopause and perimenopause cause the vulva to become thinner, less lubricated and much more delicate and prone to irritation.

Young girls who have yet to go through puberty are also susceptible to vulvitis as their bodies do not yet produce adult levels of oestrogen.

Genital herpes is a sexually trasmitted infection (STI) spread through unprotected vaginal, oral or anal sex. It can also be spread by sharing sex toys that have not been washed or covered with a new condom each time they're used.

The condition presents as a series of small blisters which burst to leave red, open sores around the vagina. An infected person may also find these blisters around their anus, bottom or thighs and, in men, on the penis.  If you have herpes, you are likely to experience a tingling, burning or itching feeling around your genitals and pain during urination. Women with herpes may also experience unusual vaginal discharge.

It may take months or even years for blisters to appear after infection. Unfortunately there is no cure for herpes but the symptoms can be treated. The symptoms may go on their own, but another outbreak may occur in the future.

Genital warts is a common sexually transmitted infection which is caused by the human papillomavirus (HPV).

A person who has genital warts may notice small lumps or growths with a rough texture which were not there before around the vagina, penis or anus, but in some cases warts may also appear on the cervix. As a result, these are harder to spot.

Although the appearance of a wart may cause no physical discomfort, some people can find them itchy and painful. The good news is that genital warts are easily treated.

Lichen sclerosus is a skin condition which causes white patches to develop on the genitals and other parts of the body. It can affect adults and children but it is much more common in women aged over 50.

The condition is characterised by itchy, white patches, which may be smooth or crinkled. These are easily damaged and often hurt or bleed if scratched, rubbed or irritated. The patches can appear anywhere on the body but in women they are more often found on the vulva or anus.

There is no cure for lichen sclerosus, but treatment can help to relieve symptoms.

Although the condition can be managed, skin affected by lichen sclerosus may become scarred and tight over a period of time. This may cause the vulva to shrink, affecting the clitoris and labia minora. This can cause discomfort during sex and when going to the toilet. If this is severe, then an operation may be needed, such as surgery to widen the vagina.

Lichen sclerosus increases the risk of getting vulval or anal cancer. Although the overall risk remains low, it is advisable to check yourself for symptoms regularly if you have been diagnosed with lichen sclerosus.

It is not known exactly what causes lichen sclerosus, but it is not caused by poor hygiene and it is not contagious, so it cannot be passed on through sexual intercourse.

Thrush is a common yeast infection. It is harmless, but it can cause great discomfort and in some cases it can keep coming back. Symptoms of vaginal thrush include odourless white vaginal discharge and irritation and itching around the vagina. Women with thrush may find they experience stinging or soreness when urinating or while having sex.

Thrush is not an STI, but it can be triggered by sexual intercourse. Other things that may trigger thrush include antibiotics, damaged or irritated skin, pregnancy, HRT, poorly controlled diabetes or a weakened immune system (including people going through chemotherapy).