Don’t suffer in silence: Vulvar skin conditions explained

Some health conditions can be embarrassing to talk about. In fact, some can feel so mortifying that we don’t seek treatment.

Having a problem “down there” isn’t anything to be ashamed of. In fact, there are skin conditions that can affect the vulva that are not only common, they’re treatable.

“No one should suffer in silence because they feel uncomfortable seeking treatment,” said Avni Patel, MD, a dermatologist at Endeavor Health who specializes in vulvar dermatology. “Many vulvar skin conditions are treatable. However, due to lack of diagnosis or hesitancy to seek care, many experience life-altering discomfort.”

Q: What are some of the most common vulvar skin concerns people have?

A: “The most common reason I see patients is vulvar itching or pain that is not improving over time or with previous treatments. There are many conditions that can contribute to genital symptoms, and symptoms are often reported to primary care doctors, gynecologists, and dermatologists.”

Common skin concerns include:

• Lichen sclerosus: A chronic skin condition that can cause pink or white discoloration, itching, pain, and, at times, difficulty with intimacy. It’s not contagious or sexually transmitted. Treatment is crucial, as delays can cause scarring or lead to development of cancer in a small percentage of cases.
• Lichen planus: A non-contagious rash of flat purple bumps, typically on the body. Rarely, it can involve the mouth and genitals, causing pain and ulcerations.
• Eczema and contact dermatitis: Itchy and flaky skin that can look red or dark in color. Scratching the area may make small cuts, which can sting or burn. Contact dermatitis can be caused by an irritation or allergy to many substances that touch the area, including soap, detergent, underwear, urine, and menstrual hygiene products.
• Psoriasis: smooth or shiny pink, itchy skin in the genital area.

Q: Is vulvar itching usually caused by a yeast infection?

A: A yeast infection is one of many causes of vulvar itching. However, if treating for yeast does not alleviate symptoms, other diagnoses should be explored. Over-the-counter medication for a yeast infection won’t help if you don’t have a fungal infection.

“Women often believe that vulvar itching signifies a yeast infection, but that’s not necessarily the case,” Dr. Patel said. “If you’re in discomfort, don’t wait it out. Talk to your doctor about your symptoms so you can get relief.”

Q: When should you see a doctor for a vulvar skin condition?

A. “Rashes or discomfort in the genital area should receive medical attention,” Dr. Patel said. “By seeking treatment early, you can receive faster alleviation of symptoms and potentially prevent some serious or severe complications.”

Gentle vulvar self-care steps can help reduce vulvar itching and irritation. Wear loose clothing and cotton underwear, gently cleanse the area with plain water, and avoid wet wipes or “vaginal” washes.