Women’s Health:
Vulvar dermatitis: what is it and how to treat it?

Vulvar dermatitis is a common skin condition that causes irritation, inflammation and itching in the vulva, the external part of the female genitals. It can cause crust formation in the folds of skin around the vagina, along with red patches and thin cracks.

Symptoms of vulvar dermatitis

The most common symptom of vulvar dermatitis is mild to severe itching. Other symptoms include:

• Redness
• Swelling
• Burning
• Dryness
• Pain
• Blisters or cracks
• Skin feels burning and sensitive
• A damp feeling in the vulva caused by fluids seeping out of damaged skin
• Pain while insertion, during intercourse or while inserting tampons and menstrual cups

What causes vulvar dermatitis?

• Irritants: Soaps, shampoo, bath salts, detergents, dyes, perfumes, vaginal douches, spermicides and harsh toilet paper can all irritate the delicate skin of the vulva.
• Allergic reactions: You may develop an allergic reaction to a product that you use on your vulva or that comes into contact with it, such as laundry detergent, fabric softener, perfume or latex condoms.
• Friction: Tight clothing, excessive sweating and sexual activity can all irritate the vulva. Even friction with chemically treated clothing and materials such as nylon underwear can cause it.
• Medical conditions: Certain conditions, such as eczema, psoriasis and diabetes, can increase your risk of developing vulvar dermatitis.
• Menopause: Declining oestrogen levels after menopause can make the vulva thinner and more susceptible to irritation.

There are also some known allergens which don’t immediately trigger the symptoms of vulvar dermatitis but their contact can contribute to vaginal irritation, such as:

• Neomycin
• Benzocaine
• Chlorhexidine
• Imidazole antifungal
• Propylene glycol
• Tea tree oil
• Fragrances
• Latex

Other causes can include health conditions such as vulvar cancer (rare cases), pubic lice, psoriasis and infections.

Diagnosis of vulvar dermatitis

If you suspect having vulvar dermatitis, immediately contact your healthcare provider, who can guide you through the diagnosis and treatment. They usually record your medical history and symptoms and conduct a physical exam. After patch testing for allergies and biopsy to rule out other health concerns, they can initiate the treatment of vulvar dermatitis.

Care guidelines for vulvar dermatitis

• Identify and avoid triggers: Determine the cause of the dermatitis and avoid exposure to irritants or allergens.
• Maintain proper hygiene: Keep the vulvar area clean and dry. Use mild, fragrance-free soap and water for cleansing.
• Avoid scratching: In the case of severe itching, use medicines and ointments, as scratching can lead to further inflammation and potential infection.
• Topical treatments: Depending on the severity of the dermatitis, your doctor may prescribe topical anti-inflammatory creams to alleviate symptoms.
• Antifungal or antibacterial medications: If a fungal or bacterial infection causes dermatitis, your doctor may prescribe antifungal or antibacterial medications, such as creams, ointments or oral antibiotics, to treat the underlying infection.
• Lifestyle modifications: Making lifestyle changes can also help manage vulvar dermatitis. These may include wearing loose-fitting cotton underwear, avoiding excessive heat and moisture in the genital area and practising safe sex to reduce the risk of sexually transmitted infections.

With these care guidelines in mind, you can manage mild cases of vulvar dermatitis and even avoid it. In case the symptoms extend to fever and foul-smelling vaginal discharge, reach out to your healthcare provider for further medical counsel.

Sources:
WebMD
Cleveland Clinic
University of IOWA
Medical News Today