Vulval Dermatitis

Dermatitis is the most common cause of chronic vulval symptoms. In some cases, vulval dermatitis can be caused by a genetic predisposition to allergies and hypersensitivity. These women will have conditions like asthma, hay fever or dermatitis in other areas of the body. Vulval dermatitis can also be caused by contact with an irritant or allergen such as:

• laundry detergents, toilet paper, deodorants, dusting powders/talc
• lubricants and spermicides
• sanitary pads and panty liners
• bath products, soap and shower gels
• depilatory products
• underwear (lace, G-strings)
• latex in condoms or a diaphragm
• over-the-counter medication (thrush treatments)

The main initial symptom of dermatitis is itching. Scratching the area can result in broken skin, burning or stinging, and pain during sex. Treatment for dermatitis usually involves the use of a topical corticosteroid cream. Cool compresses and antihistamines may be used to bring relief from symptoms. If the dermatitis is thought to be due to an allergy or irritant, it is important that attempts are made to identify and avoid the substance. It can take some time for symptoms to resolve as the skin of the vulva generall y takes longer to heal than in other areas of the body. If a woman’s symptoms persist she should return to her doctor as women with vulval dermatitis may develop secondary infections such as thrush. Some general tips for vulval care are:

• Switch to hypoallergenic versions of products like toilet paper and laundry detergent as these products have no or limited perfume and colourings known to cause irritation.
• Avoid soap or use a soap substitute.
• Take showers instead of baths and do not use douches or talc.
• Wear cotton underwear and avoid tight-fitting trousers, pantyhose and G-strings.
• When showering avoid getting shampoo or conditioner residue on the vulval area. Alternatively, wash hair in the basin.
• Use tampons rather than sanitary pads where possible—they are less irritating to the vulva. If pads are preferred, consider using washable cloth sanitary pads. Avoid the use of panty -liners between periods. Avoid repeated use of over the counter anti-fungal preparations for thrush. If symptoms of thrush continue after an initial treatment women should consult their doctor as these preparations are a common cause of irritation.