Vulvar dermatitis is a common skin condition that affects the vulva, the external part of the female genitalia. It causes itching, irritation, inflammation, and sometimes pain in the vulvar area. Vulvar dermatitis can have various causes, such as contact with irritants or allergens, hormonal changes, infections, or other skin disorders. In this article, we will explain what vulvar dermatitis is, what causes it, how it is diagnosed and treated, and how it can be prevented.
What is Vulvar Dermatitis?
Vulvar dermatitis is a type of dermatitis, which is a general term for skin inflammation. Dermatitis can affect any part of the body, but it is more common in areas where the skin is exposed to heat, moisture, friction, or chemicals. The vulva is one of these areas, as it is constantly in contact with clothing, menstrual products, hygiene products, sexual fluids, and other substances that may irritate or trigger an allergic reaction in the skin.
Vulvar dermatitis can be classified into two types: allergic contact dermatitis and irritant contact dermatitis. Allergic contact dermatitis occurs when the immune system reacts to a substance that causes an allergy (allergen), such as latex, nickel, perfume, or preservatives. Irritant contact dermatitis occurs when the skin is damaged by a substance that irritates it, such as soap, detergent, urine, or sweat. Both types of vulvar dermatitis cause similar symptoms, such as:
- Itching, burning, stinging, or rawness in the vulvar area
- Redness or darkening of the skin (depending on the skin tone)
- Dryness, cracking, or thickening of the skin
- Small bumps or blisters on the skin
- Fluid leakage from the skin (weeping)
- Pain during sexual intercourse or tampon insertion
Symptoms of Vulvar Dermatitis
The symptoms of vulvar dermatitis may vary in severity and duration depending on the cause and the individual's sensitivity. They may also worsen at certain times, such as at night, during menstruation, when sweating, or after sexual activity.
What Causes Vulvar Dermatitis?
Vulvar dermatitis can be caused by various factors that irritate or trigger an allergic reaction in the vulvar skin. Some of these factors are:
- Hygiene products: Soap, bubble bath, shampoo, conditioner, deodorant, perfume, douche, talcum powder, wipes
- Laundry products: Detergent, fabric softener, dryer sheets
- Clothing: Underwear made of synthetic materials (such as nylon or polyester), tight-fitting clothes
- Menstrual products: Pads, panty liners, tampons
- Sexual products: Condoms (especially latex ones), lubricants (especially those containing glycerin), spermicides
- Food: Spicy foods (such as chilli peppers), acidic foods (such as citrus fruits), food preservatives (such as sulfites)
- Medications: Antibiotics (especially those containing neomycin), topical steroids (if used for a long time or in high doses), antifungal creams
- Infections: Yeast infections (candidiasis), bacterial vaginosis (BV), sexually transmitted infections (STIs) such as herpes or chlamydia
- Other skin conditions: Psoriasis , lichen sclerosus , lichen planus , seborrheic dermatitis
Some people may be more prone to developing vulvar dermatitis than others.
Risk Factors of Vulvar Dermatitis
Risk factors include:
- Having a history of eczema , asthma , hay fever , or other allergic conditions
- Having low oestrogen levels , such as during puberty or menopause
- Having sensitive skin or a family history of skin problems
- Having diabetes, obesity, or a weakened immune system
How is Vulvar Dermatitis Diagnosed?
Vulvar dermatitis can be diagnosed by a healthcare provider who specialises in gynaecology or dermatology. The diagnosis is based on:
- A medical history: The provider will ask about your symptoms , when they started , how often they occur , what makes them better or worse , and what products you use on your vulva or vagina.
- A physical examination: The provider will examine your vulva and vagina for signs of inflammation , infection , or other skin conditions . They may also take a swab sample from your vagina to test for yeast , bacteria , or STIs.
- A patch test: If an allergy is suspected , the provider may perform a patch test to identify the specific allergen that causes your reaction . This involves applying small patches of different substances to your skin and observing for any signs of irritation after 48 hours.
How is Vulvar Dermatitis Treated?
The treatment of vulvar dermatitis depends on the cause and the severity of the symptoms. The main goals of treatment are to:
- Identify and avoid the irritant or allergen that causes the dermatitis
- Relieve the itching , irritation , and inflammation of the skin
- Prevent secondary infections or complications
The treatment options may include:
- Topical medications: These are creams or ointments that are applied to the affected skin to reduce inflammation and itching. They may contain corticosteroids (such as hydrocortisone), antihistamines (such as diphenhydramine), antibiotics (such as mupirocin), or antifungals (such as clotrimazole).
- Oral medications: These are pills that are taken by mouth to treat the underlying cause of the dermatitis, such as an infection or an allergy. They may include antifungals (such as fluconazole), antibiotics (such as metronidazole), antihistamines (such as cetirizine), or immunosuppressants (such as azathioprine).
- Moisturisers: These are products that are applied to the vulvar skin to keep it hydrated and prevent dryness and cracking. They may be creams, lotions, oils, or ointments that are fragrance-free, hypoallergenic, and pH-balanced. Examples include petroleum jelly, mineral oil, coconut oil, or aloe vera gel.
- Cold compresses: These are cloth pads soaked in cold water or ice packs wrapped in a towel that are applied to the vulvar area to soothe the burning and stinging sensation. They should be used for 10 to 15 minutes at a time, several times a day.
- Baths: These are warm water baths that are taken for 15 to 20 minutes at a time, once or twice a day. They can help cleanse the vulvar area and relieve the itching and irritation. They may be plain water baths or contain additives such as baking soda, oatmeal, or vinegar.
- Lifestyle changes: These are modifications that can help prevent or reduce the exposure to irritants or allergens that cause vulvar dermatitis. They include:
- Wearing loose-fitting cotton underwear and clothing
- Changing underwear and menstrual products frequently
- Washing the vulvar area with plain water or mild soap
- Rinsing the vulvar area well after urinating or defecating
- Patting the vulvar area dry with a soft towel after bathing
- Avoiding scratching or rubbing the vulvar area
- Avoiding scented or coloured products on the vulvar area
- Avoiding sexual intercourse or using lubricants and condoms during a flare-up
How can Vulvar Dermatitis be Prevented?
Vulvar dermatitis can be prevented by following some of the lifestyle changes mentioned above, such as:
- Wearing loose-fitting cotton underwear and clothing
- Changing underwear and menstrual products frequently
- Washing the vulvar area with plain water or mild soap
- Rinsing the vulvar area well after urinating or defecating
- Patting the vulvar area dry with a soft towel after bathing
- Avoiding scratching or rubbing the vulvar area
- Avoiding scented or coloured products on the vulvar area
- Avoiding sexual intercourse or using lubricants and condoms during a flare-up
In addition, you can also:
- Keep a diary of your symptoms and possible triggers to identify what causes your dermatitis.
- Consult your healthcare provider before using any new products in your vulvar area.
- Get tested for allergies if you suspect you have an allergic reaction to something.
- Seek medical attention if your symptoms do not improve with home treatment or if they worsen.
Sources
[1] Debbo Africa: https://debbo.africa
[2] Vulvar Dermatitis: Causes, Symptoms, Diagnosis & Treatment. Cleveland Clinic. https://my.clevelandclinic.org/health/diseases/24336-vulvar-dermatitis
[3] Vulvar Dermatitis: Symptoms and Treatment. Verywell Health. https://www.verywellhealth.com/how-to-care-for-vulvar-dermatitis-symptoms-and-treatment-methods-5194033
[4] Vulvar Dermatitis: What to Know About Eczema on the Vagina. WebMD. https://www.webmd.com/skin-problems-and-treatments/eczema/eczema-vagina
[5] Vulval dermatitis. The Vulval Pain Society. https://vulvalpainsociety.org/about-vulval-pain/vulval-pain-conditions/vulval-dermatitis/