GENERAL CARE OF THE VULVA

Vulval skin is sensitive. It may react to both irritants such as soaps and a whole range of substances may cause allergy.

The sort of clothing you wear may have an effect on your vulval disease. The recommendations here are general for all types of vulval disease and should be used as an adjunct to more specific treatment prescribed by the clinic doctor.

CLOTHING Always wear loose fitting underwear. Try to avoid tight outer garments such as bicycling shorts or tight leggings. Sometimes if very uncomfortable the wearing of no knickers at all is quite helpful.

WASHING Avoid contact with all soap. You may find it beneficial to start washing your hair separately to the rest of your body as shampoo can irritate. Aqueous cream BP used as a soap substitute is soothing for most vulval disorders. It can be used as a local emollient.

It is important that you avoid contact with non-prescribed over-the-counter preparations which might make your skin condition worse. Avoid contact with perfume and personal deodorants.

Prepared by BSSVD to help patients.

LICHEN SCLEROSUS (LS)

You have been told that you are suffering from lichen sclerosus. Lichen sclerosus is a common itchy disease which affects genital and occasionally non-genital skin. It may occur in adults and children. Your symptoms may have lasted for many years. Lichen sclerosus may run in families.

You may have noticed white or red areas in your vulva which may crack and be sore.

Your symptoms should improve with treatment which will consist of strong steroid creams/ointment which should control your symptoms. As time goes on and your lichen sclerosus improves you will need less frequent treatment.

In very few women with lichen sclerosus a vulval skin cancer may occur. It is therefore important that you should report any lumps or unusual changes in your symptoms immediately to your doctor. We advise patients with LS to have regular check-ups and you will be advised to either attend the clinic or your GP on a yearly basis.

Please read the attached General Care of the Vulval Leaflet which will help to soothe and protect your vulval skin.

Address for further information - National Lichen Sclerosus Support Group (NLSSG) P O Box 5830. Lyme Regis. Dorset. DT7 3ZU

Prepared by the BSSVD to help patients.

VESTIBULITIS

You have been told that you are suffering from vulval vestibulitis.

We do not know the cause of vulval vestibulitis, but it is neither infectious nor cancerous.

It is characterised by pain on pressure at the area around the vaginal opening (the vestibule).

This usually occurs at sexual intercourse or when inserting tampons. Patchy redness may be present in this area but this does not always occur.

Lots of treatment have been used for this condition and you may find your doctors have provided you with some or all of them: emollient cream (moisturisers); EMLA, Ketoconazole cream, topical steroid creams, tricyclic antidepressant tablets.

These are all prescribed to ease the pain of vestibulitis. Even antidepressant tablets act as painkillers in small doses. If necessary the dose of these tablets may be increased to help you.

You should also be aware that not all treatments work for everyone and it may take a long time for your symptoms to improve.

Please read the attached General Care of the Vulval Leaflet which will help to soothe and protect your vulval skin.

Address for further information - Vulval Pain Society - VPS, PO Box 7804, Nottingham, NG3 5ZQ. www.vul-pain.dircon.co.uk

Prepared by the BSSVD to help patients.

LICHEN SIMPLEX

You have been told that you are suffering from lichen simplex. Lichen simplex is a common non-infectious itchy disease. You may have had eczema/dermatitis elsewhere before. You will have found it difficult to stop itching especially at night.

Your treatment will consist of strong steroid creams/ointment and perhaps an antihistamine tablet to take at night. This might make you feel a little drowsy. It is important you do not drink alcohol with this tablet and driving may be affected. Some people find taking the tablet 1 hour before bed is helpful.

Lichen simplex may commonly recur especially when you are stressed. In some cases your doctor may wish to do patch tests to investigate whether you are reacting to something with which you are in contact.

Some women with LS are iron deficient. If your blood test shows this to be the case you will be given some iron.

Please read the attached General Care of the Vulval Leaflet which will help to soothe and protect your vulval skin.

Ask your Clinic Doctor or Nurse if you require further information.

Address for further information - Vulval Pain Society - VPS, PO Box 7804, Nottingham, NG3 5ZQ. www.vul-pain.dircon.co.uk

Prepared by the BSSVD to help patients.

EROSIVE LICHEN PLANUS

You have been told that you are suffering from lichen planus.

Erosive lichen planus is an itchy disease which may affect the skin anywhere on the body but when it affects moist surfaces in the mouth and genital area it causes raw areas which are painful.

Erosive lichen planus of the vulva may last for years. Your treatment may consist of strong steroid ointment. Your doctor may feel it necessary to use tablets to control your disease. Should this be necessary the proposed tablets and their potential side effects will be discussed with you.

Rarely women with lichen planus may develop a cancer. It is therefore important that you should report any lumps or unusual changes in your symptoms immediately to your doctor.

Please read the attached General Care of the Vulval Leaflet which will help to soothe and protect your vulval skin.

Address for further information - Vulval Pain Society - VPS, PO Box 7804, Nottingham, NG3 5ZQ. www.vul-pain.dircon.co.uk

Prepared by the BSSVD to help patients.