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Vulval Dermatoses and Genital Skin Concerns

Skin of the genital area can be sensitive and susceptible to inflammation. This delicate skin is vulnerable to rashes, including contact dermatitis, irritant dermatitis, or psoriasis. There are also some other skin conditions which genital skin is specifically prone to, such as lichen sclerosus and lichen planus.

Dermatologists are usually the best qualified to diagnose and treat genital skin problems.

Dr Anne Farrell has a special interest in genital skin conditions, having earned a Doctor of Medicine (MD) degree at the university of Oxford and completing postgraduate research on lichen sclerosus. During her research, she published extensively in a number of influential medical journals on this disorder. Dr Farrell has also co-founded specialist vulval dermatoses clinics at many prestigious medical centres, including the University of Wales Cardiff and St George’s teaching hospital. She regularly lectures on genital skin conditions at medical meetings.

What symptoms can be signs of vulval skin inflammation?

Symptoms can include mild, moderate, or severe itching or discomfort and painful intercourse. In the case of lichen sclerosus, the appearance of smooth white spots is common, as well as blotchy, wrinkled patches of skin. Some individuals may easily develop bruises or tears. Lichen sclerosus can also affect men and children, although it mostly commonly develops in postmenopausal women.

How is the diagnosis made?

The diagnosis is made from reviewing the medical history, examining the clinical appearance of the area, and sometimes performing tests such as swabs, small skin biopsies, or allergy testing.

What treatments are available?

Obtaining the correct diagnosis is the important first step. Treatment usually involves avoidance of irritating soaps with soap substitutes, such as emulsifying ointment and prescription creams (such as steroid creams). Lichen sclerosus can sometimes improve on its own, but often needs an appropriate duration of steroid cream to control the symptoms and improve the appearance of the skin. Patients who have been diagnosed with certain genital skin conditions, such as lichen sclerosus, need monitoring every six to 12 months, because of the small theoretical risk of developing squamous cell carcinoma. However, with appropriate diagnosis and treatment genital skin conditions should be easily managed and the symptoms and signs easily controlled.

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