Vulvar Skin Conditions

The vulva is a highly sensitive part of a female’s anatomy, leaving it prone to irritation. In some, chronic skin conditions can develop as a result of underlying inflammation. A proper diagnosis, treatment plan, and good vulvar care are key to helping manage symptoms and improve quality of life.

Vulvar skin conditions is an umbrella term for conditions that affect the skin of the vulva, which is a female’s external sexual organ. Common symptoms of vulvar conditions include a burning sensation, pain, and itching. In some cases, the vulva appears red and swollen. Below, we dive into three of the most common vulvar skin conditions. 

Vulvar lichen sclerosus

Vulvar lichen sclelorus is an inflammatory skin disorder that affects the vulvar or anal area in women or vulva owners. It's especially common in individuals with psoriasis and can arise during peri to post menopause. Itchiness is usually the first symptom. It may become severe enough to disrupt sleep, interfere with quality of life, and cause painful intercourse.

The condition is diagnosed through clinical examination by a physician, and sometimes a biopsy (laboratory testing of tissues). The hallmark visual symptoms are patches of white shiny skin on the vulva. They may be painful and irritated. If the condition progresses, the vulvar tissues can shrink and cause the clitoral hood to fuse. This is why prompt treatment is crucial, no matter how mild the symptoms are. The standard treatment is corticosteroids, which work to reduce inflammation.

Lichen planus

This skin condition is thought to result from an overactive immune system, and can cause symptoms in the vulva, vagina and inside the mouth. It typically presents as itchy, purple-ish bumps, sometimes with streaks of white. Symptoms include pain, inflammation, redness, and a burning sensation. Like vulvar lichen sclerosus, it can interfere with sleep, intercourse and quality of life. The standard treatment is high-potency corticosteroids, which work to reduce inflammation.

Vaginal dilators may also be effective in treating and prevent vaginal adhesions resulting from inflamed tissues. The dilator is coated with corticosteroid ointment or estrogen vaginal cream. A pelvic health physiotherapist can offer you more information on the use of vaginal dilators.

Lichen simplex chronicus

This is non-scarring, chronic inflammatory disease of the vulvar skin characterized by intense itchiness. It often happens in people with a history of allergic conditions, like hay fever, asthma and childhood dermatitis. Lichen simplex chronicus is usually triggered by environmental irritants (e.g., clothing, chemicals in topical products, heat, perspiration), or co-existing dermatologic conditions (e.g., lichen sclerosus).

Symptoms include skin that is thickened and leathery, with changes in colour (hyper- or hypopigmenteation). Treatment requires a multitargeted approach, including medications (corticosteroids), trigger avoidance and proper vulvar hygiene.

If you are experiencing any vulvar skin symptoms, talk to your doctor so that a proper diagnosis can be made. Effective treatments are available, including pelvic health physiotherapy.

What Is The Role of The Pelvic Floor in Vulvar Skin Conditions?

The pelvic floor is a group of dome-shaped muscles, ligaments, and tissue that are located at the bottom of the pelvic bones. A strong pelvic floor is vital for our health, and is needed for many daily functions, including:

• Supporting the pelvic organs

• Stabilizing the low back and hip joints

• Maintaining bladder and bowel continence

• Optimizing sexual sensation and arousal

A weak pelvic floor is not a direct cause of vulvar skin conditions, but the two are often intertwined. Many women who suffer from vulvar skin conditions also have issues with their pelvic floor, such as tightness, reduced mobility and scar tissue (adhesions). Pelvic floor dysfunction can lead to pelvic pain, painful sex (dyspareunia), and inflammation.

How Can Pelvic Health Physiotherapy Help Me?

After seeing a doctor to get a diagnosis, a good next step is reaching out to a Pelvic Health Physiotherapist, who has specialized training in pelvic health issues. Their work will be focused on assessing scar tissue and tightness, using gentle techniques to help improve blood flow to the affected area(s), and improve tissue elasticity. Your Pelvic Health Physiotherapist will also tailor a plan to treat any issues arising from vulvar skin conditions, such as painful intercourse and pelvic pain.

How Do We Approach Treatment For Chronic Pelvic Pain?

At Proactive Pelvic Health Centre, we’re dedicated to helping destigmatize issues related to pelvic health, and empowering people to take control of their bodies. You will be in good hands, surrounded by a supportive and empathetic team who is comfortable talking about everything “down there” and improving your well-being.

The first step: your Pelvic Health Physiotherapist will take your full medical history and discuss your symptoms. With informed consent, they will perform a complete physical assessment of the affected tissues. Based on the examination, your Pelvic Health Physiotherapist will work with you to put together a treatment plan specific to your symptoms. We use a variety of clinically-proven techniques, from manual therapy to pelvic floor exercises, to help improve the strength of your pelvic floor and promote optimal blood flow.