Vulva pain and discomfort may also be associated with psoriasis and ulcers, both of which can be treated with a topical cream. Lesions, however may require surgery.
Psoriasis
Women who suffer from psoriasis of the vulva will, nearly always, have psoriasis somewhere else on their body. It rarely occurs solely on the vulva. On the vulva, you will often have a red rash with a distinct border, with less scaliness than you would usually see with psoriasis on other parts of the body. Itchiness is the main symptom, and you’ll need to use a high-potency topical cortisone purely on an as-required basis.
Aphthous ulcers
These ulcers are exactly the same as mouth ulcers. There are often many of them, with small punched-out ulcers scattered throughout the inner part of the vulva. Pain is the main symptom and they usually erupt at the same time as mouth ulcers, commonly at times of stress. They respond well to cortisone cream of medium potency applied several times daily, which is the same treatment as for mouth ulcers.
Pre-cancerous lesions
These lesions are usually single, but you can also get multiple lesions. They should be inspected if you have an area of itchiness in one spot and on examination, there is a well-defined lesion, either pale or reddish, and the irritation is confined to the lesion. In older women, the lesion is often associated with lichen sclerosus. If you are a younger woman, you’re more likely to have more than one lesion and they are often associated with wart virus infection. Always be concerned if there is a focal area of irritation anywhere on your vulva. Examination is essential and you’ll need to have a biopsy to confirm the diagnosis.
Treatment usually involves having the lesion surgically removed under general anaesthetic (GA). If you have more than one lesion, laser treatment under GA is preferable. If the lesions cannot be treated in this way, prolonged application with a special cream (Imiquimod) that stimulates a local immune response can be effective. You’ll need long-term follow-up to detect any early recurrences.
Related information
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