[37F] Experiencing localized vulvar itching

Patient Description

A 37-year-old female has been experiencing persistent itching localized to one spot on the vulva near the vaginal entrance for over a year. The affected area appears ashy. The patient rates the itchiness as a 5 out of 10 in severity. Temporary relief has been obtained using Vagicaine and coconut oil. The patient has a history of Anxiety Disorder, diagnosed at age 14 and again at 36. She is currently taking Claritin D for allergies. No new sexual partners have been reported, and there are no other associated symptoms or known drug allergies.

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Arora's Assessment

What might be happening

Based on the information you've provided, possible explanations for your symptoms include:

  • Vulvar Dermatitis: This is a type of skin irritation that affects the vulva. It can be caused by a variety of factors, such as allergies, irritants, or infections. The itching and ashy appearance you described could be symptoms of this condition.

    • Treatment usually involves avoiding the irritant or allergen, applying topical creams or ointments, and in some cases, taking oral medication.
  • Lichen Sclerosus: This is a rare skin condition that typically affects the genital and anal areas. It can cause itching, changes in skin color (such as an ashy appearance), and discomfort.

    • Treatment usually involves the use of strong topical steroids. In some cases, other medications may be necessary.
  • Yeast Infection: This is a common fungal infection that can cause itching, redness, and a thick, white discharge. However, you did not mention having a discharge.

    • Treatment usually involves antifungal medication, which can be taken orally or applied topically.

Please note that these are only possible explanations and not a definitive diagnosis. It's important to consult with a healthcare provider for an accurate diagnosis and treatment.

What you can do

Here are some general suggestions that might help you manage your symptoms:

  1. Avoid scratching the area as much as possible. This can cause further irritation and potentially lead to an infection.
  2. Continue to apply Vagicaine and coconut oil if they provide relief. However, be aware that some products can potentially cause further irritation.
  3. Wear cotton underwear and loose-fitting clothing to reduce irritation.
  4. Avoid using scented soaps, lotions, or other products in the genital area.

What you should look out for

Please seek immediate medical attention if you experience any of the following:

  • Severe pain or discomfort
  • An increase in the severity or frequency of your symptoms
  • The development of new symptoms, such as a discharge, sores, or blisters
  • Any signs of an infection, such as redness, swelling, or a fever

Remember, it's important to consult with a healthcare provider for an accurate diagnosis and treatment.

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11 mo ago

People Also Ask


What are the common causes of vulvar dermatitis?

Vulvar dermatitis can be caused by allergies, irritants such as soaps or detergents, infections, or even stress. Identifying and avoiding the trigger is key to managing the condition.


How is lichen sclerosus diagnosed and treated?

Lichen sclerosus is typically diagnosed through a physical examination and sometimes a biopsy. Treatment often involves the use of strong topical steroids to reduce inflammation and itching.


Can anxiety disorders affect skin conditions like itching?

Yes, anxiety disorders can exacerbate skin conditions, including itching, due to stress and the body's response to anxiety. Managing anxiety may help alleviate some skin symptoms.


What are the signs that a vulvar condition might be a yeast infection?

Signs of a yeast infection include intense itching, redness, swelling, and a thick, white discharge. If these symptoms are present, antifungal treatments are usually effective.


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