Managing Vulval Skin Conditions: A guide to moisturisers and steroids

General tips for vulval health

• Avoid using soaps, bubble baths, deodorants, and wet wipes in the vulval area.
• Wear loose-fitting silk or cotton underwear and sleep without underwear to promote airflow.
• Use ice packs for burning sensations and consider relaxation techniques for pain relief.
• Avoid shaving or waxing and opt for trimming instead to reduce irritation.

Understanding emollients and your skin

What are emollients

Emollients, also known as moisturisers, play a vital role in soothing and hydrating your vulval skin. They help prevent dryness, itching, and discomfort by replacing natural oils and maintaining moisture.

For vulval care, we recommend avoiding moisturizers that contain fragrances, perfumes, or other potential irritants, as these can cause irritation or exacerbate symptoms. Instead, patients should use non-scented, hypoallergenic emollients specifically designed for sensitive skin.

Why use emollients for vulval skin conditions?

Vulval skin conditions such as vulval eczema, lichen sclerosis, and vulval dermatitis can cause discomfort, itching, and soreness. Emollients can help to relieve these symptoms by moisturizing and nourishing the affected area, reducing dryness and irritation.

Cooling relief:

If your skin feels irritated, you can keep emollient cream in the fridge and apply it whenever needed to cool and soothe your skin.Cooling relief:

Finding the right one:

It’s essential to find the moisturizer that works best for you. If the first one you try doesn’t seem to work well, don’t worry!

There are many options available, so it’s worth trying another until you find the perfect fit for your skin.

Using emollients regularly can help keep your skin protected and prevent flare-ups, so don’t hesitate to incorporate them into your daily skincare routine.

How do emollients work?

Emollients work by trapping moisture and forming a protective layer on your skin, aiding in skin repair and hydration. They are essential for preventing dryness, cracking, and irritation.

Types of emollients

There are various types of emollients available, including ointments, creams, and lotions. Ointments are greasier and ideal for very dry or thickened skin, while creams are less greasy and suitable for daytime use.

Using emollients effectively

How often should emollients be applied?

Apply emollients at least three times a day, ideally four to six times, even after symptoms improve. Consistent use is crucial for maintaining skin health.

How to use emollients

• Wash your hands thoroughly
• Avoid putting fingers directly into emollient containers to prevent contamination
• Cleanse the area: Gently wash the vulval area with lukewarm water and a mild soap or emollient wash. Pat dry with a soft towel.
• Apply the emollient: Using clean hands, apply a thin layer of emollient to the vulval area, in the direction of hair growth, leaving a thin layer to soak in for up to 10 minutes covering the affected skin completely. Do not rub them in.
• Repeat as needed: Apply emollients regularly, especially after bathing or using the restroom, to keep the skin hydrated and protected.

Precautions when using emollients

• Avoid using emollients if you are allergic to any of the ingredients.
• Do not apply emollients to broken or infected skin without consulting a healthcare professional.
• If you experience any irritation or allergic reaction, discontinue use and seek medical advice.

What are topical steroids?

Topical steroids are anti-inflammatory medications used to reduce redness, itching, and swelling associated with skin conditions. They are available in various strengths and formulations.

Why use topical steroids for vulval skin conditions?

If you’ve been diagnosed with Lichen Sclerosis (LS), your healthcare provider may have prescribed topical corticosteroids as part of your treatment plan.

These medications are considered the gold standard for managing LS symptoms. Topical steroids are often prescribed for vulval skin conditions to help manage inflammation and alleviate symptoms such as itching, soreness, and discomfort.

Using steroid ointments on the vulva

Common concerns and questions

How often should I apply the steroid?

Follow these steps unless advised otherwise by your healthcare provider:

• Once a day every day for one month.
• Once every other day for one month.
• Twice a week in the long term to prevent symptom recurrence.

Using topical steroids wisely

How much steroid ointment should I use?

Use one half of a fingertip unit or pea-sized amount per application. A fingertip unit is from the end of your finger to the first joint. A 30g tube should last at least 3 months; if not, you might be using too much.

If necessary, use a mirror to ensure precise application. Wash your hands again after applying the steroid to avoid spreading it to other areas of your body.

Is it normal for the ointment to sting my skin?

Some stinging may occur on broken skin initially, but it will lessen as the skin heals.

My symptoms have gone; should i stop using the steroid ointment?

No, continue using twice a week even when symptom-free to prevent flare-ups and recurrence of itching and soreness.

How to use a barrier cream with the steroid?

Apply the steroid ointment at least 20 minutes before the barrier cream for optimal absorption.

Using topical steroids with emollients

If prescribed, apply emollients at least 15-30 minutes before or after topical corticosteroids. Ensure the skin is moist but not slippery when applying steroids.

We hope this leaflet empowers you with the knowledge to care for your vulval skin effectively. Remember to consult your healthcare provider if you have any questions or concerns. Consistent and proper use of emollients and steroid ointments ensures the best outcomes for your skin.

Take charge of your vulval health and stay well! With best wishes for your skin health and
well-being.