Women's Health Community

Wow, you've been through the wringer - so sorry about that! I had a hyst/ooph which is bad enough by itself! It seems like you could use vaginal estrogen since it doesn't have systemic effects. I know it's generally said that you can't use systemic estrogen if you've had breast cancer but doesn't that depend on the type of cancer (e.g., estrogen receptor positive versus other types)? Some women say that inserting a capsule of vitamin E helps keep the tissues lubricated.

Hope you get some relief soon!

Dear An: Gosh, I am assuming that you have vulvar eczema rather than eczema within the vagina--hope I am tracking you correctly. First I am going to answer for this scenario, OK?

I was unable to find a good review study on vulvar eczema at the National Library of Medicine site. The following link is a decent over view of treatment options in lay language:

http://www.livestrong.com/article/12969-treat-eczema-genital-region/

I believe that the ointment referred to in this link is an immune modulator. A newer class of medications are the topical immune modulators (e.g., tacrolimus or pimecrolimus). In an analysis of over 8,000 patients with eczema, topical pimecrolimus used twice a day was compared to topical tacrolimus and steroid creams. Moderate and potent strength steroid creams, along with tacrolimus, were found to be more effective than the pimecrolimus (Ashcroft, 2007).

Hopefully, if the condition is actually inside the vaginal canal, it has been conclusively diagnosed as eczema rather than severe vaginal atrophy (a low estrogen condition), or one of the other vaginal dermatology conditions such as lichen planus. If a woman is not a candidate for a prescription vaginal estrogen, she may turn to a vaginal moisturizer. Unlike a lubricant which is used just during sex, a moisturizer is used at any time with the effects lasting three days. A small amount of a bio-adhesive gel is squeezed out into the vagina with a narrow inserter. The moisturizer releases purified water to hydrate surrounding tissues creating a moist film (van der Loak, 2002). The gel is comprised of polycarbopil, a large molecule that is not absorbed. It clings to vaginal skin cells for three to five days until the skin cells are shed when newer cells mature (Milani, 2000). After three days the gel is shed along with the older skin cells.

It's not enough for these products to provide relief from vaginal dryness. They are also being touted as a way to correct vaginal pH. A healthy vaginal pH is relatively acidic (pH 3.8-4.5). An acidic pH discourages undesirable bacteria and encourages the growth of the beneficial, hydrogen peroxide producing lactobacilli.

Here's a recent citation on lichen planus from National Library of Medicine site:

Acta Obstet Gynecol Scand. 2010 Jul;89(7):966-70.
Vaginal involvement in genital erosive lichen planus.
Helgesen AL, Gjersvik P, Jebsen P, Kirschner R, Tanbo T.


The National Resource Centre for Women's Health, Oslo University Hospital, Norway. anneliseord@yahoo.no
Abstract

A specialized Vulva Clinic with dedicated gynecologists and dermatologists was established in Oslo, Norway, in 2003. Fifty-eight women referred to the clinic in 2003-2009 were diagnosed with genital erosive lichen planus. All patients filled out a questionnaire. Gynecological examination, including vaginal inspection, was performed, if necessary in general anesthesia. Median age at symptom start was 51 years (range 17-78 years) with 15 women (26%) being younger than 40 years old. Sexual abstinence was reported by 36 women and dyspareunia by another 10. On examination, vaginal involvement was seen in 49 women, including vaginal synechiae in 29 and total obliteration of the vagina in 9. Of 56 women treated with topical corticosteroids for at least three months, two had complete response and 36 partial responses. Similarly, of 22 women treated with tacrolimus, three had complete and six partial response. We conclude that vaginal involvement is more common in genital erosive lichen planus than previously reported.

Bottom line, go back to your GYN and/or consider a dermatology consult. You deserve to keep your genital health despite the enormous burden of your diagnoses.

In Respect and Sympathy,
Jane

I was diagnosed with spongiotic dermatitis. It's a form of acute eczema which I have various places on my body, including my labia. I didn't want to use steroids there because it thins the skin and I like to do things as naturally as I can. I tried Eucerin, Neopsporin Eczema cream, and more.

The thing I found that works the best is coconut oil. Usually I only have to use it twice a day (before bed and when I wake up). It has healing properties so it not only stops the itching, but helps the condition of the skin. I use it on all my eczema and any other dry skin area. I even use it on mosquito bites to stop the itch.