‘Psoriasis’ in Greek means ‘itching condition’. It is a chronic skin disease which occurs when the immune system overreacts leading to an overproduction of new skin cells. The diagnosis is difficult and the treatment is long-term as there is relapse. ‘Vulvar psoriasis’ as the name suggests affects the vulva or female genitals. It can occur in adults as well as children.
It presents as pink shiny patches of skin with defined edges but without the usual scales. The absence of scales is due to the friction between two skin surfaces of the groin which rubs them off, as well as the moist environment. It affects the outer skin of the genitals and can extend up to the buttocks and thighs. It is very itchy and sore and if the skin cracks open due to scratching, could lead to an infection. Vulvar psoriasis is not contagious.
- Onset of small areas of redness which are scaly in appearance.
- Worsening of a long-term rash.
- Severe itching, stinging, swelling and pain of the affected area.
- Persistent rash which improves with cortisone creams and returns once their application is stopped.
- Pitting or denting of nails.
- Scaling of the scalp.
- Family history of psoriasis.
- Severe conditions may be due to inflammatory bowel disease and arthritis.
- Being overweight as the skin folds will be deeper, leading to sweating and friction.
- Certain medications used in the treatment of depression, malaria, high blood pressure, heart conditions and arthritis.
- Tight clothing which causes friction.
- Deodorants and antiperspirants.
- Contraceptives such as spermicides, sheaths and caps.
- Sanitary towels.
- Toilet paper.
How to Treat Vulvar Psoriasis
Vulvar psoriasis cannot be treated in any single way as it is a genetic condition. Since it is a recurring condition which will be experienced on and off throughout life, its symptoms can only be managed.
Topical steroids in the form of creams and ointments containing hydrocortisone and triamcinolone 0.1% usually take care of mild cases and also the associated itching. However, there is the tendency of the creams becoming ineffective with time. Unperfumed moisturizers, mineral oils and nappy rash creams also help. In more serious cases, stronger steroids such as clobetasol and halobetasol 0.05% may be prescribed for a short period. Coal tar creams, tar shampoos and salicylic acid are also used in treatment. Zinc and castor oil also give relief.
Supplements of Vitamin D analog or Vitamin D3 which is considered to be more potent than Vitamin D2 are also prescribed.
Phototherapy also known as light therapy and heliotherapy is also used to treat the condition. It uses daylight and other sources of light for a prescribed amount of time.
Vulvar Psoriasis Home remedies
There are many home remedies which take care of the problem effectively.
- A vegetarian diet is recommended to improve symptoms.
- Intake of cod liver oil supplements is beneficial due to the high content of omega-3 fatty acids.
- Diet rich in fruits and vegetables.
- Caffeine and alcohol should be avoided as they cause dehydration.
- Soap-free cleansers. These should be 100% soap and perfume -free and can be bought from a chemist. Bubble baths and use of essential oils should also be avoided.
- Rubbing and scratching should be avoided while cleansing the area.
- Wearing only cotton underwear which is not too tight.
- Use of moisturizers which do not contain perfume such as petroleum jelly or glycerine.
- Tampons should be used instead of sanitary pads if possible.
- Staying away from the use of toilet paper with perfume or colour.
- Wearing of pantyhose, G-strings and tight trousers should be avoided.
- Panty liners, talcum powder and perfumes should not be used.
- Losing weight if obese.
- Since the condition is aggravated by stress, it should be managed by taking up activities which help one to relax.