What is Vulvar Dystrophy?

Vulvar dystrophy is a change in the skin of the vulva, the outer part of a female’s genitals. The area becomes dry, with white or grey patches, and the skin of the vulva becomes either too thick or too thin. Symptoms include extreme burning and itching. This is a progressive condition which can lead to narrowing of the vaginal and rectal openings if left untreated.

The symptoms are similar to other feminine conditions, and is often initially mistreated as a yeast infection. This is not an infection, however, but a skin condition. There are actually four different types of dystrophy affecting the vulva, so it is very important that a correct diagnosis be obtained in order to prescribe the proper treatment. To do this, a doctor will generally perform a vulvar biopsy, which involves deadening the area and taking a small skin sample. A microscopic examination of the sample can help determine the exact type of condition.

Squamous cell hyperplasia, also known as hypertrophic vulvar dystrophy, is the most common form, accounting for between 40% and 45% of diagnosed cases. In this form, the skin becomes unusually thick with white or gray patches. Steroid creams have been proven an effective means of treatment for both the symptoms and the condition.

Lichen sclerosis, another form of vulvar dystrophy, results in a thinning of the skin. In addition to itching and burning, surface bleeding may also occur because the thin skin tears easily. Regular steroid creams can only provide short-term relief of this condition, and can actually exacerbate the problem by thinning the skin even more. Traditional treatment has been with a testosterone laced petroleum jelly. Clobetasol, a newer synthetic fluorinated corticosteroid cream, has also proven very successful in not only treating the symptoms, but in eliminating the condition altogether.

Lichen simplex chronicus involves thickened white patches on just one side of the vulva. The associated itching seems to increase in the evening, when the vulva is dry, or during times of excessive stress. This form responds well to steroid creams. In some cases, a sedative may also be prescribed to be taken at night.

A fourth form of vulvar dystrophy, lichen planus, is a chronic inflammatory skin disease which can cause red areas or sores. This is more pervasive, and can involve not only the vulva, but the vagina as well. If untreated, the walls of the vagina can swell and actually close over time. If the area does not respond to creams, injections of alcohol may be required. At times, a woman may actually be diagnosed with mixed dystrophics, a combination of squamous hyperplasia and lichen forms of vulvar dystrophy.

If a woman is experiencing symptoms of extreme itching and burning, surface bleeding, or unexplained soreness, it is important to seek medical attention. If vulvar dystrophy is suspected, a vulvar biopsy should be conducted to aid in selecting the proper treatment. This is a relatively painless procedure which can be conducted in a medical office.

The causes of vuvlar dystrophy are unknown, though it is occasionally linked to infections, irritants or human papilloma virus (HPV). Once the condition appears, it seems to worsen with irritants. To aid in healing, women should follow the medication instructions and wear loose-fitting, cotton underwear. They should also avoid bath oils, perfumed soaps, tampons, spermicidal creams, feminine hygiene products, and scented laundry detergents.