All about vulval skin conditions

The term “vulva” is used to refer to the external area of the female genitalia. It consists of the mons pubis, clitoral hood, labia majora, labia minora and perineum. While “vagina” is widely used colloquially to refer to the entire female sexual organ, it is actually the internal canal between the vulva and the uterus. Mr Sandeep Sharma, a Consultant Gynaecologist, explains what the common disorders of the vulva are, as well as required treatments.

What is the vulva?

The vulva is the name given to the skin of the external genital area in women. This includes the mons pubis, which is also the area where pubic hair is located. The other areas within the vulva are the clitoral hood, which is the small prepuce of skin covering the sensitive clitoris. The labia majora is the bulge on either side of the vaginal opening and is also hair-bearing. The thin ‘lips’ which are next to and cover the vagina are called labia minora, while the skin below the vagina going up to the opening of the back passage is the perineum.

What symptoms should I pay attention to?

If you are suffering from itching, soreness, pain or irritation which has been present for beyond a few days, you should see a doctor so that you can be examined to exclude skin conditions affecting the vulval skin.

What are common disorders of the vulva?

There are different skin conditions affecting the skin of the vulva. Some of these can be related to infections such as HPV, herpes or fungal infections like candida. However, these can often be benign long-lasting conditions called lichen sclerosis or lichen planus. It is essential for these to be diagnosed as these can be pre-cancerous. There are other pre-cancerous lesions called VIN (vulval intraepithelial neoplasia), which can only be diagnosed by a biopsy that can be taken under local anaesthetic in a clinic.

Who is at risk of vulval disease?

Vulval conditions can affect women of all age groups. However, vulvar cancer usually affects women who are more than 60 years of age. Vulvar cancer can often present itself many years earlier as pre-cancerous skin conditions, and therefore it is so important to take notice of these and see a doctor at the time so that they can be treated and monitored if necessary.

How does my specialist diagnose vulval disease?

This usually begins with a clinical examination. Some women will need a vulvoscopy performed with 5% acetic acid application. This may then be followed by a small biopsy of the vulval skin which can be taken in a clinic under a local anaesthetic.

How are different vulval diseases treated?

This depends on the cause of the condition. Some will require a small surgical procedure to remove the affected skin, for example, a wart-like lesion. Others require the application of skin creams or ointments that your doctor can prescribe. Certain vulval skin conditions require treatments that have to be carried out for a few years or even for life.

You can make an appointment with Mr Sandeep Sharma at one of his various clinics in Yorkshire here.